Steroid Injection Therapy

Steroid injection therapy has been widely practised in treating musculoskeletal conditions (joints and soft tissues). Steroid injection using a drug called corticosteroids usually known as 'cortisone' helps;

• To reduce the pain and
• To reduce the inflammation.

The steroids used for injection therapy are anti-inflammatory drugs. Steroid injection therapy helps you to achieve a faster pain relief which allows you to return to normal activities quicker. You could have an injection therapy if you suffer with pain from the following conditions;

• Osteoarthritis of joints - Knee, shoulder, base of thumb, base of big toe, wrist and ankle.
• Rheumatoid arthritis
• Shoulder/ rotator cuff impingement
• Frozen shoulder
• Biceps tendinitis (tendinopathy)
• Tennis elbow / Golfer's elbow
• Trigger finger(s)
• de Quervain's tenosynovitis (Wrist tendinitis)
• Plantarfasciitis
• Trochanteric Bursitis
• Prepatellar (knee) bursitis (Housemaid's knee)
• Elbow bursitis (Student's elbow)

At Relive Physiotherapy, we have over 10 years of injection therapy experience. Our expert chartered physiotherapist Raj Gandhi (Thiyagaraj Gandhi) has undertaken relevant extensive trainings approved by the governing bodies (such as HCPC, CSP) to practice injection therapy. Raj is our qualified Independent Prescriber.

During your physiotherapy appointment, please ask our staff if steroid injection therapy is an option for your treatment care. Our physiotherapists suggest you all the treatment options including steroid injection therapy keeping your full recovery in mind. Our physiotherapists will assist you reaching a decision by answering all your questions that you may have.

Before the procedure, you will have a clinical discussion with Raj about the benefits and possible complications of the injection therapy. Please wear comfortable clothes for an easy access to the site of injection. Raj will then ask you to sign the informed consent form before performing the injection(s).

Following the procedure, you will be given an after care. You will be advised to wait for 15 – 20 minutes after the injection so we ensure that you are safe to be discharged. You will receive a report regarding the consultation and the injection therapy and your GP will be copied.

Useful information before having a steroid injection

1. The effect of injection therapy varies from individual to individual. But the steroid usually continues working for around 4 - 6 months.
2. You should not have a steroid injection if you suffer with an infection or suspect one. Usually one injection is sufficient. However, if the pain level is severe and has been a longstanding pain you may require more.
3. National Institute for Clinical Excellence (NICE) recommend that no joint should be injected more than three times a year.
4. Inform our physiotherapists if you;

• Suffer from allergies due to drugs, food, etc.
• Take prescribed drugs such as anticoagulants (blood thinning tablets).
• Suffer with diabetes, any heart conditions and epilepsy.
• Had recent surgery or about to have surgery in the affected area.
• Are pregnant and/ or breast feeding.

Possible side effects

Side effects are kept to minimum by the best aseptic techniques, examination and keeping drug dose to recommended levels.

• The injected area may feel sore for about 48 hours after the injection.
• Facial flushing may last up to 48 hours after the injection.
• Diabetes suffers may find their blood sugar level alters for a few weeks.
• Change is menstrual cycle.
• There is a small risk of skin dimple due to steroid induced fat tissue loss.
• Minor bruising at the site of injection.
• Very rarely a rupture may occur in the tendon. Hence, if you are having a soft tissue injection it is important to follow the aftercare advice.
• Very rarely there is a small risk of infection [approximately 1 in 10,000 procedures] following injection.

If you experience symptoms such as unexpected pain, warmth or redness around the injected area or unexpected flu like symptoms, you must consult your GP or attend Accident & Emergency (A&E). Explain the medical staff you have recently had an injection, as a possible infection could potentially be serious.

If you are interested in the steroid injection, please let your physiotherapist know and they will go through in detail if this is the best course of treatment for you - keeping your full recovery in mind.