Musculoskeletal corticosteroid injection

Steroid injections are given for many conditions. They can decrease inflammation and help with pain. Your therapist / doctor feels that a steroid injection may help as part of your treatment.

This leaflet explains:

• what are corticosteroid injection is

• what the benefits and alternatives are

• the risks and benefits of having a corticosteroid injection, and

• what you can expect when you come to the hospital.

If you have any questions or concerns, please speak to the doctor, nurse, or therapist caring for you.

This leaflet does not list all the uses and side effects of the medicines we use. For further information, please read the manufacturer’s leaflet that comes with the medicine.

What is a corticosteroid injection?

A steroid injection is a small amount of anti-inflammatory medication. It is injected into a specific area of your body to treat a condition.

Your therapist / doctor may give you a local anaesthetic at the same time. This will help reduce the immediate pain you have following your injection.

What are the benefits? Why should I have a corticosteroid injection?

The injection can help to relieve swelling, pain, and stiffness caused by inflammation. This may allow you to start your rehabilitation and return to normal activities sooner.

A steroid injection can also be helpful in diagnosing your condition. Especially if it is not clear which structures are causing your pain.

Are there alternatives?

There are other treatments for these types of inflammatory or arthritic conditions, including:

• medication (anti-inflammatory tablets), and

• physiotherapy.

Your therapist / doctor can advise on whether any of these are likely to be helpful for you.

There is also the option of doing nothing. However, your symptoms may continue if you do this.

Are there any reasons not to have the injection?

Yes.

• If you have an infection on your skin or anywhere else in your body.

• If you are allergic to steroids or local anaesthetic.

• If you feel unwell.

• If you are due to have surgery in that area soon.

• If you have poorly controlled diabetes.

• If you do not want the injection.

• If you are under 18.

What are the possible side effects?

• Flushing of your face for a few hours or days after having your injection.

• You may have a small area of fat loss or skin colour change. This can be seen for about two to three years after your injection.

• An increase in pain 24 to 48 hours after your injection.

• Slight vaginal bleeding or changes to your monthly period.

• If you are taking blood thinning drugs you may have some temporary bleeding or bruising. We will carry out injections if you are taking warfarin, provided:

  • your blood test for the warfarin does not suggest that you are taking too much, and

  • that you are not bleeding from somewhere.

  We need a recent INR result to complete your injection. We will proceed with the injection if your INR is below 2.5.

• If the area becomes hot, swollen, and painful, you may have developed an infection. For advice, please:

  • contact your GP, or

  • go to your local Emergency Department or Urgent Treatment Centre.

• We will ask you to wait in the department for a short time after your injection. This is to check that you have not had an allergic reaction to the drug.

• For diabetic patients. Your blood sugar may run a bit higher or be more erratic for a few days after a single steroid injection. Take care with monitoring this. This effect does not stop you being able to have an injection.

What happens before my injection?

Before your injection, your therapist / doctor will explain the procedure's benefits and risks. There will be time to ask any questions before you give your consent.

Why do I need to sign a consent form?

All patients must give permission before they receive any type of medical treatment, test, or examination. You will be asked to give your consent verbally.

• You must give your consent voluntarily.

• The hospital must give you all the information you need to make a decision about your treatment. This is so you can give us informed consent.  If you have not been given this information, or you have but you still have questions, please speak to a member of staff. 

• You must be capable of giving consent. This means that you understand the information given to you and can make an informed decision.

When we ask you to give consent, please use this time to ask any questions you may still have. For more information, please go to the NHS Consent for Treatment web page. Remember, you can withdraw your consent for treatment at any time.

Is there anything I can do to prepare for my surgery?

Yes. Compared to non-smokers, smokers are more likely to have complications in tissue healing and infections after injuries or surgery. If you smoke, free friendly support and medication to help you stop smoking is available. For more information, please contact One You Kent Smokefree on telephone 03001 231 220, or email or visit their web site.

What happens during my injection?

• You will be placed in a comfortable position and the area cleaned.

• Your therapist / doctor will place a needle into the affected part of your body. They will then inject the solution through the needle.

Will I feel any pain?

The injection can be uncomfortable during the procedure. Some of medicines can sting as they are injected.

Your therapist / doctor may give you a local anaesthetic at the same time, which will numb the area. The area may be numb for a few hours following your injection. Feeling will slowly return to normal.

How long will it take for me to feel the effects of the injection?

If you had a local anaesthetic, your pain may start to improve within a few minutes. However, the pain may return as the local anaesthetic wears off.

The steroid usually starts to work after 24 to 48 hours, but it may take two to three weeks. The effects vary from person to person.

How long will I be in hospital for?

You will have your injection during your outpatient clinic appointment. Your therapist / doctor will discuss the procedure with you first. You can use this time to ask any questions. The injection should not take more than a few minutes.

After the injection you can go home.

Can I drive home?

Most people feel able to drive after their injection. However, if you feel pain after your injection then you may find driving difficult. So if possible, you should arrange for someone to drive you home following your procedure.

What do I need to do after I go home?

Depending on the cause of your pain, your therapist / doctor may ask you to rest the area for a short time after your injection. This does not usually mean total rest, but do not do any activity that makes your pain worse. After this time, you should try to slowly return to doing your normal activities.

If you are having any other medical treatment within six weeks of your injection, you must tell the treating clinician that you have had a corticosteroid injection.

Will I have a follow-up appointment?

Your therapist / doctor may ask you to return for a follow-up appointment. This will be to check your progress. You may need more than one injection, and we will discuss this at your follow-up appointment.

What if I have any questions or concerns?

Please contact the secretary of the person you saw in the Fracture Clinic. Their contact information will be on your appointment letter.