Steroid injection therapy

Dealing with persistent pain and inflammation can significantly impact your quality of life. If you’re searching for effective relief, steroid injection therapy might be a treatment option worth exploring. This approach is commonly used to manage a variety of conditions, from arthritis to tendinitis, helping individuals regain comfort and mobility. Let’s delve into what steroid injection therapy involves, the conditions it can treat, and what you can expect from the procedure.

What is Steroid Injection Therapy?

Steroid injection therapy involves administering corticosteroids—powerful anti-inflammatory medications—directly into a painful or inflamed area of the body. These are not the anabolic steroids sometimes misused by athletes; rather, they are synthetic drugs that closely resemble cortisol, a hormone naturally produced by your body’s adrenal glands.

The primary goal of steroid injections is to reduce inflammation and, consequently, alleviate pain. When injected into a joint or soft tissue, steroids decrease redness, swelling, and irritation in the targeted area. This can lead to significant pain relief and improved function, allowing individuals to move more easily and participate more fully in daily activities. These injections can be particularly helpful in treating conditions like arthritis, tendinitis, or bursitis.

Commonly used corticosteroids include:

  • Hydrocortisone
  • Triamcinolone
  • Methylprednisolone

Often, a local anaesthetic is combined with the steroid in the injection. This provides immediate, short-term pain relief while the steroid begins to take effect, which can take a few days to a week.

Conditions Treated with Steroid Injection Therapy

Steroid injections are versatile and can be used to manage a wide array of musculoskeletal conditions. Their ability to target inflammation makes them effective for both joint-related issues and problems affecting soft tissues.

Some of the most common conditions treated include:

  • Inflammatory Arthritis: Conditions like rheumatoid arthritis often involve significant joint inflammation. Steroid injections for rheumatoid arthritis can help calm flare-ups and reduce pain and stiffness in affected joints.
  • Osteoarthritis: While primarily a “wear and tear” condition, osteoarthritis can also involve inflammatory episodes. Steroid injections for osteoarthritis can provide temporary relief from pain and swelling, especially in joints like the knee or hip.
  • Joint Pain: General joint pain in areas such as the shoulder, elbow, wrist, knee, or ankle can be targeted with steroid injections. This includes conditions like:
    • Shoulder pain (e.g., rotator cuff issues, frozen shoulder)
    • Elbow pain (e.g., tennis elbow, golfer’s elbow)
    • Hip pain (e.g., trochanteric bursitis)
    • Knee pain
  • Tendonitis: Inflammation of a tendon, such as Achilles tendonitis or patellar tendonitis, can benefit from the anti-inflammatory effects of steroid injections.
  • Bursitis: Inflammation of a bursa (a small, fluid-filled sac that cushions bones and tendons near joints) is a common target for steroid injection therapy.
  • Soft Tissue Conditions: Injections can be administered into inflamed soft tissue areas, such as around tendons (peri-articular injections) or directly into a bursa.
  • Sciatica: In some cases, epidural steroid injections are used to reduce inflammation around nerve roots in the spine, helping to alleviate the leg pain associated with sciatica.
  • Carpal Tunnel Syndrome: Steroid injections can help reduce swelling around the median nerve in the wrist.

The effectiveness of steroid injection therapy can vary depending on the individual and the condition being treated. For many, it offers significant pain management and an improved ability to engage in physical therapy and daily activities.

The Procedure: What to Expect

Undergoing steroid injection therapy is generally a straightforward outpatient procedure. Here’s a general idea of what you might expect:

  1. Consultation: Before the injection, you’ll have a consultation with your doctor or a health professional. They will discuss your symptoms, medical history, and whether a steroid injection is the right treatment for you. This is the time to ask any questions you may have.
  2. Preparation: The skin over the injection site will be cleaned thoroughly, often with an antiseptic solution, to minimize the risk of infection.
  3. Local Anaesthetic: As mentioned, a local anaesthetic (like lidocaine) is often mixed with the steroid or injected separately just before the steroid. This helps to numb the area and reduce discomfort during the injection. You might feel a brief stinging or burning sensation as the anaesthetic is administered.
  4. The Injection: The doctor will then carefully insert a needle into the targeted joint or soft tissue area and inject the corticosteroid medication. For some injections, especially those in deeper joints or near sensitive structures like the spine, imaging guidance (such as ultrasound or X-ray/fluoroscopy) may be used to ensure precise placement of the needle.
  5. After the Injection: Once the needle is removed, a small bandage may be applied to the injection site.

How Steroid Injections Work:

  • Reduce Inflammation: Corticosteroids work by decreasing the production of inflammatory chemicals in the body. This reduction in inflammation is the primary mechanism for pain relief.
  • Pain Relief: By calming the inflammation, the pressure on nerves is reduced, and pain signals are lessened. The pain relief can last from a few weeks to several months, or even longer in some cases.

It’s common to be advised to rest the treated area for a day or two after the injection and to avoid strenuous activity. You might notice a temporary increase in pain or swelling at the injection site, sometimes called a “steroid flare,” before the medication starts to work. This usually subsides within a couple of days.

Benefits and Risks of Steroid Injection Therapy

Like any medical treatment, steroid injections offer potential benefits but also come with potential risks and side effects.

Benefits:

  • Targeted Pain Relief: Injections deliver medication directly to the source of pain and inflammation, often providing more effective relief than oral medications for localized problems.
  • Reduced Inflammation: This is the core benefit, leading to decreased swelling, stiffness, and pain.
  • Improved Function: By reducing pain and inflammation, steroid injections can help improve range of motion and overall function of the affected joint or area.
  • Minimally Invasive: Compared to surgical options, injections are a less invasive way to manage pain.
  • Diagnostic Tool: In some cases, if an injection provides significant pain relief, it can help confirm the source of the pain.
  • May Delay or Avoid Surgery: For some individuals, successful steroid injection therapy can postpone or even eliminate the need for more invasive surgical procedures.

Risks and Potential Side Effects:
While generally safe, especially when administered by an experienced health professional, there are potential downsides:

  • Pain at Injection Site: Temporary soreness, bruising, or a “steroid flare” (a brief increase in pain and inflammation) can occur for a day or two.
  • Infection: Though rare (especially when sterile techniques are used), there’s a small risk of infection at the injection site. Seek medical attention if you notice increasing redness, swelling, warmth, or fever.
  • Tendon Weakening or Rupture: Repeated injections into or around a tendon can potentially weaken it over time, increasing the risk of rupture. This is why doctors usually limit the number of injections into the same area.
  • Skin Changes: Thinning or lightening of the skin color around the injection site can occur.
  • Elevated Blood Sugar: Steroids can temporarily raise blood sugar levels. Patients with diabetes need to monitor their blood sugar closely after an injection and discuss this with their doctor beforehand.
  • Allergic Reaction: Though uncommon, allergic reactions to the steroid or anaesthetic are possible.
  • Facial Flushing: Some people experience temporary redness and warmth in the face.
  • Cartilage Damage: There’s some concern that very frequent, high-dose injections into a joint might accelerate cartilage damage over the long term.
  • Systemic Effects: While most of the steroid stays localized, some can be absorbed into the bloodstream, potentially causing systemic side effects if injections are frequent or high-dose. These are rare with occasional joint injections.

Aftercare:

  • Rest the injected area for 24-48 hours.
  • Apply ice to the area if you experience soreness.
  • Monitor for signs of infection.
  • Follow any specific instructions given by your doctor.

It’s crucial to discuss your medical history and any concerns with your doctor to determine if the benefits of steroid injection therapy outweigh the potential risks of steroid injections in your specific situation.

Important Considerations

Before proceeding with steroid injection therapy, there are several important factors to consider and discuss with your healthcare provider:

  • Who Should Not Have Steroid Injections (Contraindications):
    • Individuals with an active infection in the area to be injected or a systemic infection.
    • Those with known allergies to corticosteroids or local anaesthetics.
    • Patients with bleeding disorders or those taking high doses of blood-thinning medication may need special precautions.
    • Uncontrolled diabetes (as steroids can raise blood sugar).
    • Certain other medical conditions might make steroid injections less suitable.
  • Frequency of Injections: There’s a limit to how often you can receive steroid injections in the same area. Typically, doctors recommend waiting at least 3-4 months between injections into the same joint, and often limit the total number to 2-3 per year for a specific site to minimize risks like tendon damage or cartilage thinning.
  • Interactions with Other Medications: Inform your doctor about all medications you are currently taking, including over-the-counter drugs and supplements, as steroids can interact with some medications (e.g., blood thinners, diabetes medications).
  • Vaccinations: If you’re scheduled for vaccinations, discuss the timing with your doctor, as steroid injections might affect your body’s response to some vaccines.
  • Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the use of steroid injections with your doctor, as specific precautions may be necessary.
  • Alternatives to Steroid Injections: It’s important to be aware of other treatment options. These may include:
    • Oral anti-inflammatory medications (NSAIDs)
    • Physical therapy and targeted exercises
    • Activity modification and rest
    • Bracing or splinting
    • Other types of injections (e.g., hyaluronic acid for knee osteoarthritis)
    • Weight management
    • In some cases, surgery may be an alternative if conservative treatments fail.

Your doctor will help you weigh the pros and cons and decide on the most appropriate treatment plan for your specific condition and needs. Open communication is key to making an informed decision about steroid injection therapy.

Conclusion: Key Takeaways and Next Steps

Steroid injection therapy can be a valuable tool for managing pain and inflammation associated with a variety of musculoskeletal conditions, including arthritis, tendinitis, and bursitis. By delivering potent anti-inflammatory medication directly to the affected area, these injections can provide significant pain relief, improve joint function, and enhance overall quality of life for many individuals.

Key Takeaways:

  • Steroid injections target localized inflammation to reduce pain and improve mobility.
  • They are used for a range of conditions, from rheumatoid arthritis and osteoarthritis to soft tissue problems like bursitis.
  • The procedure is generally quick, often performed with a local anaesthetic, and may involve image guidance for precision.
  • Benefits include targeted relief and potentially delaying or avoiding surgery.
  • Risks include temporary pain, infection (rare), skin changes, and potential effects on blood sugar. Discuss these thoroughly with your doctor.
  • Aftercare typically involves resting the area and monitoring for any adverse reactions.
  • There are limitations on the frequency of injections and certain contraindications.

If you are experiencing persistent joint or soft tissue pain, and other conservative treatments haven’t provided adequate relief, steroid injection therapy might be an option to discuss with a specialist.

Ready to explore your options for pain relief?
To discuss whether steroid injection therapy is right for you, consider booking an appointment.
You can book online via this link: https://www.circlehealthgroup.co.uk/consultants/david-shields
Or, you can contact us by email for an appointment: info@theupperlimbclinic.co.uk

Take the first step towards managing your pain and improving your well-being.