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Joint injections

Key points

Injecting steroids into a painful joint can help ease pain and reduce swelling, for example, from injury or arthritis. 

Steroid injections can be used if one of your joints is affected by arthritis or inflammation. Steroid joint injections can help reduce pain and swelling in your joint and allow it to move more easily. Your pain relief can last for anything from one week to three months or longer. The injections can be repeated every three months if you need them. General advice is that joints are injected no more than four times per year.

All injection treatments at the Mansfield Clinic are performed by Dr Allfree, who has had many years’ experience in carrying out joint and soft tissue injections.

Are there any alternatives to a steroid joint injection?

The alternatives to steroid joint injections will depend on what is causing your pain. Alternative treatments include anti-inflammatory drugs, painkillers, manual therapy, or Hyalgan injections. Dr Allfree will discuss the options available to you.

Preparing for a steroid joint injection

The injection will usually contain a local anaesthetic unless you are allergic to local anaesthetic. You may be given a separate injection of local anaesthetic into the skin before your steroid injection. This helps to make the steroid injection into the affected joint as comfortable as possible.

Dr Allfree will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed.

What happens during a steroid joint injection?

The area will be examined and your skin will be cleaned with a sterile wipe. If you are having a local anaesthetic injection into the skin this will be given first with a very fine needle. The steroid will then be injected into the joint.

If you have arthritis, you may have too much fluid in your joint, making it feel tight and uncomfortable. If this is the case, after the skin has been anaesthetised Dr Allfree may draw the fluid out with a syringe before your injection. This is known as joint aspiration, and sometimes simply aspirating a joint can make it feel better.

What to expect afterwards

After a local anaesthetic it may take several hours before the feeling comes back into your joint. Take special care not to bump or knock the area. You may need pain relief to help with any discomfort as the anaesthetic wears off. You will be able to go home as soon as you feel ready. Before you go home the movement you have in your joint will be assessed, and you may be given some exercises to do at home.

If you have had an injection in your spine, you may need someone to drive you home, depending on the type of injection you have. It may be a good idea to check first with Dr Allfree. With other joints, such as your shoulder or knee, you will be able to drive straight away.

Recovering from a steroid joint injection

You will feel some discomfort as the local anaesthetic wears off. At first, the pain may be worse than before the injection, this is called a ‘steroid flare’. If you need pain relief, you can take painkillers such as paracetamol or ibuprofen, provided that they do not interact with any other medications that you are taking. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Most people have no problems after steroid joint injections. However, you should contact the Mansfield Clinic if you have a high temperature or persistent swelling, redness or if the discomfort from the injection doesn't settle within the first few days.

What are the risks?

As with every medical procedure, there are some risks associated with steroid joint injections. These can be either side-effects or complications:

1) Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having a procedure. Side-effects of steroid joint injections include:

  • an increase in pain and swelling in the injected area – this usually settles within a few days
  • thinning or a change in the colour of the skin around the injection site – this tends to be more common with stronger or repeated injections
  • a flushed or red face. This settled within 24-48 hours.     

2) Complications

Complications are when problems occur during or after a procedure. Complications of steroid joint injections can include:

  • infection – you may need treatment with antibiotics
  • damage to nerves or tendons – this is more likely with repeated injections
  • changes in the menstrual cycle in women - this usually settles after a couple of cycles
  • changes in your mood or insomnia
  • cartilage damage – this tis more common with repeated injections, and provided that injections are used sensibly it does not happen