Overview

Steroids are medicines that reduce swelling (inflammation). The steroids we use are called corticosteroids or cortisone.

Corticosteroids are not the same as the steroids that build up muscle or improve athletic performance.

Injecting steroids is safer than taking them by mouth. This means the steroids go directly to the area we inject and nowhere else.

Depending on your condition, we might recommend that you have a local anaesthetic with your steroid injection. This numbs the area and makes you feel less pain for a few hours.

Benefits of steroid injections

Steroid injections help to reduce swelling, pain and stiffness caused by inflammation.

The effects of steroid injections are not permanent. They usually last for about 6 weeks. Everyone responds to steroid injections differently. For some people, the effects can last longer.

This temporary pain relief can help you get back to your normal activities faster. This leads to more long-term improvements.

It can also help us find out what’s causing your pain so we can diagnose your condition.

Risks of steroid injections

Like all procedures, steroid injections have some risks and side effects.

1 in 10 people feel more pain immediately after having a steroid injection. It usually lasts for up to 2 days, then gets better on its own.

The steroid injection might also increase your blood sugar levels. 1 in 100 people with diabetes notice changes to their blood sugar levels.

Other common side effects include:

• redness in the face that can last a few hours
• losing fat in the area of the injection
• a change in skin colour around the area of the injection – this can be temporary or permanent
• bruising
• bleeding
• vaginal bleeding or irregular periods

Rare side effects include:

• getting an infection
• allergic reactions

If you have more than one steroid injection, there’s a risk of damaging your cartilage and tendons.

Who can have a steroid injection

Most people can have steroid injections safely.

Do not have a steroid injection if you:

• feel unwell
• have an infection
• are taking antibiotics
• are allergic to local anaesthetic or steroids
• plan to have surgery in the injection area less than 1 week after the injection
• have diabetes that is difficult to control
• recently had a vaccine or plan to have a vaccine less than 2 weeks after the injection

If you cannot have a steroid injection, we’ll discuss other treatment options with you. This might include:

• making changes to your lifestyle
• other medicines
• physiotherapy
• using a splint or other support for your joints
• surgery

Before the procedure

Tell us about any medical conditions you have. This includes:

• cancer
• HIV
• hepatitis C
• diabetes
• thyroid conditions

You should also tell us if:

• you’re pregnant or breastfeeding
• you’re allergic to any medicines
• you’re allergic to latex or plaster
• you’re taking antiplatelet medicines like aspirin
• you’re taking anticoagulant medicines like warfarin
• you're taking beta blockers like atenolol

These conditions might increase the risks of the injection. We’ll discuss this with you so you understand the benefits and risks before deciding to have a steroid injection. If you have any questions or concerns, talk to us.

During the procedure

We’ll ask you to sit or lie in a comfortable position. We’ll clean your skin with antiseptic.

We’ll gently push the needle into your skin and inject the steroid. We might also inject a local anaesthetic that will make the area feel numb. This might be mixed with the steroid into a single injection, or we might give you a separate injection.

You’ll feel some pain as the needle enters your skin. We’ll try to make sure you’re as comfortable as possible.

We’ll put a plaster over the area we injected to keep it clean.

We might ask you to stay with us for 15 minutes after the injection. This is to check for any allergic reactions and make sure you feel ready to leave hospital.

After the procedure

Pain and soreness

The injection area can be sore for a few days after the procedure. This is because the needle might have caused some bruising.

You can continue taking your regular painkillers if you need help managing the pain.

If you had local anaesthetic, your pain might feel much better immediately after the injection. But this might only last for a few hours until the local anaesthetic wears off.

The steroid usually starts working after 1 to 2 days. Sometimes it can take longer. This pain relief usually lasts for about 6 weeks.

Rest and recovery

We’ll give you advice about how long you should rest after the injection. This depends on what’s making you feel pain.

Try to avoid activities that make your pain worse for a few days. After this, go back to your normal activities gradually.

Avoid heavy lifting and repetitive use of the area you feel pain for 2 weeks. This reduces the risks of the injection and helps your tendons and joints to recover.

We might show you some exercises you can do to help you recover. We might also refer you to physiotherapy treatment.

Checking blood sugar

If you have diabetes, check your blood sugar levels every day for 3 days after the injection. Steroids can increase your blood sugar so it’s important you check it regularly.

Other treatments

If you plan to have any other medical treatments within 6 weeks after your injection, tell your healthcare team that you recently had a steroid injection.

When to get help

Follow-up appointments

Before you leave hospital, we’ll discuss the best way for you to have a follow-up appointment. This might be:

• a follow-up appointment with the musculoskeletal department
• a physiotherapy review
• a patient initiated follow-up (PIFU)

We’ll check how you’re responding to the steroid injection. We’ll also discuss the risks and benefits of having another injection if needed.