If you’re experiencing pain or inflammation from a musculoskeletal condition, then you might have been recommended a steroid injection. Is a steroid injection the right treatment for you?
These injections are normally recommended to anyone looking for short or medium-term pain relief from conditions such as trigger finger, ankle osteoarthritis, knee osteoarthritis, carpal tunnel syndrome, De Quervain’s tenosynovitis, and a lot more.
In this post, we’ll showcase whether it’s the right procedure for you so you’re able to make the best choice for your future self.
What Are Corticosteroids?
Corticosteroids (also called steroid injections) are synthetic versions of the hormone cortisol, a hormone that’s produced naturally by the adrenal glands.
They mimic the effects of cortisol and can treat anti-inflammatory issues, help manage autoimmune conditions and suppress the immune system after organ transplants.
How Do Corticosteroids Work?
Corticosteroids have two main actions: reduce inflammation and suppress the immune system.
Reducing Inflammation
For inflammation, corticosteroids enter the cells and bind to specific receptors on the nucleus's surface. This adaptation reduces the production of inflammatory cells, such as cytokines, which are signalling proteins that control inflammation.
They can also stabilise the cell membrane. It does this by decreasing its permeability and limiting the release of inflammatory chemicals, such as histamine, bradykinin, and prostaglandins.
Alongside this, they can reduce the permeability of blood vessels. This limits fluid leakage into the surrounding tissues, therefore reducing swelling.
Suppress the Immune System
To suppress the immune system, corticosteroids reduce the activity of immune cells—for example, lymphocytes and macrophages, which are two cells involved in the inflammatory process.
Because of this, using corticosteroids for autoimmune conditions such as rheumatoid arthritis, multiple sclerosis, and lupus can be effective. They can also be used to suppress the immune system after organ transplants, helping reduce organ rejection.
How is a Corticosteroid Injection Given?
A corticosteroid injection can be given in multiple ways. It can be given via tablets (oral) or as an injection in a joint (intra articular), muscle (intra muscular), or into the blood (intra venous).
The effects can start within a few hours; however, sometimes, it can take a few days. It’ll usually last for a few weeks or months.
Perhaps you’re getting a corticosteroid injection for pain relief. In that case, the injection may contain local anaesthetic. Adding this ensures immediate pain relief for a few hours.
What Conditions Can Corticosteroid Injections Treat?
These injections are used to treat pain and inflammation. As a result, they can help treat various conditions such as:
Nerve Inflammation (e.g., carpal tunnel syndrome)
Tenosynovitis (e.g., De Quervain Tenosynovitis in the thumb)
Who Can Have a Corticosteroid Injection?
When it comes to corticosteroids, they’re safe for most people. You should always inform your doctor, however, if you:
Have an infection.
Have had an allergic reaction to steroids.
Are trying to have a baby, pregnant, or breastfeeding.
Have had 4 or more steroid injections in the last year.
Have recently or are about to get a vaccination of any sort.
Have had any type of steroid injection in the last 3 months.
Are taking other medication, such as blood thinning medication (anticoagulants).
Have any of the following conditions: high blood pressure, diabetes, epilepsy, or issues with your liver, heart, or kidney.
When Should You Consider Getting a Corticosteroid Injection?
If conservative treatments haven’t relieved your pain, it’s worth considering a corticosteroid injection.
Here are some situations when you may want to think about getting a corticosteroid shot:
Pain is making an impact on your mental health.
Pain hasn’t improved with physiotherapy or any type of rehabilitation.
Pain that’s disrupting your sleep or daily activities, such as work, self-care, etc.
Pain is limiting your ability to engage in hobbies and sports you once could enjoy.
Benefits of Corticosteroid Injections
There are many benefits when it comes to corticosteroid injections. The main ones include the following:
Reduction of Inflammation, Swelling, and Pain
Corticosteroids work by targeting the inflammatory response from the body. Therefore, it reduces the production of chemicals that cause inflammation.
As a result of this, inflammation, swelling, and pain are reduced. This reduction offers a “window of relief”, allowing you to participate in other treatments to address the root problem, such as physical therapy.
Diagnostic Tool for Identifying Pain Source
Alongside the above, they can also act as a diagnostic tool. Simply put, if the injection provides pain relief, it confirms that the injected area is the root problem of the pain.
If the root problem is found, healthcare professionals can then make tailored recovery plans. This ensures that you get the right advice to future-proof the issue.
Minimally-Invasive and Convenient
Compared to surgeries or other medical interventions, corticosteroid injections are minimally invasive, quick, and don’t require an extended recovery time.
These types of injections can also be performed in outpatient settings. Therefore, you’re able to get relief from pain without the need for downtime or hospitalisation.
Risks of Corticosteroid Injections
Though corticosteroid injection offers superb benefits, there are some risks. Typically, these risks only occur with large or frequent doses.
Some side effects can be:
Joint infection
Nerve damage
Cartilage damage
Death of nearby bone
Short-term facial flushing
Tendon weakening or rupture
Short-term increase in blood sugar
Whitening of the skin around the injected area
Thinning of skin and soft tissue around the injected area
Short-term flare of pain, irritation, or swelling on the joint. This is not uncommon and referred to as a steroid flare. This usually settles down within a few days after the injection.
Thinning of a nearby bone (otherwise known as Osteoporosis)
The Process of a Corticosteroid Injection
Preparation
If you take medication for blood thinners, you need to tell the doctor. In most cases, it is safe to have a steroid injection without the need to interrupt the blood thinning treatment.
If your temperature was 38 C or greater in the last two weeks, or you had symptoms of chest infection or local skin infection at the site where the injection is intended, you should tell the healthcare professional.
If you’re ever unsure, talk to the professional performing the procedure.
During the Injection
You may or may not be asked to change into a gown. It depends on the area of injection. You’ll then be positioned so the needle for the injection can easily access the joint.
Before insertion, the area will be cleaned to eliminate the chances of infection. The professional may provide a numbing injection to reduce the pain.
Usually, the healthcare professional will use a type of X-ray called fluoroscopy or an ultrasound. This is used to get an accurate picture of where the needle is inside the body.
When insertion happens, you may feel a bit of pressure. Once inserted, the steroid is then released into the injected area.
After the Injection
Some may see redness on their skin or feel warm in some areas of their body. If you’re diabetic, you may even have an increase in blood sugar levels.
You may even be asked to:
Protect the injected areas for 24 to 48 hours
Use ice on the area of injection to relieve pain
Not use a hot tub, bathtub, or whirlpool for a few days
Watch for any signs of infection (redness, swelling, increase in pain, etc.)
Results
You may experience pain relief within a few hours; sometimes, it takes a few days. Once you start to feel the pain relief, the relief can last from a few weeks all the way to a few months.
Treatments to Try Before a Corticosteroid Injection
If you’re on the edge about trying corticosteroid injections, there are other treatments you can try beforehand.
These include some of the following:
Treatment | Reason to Try Before |
Physiotherapy Assessment | Can help identify if less invasive therapies can resolve the issue. |
Can help get a clear image of what’s wrong, helping guide treatment decisions without the need for injections. | |
Rehabilitation Exercise Program | Can often resolve pain and restore function through tailored strengthening and stretching exercise programs. |
Rest and Pain Relief Measures | Can reduce pain and inflammation via pain-relieving methods such as ice, heat, or oral/topical painkillers without needing injections. |
This is another type of injection therapy where platelets rich with growth factors are extracted from your blood sample and injected into the inflamed area. | |
Hyaluronic acid is a naturally occuring substance within our body. Intra articular Hyalouronic acid injections have proven good results in the management of mild and moderate arthritis. |
Is a steroid Injection the Right Procedure for me?
Corticosteroid injection is recommended for a range of people. We recommend this procedure for anyone who:
Is experiencing unresolved pain
Has ongoing inflammatory conditions
Cannot pinpoint the exact source of pain or inflammatory
Are looking for a minimally invasive pain and inflammatory solution
At Musculoskeletal Ultrasound & Injections Clinic we specialise in ultrasound-guided diagnostic and therapeutic procedures that help treat various musculoskeletal problems affecting tendons, joints, ligaments, and muscles.
To learn more about the pain you’re experiencing and how we can resolve it with a corticosteroid injection, contact us today. A healthcare professional will be happy to answer any of your questions.
