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Corticosteroid Injections

The aim of this information sheet is to help answer some of the questions you may have about having a corticosteroid injection. It explains the benefits, risks and alternatives of the procedure as well as what you can expect when you come to hospital. If you have any questions or concerns, please speak to Mr Limaye or the Consultant Radiologist when he is doing the injection for you. This sheet does not list all of the uses and side effects of the medicines we use – please see the manufacturer’s patient information leaflet online for further information. Sometimes your insurance company asks the specific name of the medication and procedure code. Mr Limaye mostly uses 40mg Depomedrone with some long acting chirocaine anaesthesia.

What is a corticosteroid injection?

A corticosteroid (or ‘cortisone’) is an anti-inflammatory medicine, which can be injected directly into the tissues or joints that are causing your symptoms. It is a safer alternative to taking anti-inflammatory medication by mouth. It acts directly in the area injected and is not the same as the steroids taken by bodybuilders or athletes.

What are the benefits?

The injection can help to relieve swelling, pain and stiffness caused by inflammation. This may in turn help you to start your rehabilitation and return to normal activities sooner by ‘breaking the cycle’ of pain and inflammation. It can also be helpful to aid in the diagnosis of your condition if it is not clear which structures are responsible for your pain. You may also have a local anesthetic injected at the same time, which allows for temporary pain relief.

What are the risks?

The possible side effects of the injection are rare and include:

  • Small area of fat loss or change in skin colour (hypopigmentation)around the injection site.
  • A temporary increase in pain 24 to 48 hours after the injection. If you experience increased pain for a longer period of time, then please contact us for advice.
  • Patients with diabetes may notice a temporary increase in blood sugar levels. If you have diabetes, you are advised to check your blood sugar levels for three days post- injection.
  • Flushing of the face for a few hours.
  • Temporary bruising or bleeding in the injected area, especially if you are taking antiplatelet medicines (such as aspirin) or anticoagulant medicines (such as warfarin). Please advise Mr Limaye or the Radiologist if you are taking any blood thinning medicines.
  • Infection: If the area becomes hot, swollen and painful for more than 24 hours, or if you feel generally unwell, you should contact your physiotherapist or doctor immediately. If they are unavailable, you should seek advice from your GP or Emergency Department (A&E).
  • Slight vaginal bleeding/menstrual irregularities.
  • Allergic reaction to the drug: This will usually happen immediately so you will be asked to wait for a short time after your injection to check for any reactions. If you have any signs of an allergic reaction after you have left the hospital, then please seek medical advice.

You should not have the injection carried out if you:

  • Have infection in the area to be injected or anywhere else in your body
  • History of allergy towards steroids
  • Not feeling well due to various reasons
  • Are due to have surgery in that area soon
  • Are pregnant or breastfeeding
  • Have poorly controlled diabetes
  • Do not want the injection
  • If you are high risk for corona virus infection.

Are there any other alternatives?

Alternatives to the injection include lifestyle changes, use of anti-inflammatory medicines and physiotherapy. Occasionally, a surgical opinion may be helpful. If you would like further information about these other options, then please let us know.

On the day of injection:

What happens during the injection?

The benefits and risks of the injection will be explained to you. You will then be placed in a comfortable position. The skin is cleaned with antiseptic. A needle is gently positioned into the affected area and the solution is injected through the needle. A small plaster will be placed over the site to keep it clean and you can remove it the next day. A few moments after the injection you will be examined again.

Will I feel any pain?

The injection is not particularly painful as Mr Limaye or the radiologist is thoroughly trained in this procedure. Sometimes it can be sore 8 to 12 hours after the procedure. The local anesthesia wears off then and there can be a rebound increase in the pain for a day or so. It is safe for you to continue to take prescribed analgesia during this period. The steroid usually starts to work after 48 hours, but if your problem has been there for a while it may take as long as 6 weeks to feel the full benefit. The effect of the injection varies from person to person and usually continues to last for about six to sixteen weeks.

After the injection:

What do I need to do after I go home?

You can go home after a short period of rest. You can gradually refrain normal activates when the pain settles down. If you are having other medical treatment within six weeks, you should tell the treating clinician that you have received a corticosteroid injection.

Will I have a follow-up appointment?

You may be asked to attend a follow-up appointment 6 weeks to 3 months weeks after your injection to check your progress. We intentionally leave it this long as it can take time to really appreciate if the injection has worked or not. Occasionally, more than one injection is needed, and this can be discussed at this appointment.