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Soft tissue injections

What is a steroid?

Steroids are a type of drug that can be given as injections. Steroids suppress inflammation, and they can be used very effectively to treat relieve pain, swelling and stiffness in a variety of musculoskeletal conditions including soft tissue injuries such as tennis elbow, plantar fasciitis, and ligament sprains.

Why don’t I just take anti-inflammatory tablets?

You can, but an injection can be used to target pain from inflammation in soft tissues more effectively than taking tablets. A steroid injection has a much more powerful anti-inflammatory effect than anti-inflammatory tablets, which work in a totally different way. Steroid injections can also avoid the common side effects caused by taking anti-inflammatory tablets, such as heartburn and indigestion.

What are the advantages of steroid injections?

Steroid injections are quick and easy to perform. Their action is fast, reliable with minimal side effects. By reducing your pain, you may be able to start your recovery and return to normal activities more quickly. This also means you may not need further treatment. If you do need further treatment, steroid injections can help to make physical treatment, such as osteopathy, more effective.

Are there any disadvantages of steroid injections?

There are side effects to every medical treatment that has ever been invented, and steroid injections are no different. But they are rare e.g. the chance of infection is as low as 1 in 22,000. Every effort is made to minimise the risk.

Are there any times that I should not have an injection?

Steroid injections should not be given to people with an active infection, whether on the skin or elsewhere in the body, especially if medication is being taken. This is because steroids may reduce the body’s ability to fight the infection. 

Injections are not given during pregnancy or when breastfeeding.

You need to tell Dr Allfree if you have experienced problems with injections before, such as at the dentist, as you may be allergic to local anaesthetic.

You also need to tell Dr Allfree if you:

  • are taking medicine that lower the immune response of the body, or 
  • are allergic to steroids or local anaesthetic. 
  • have diabetes, as the injection may temporarily raise blood sugar. This does not mean that they cannot be used.
  • are taking medication to prevent blood clotting. Sometimes it may be necessary for you to stop the blood thinning medication for a few days before receiving the injection, but Dr Allfree will advise you.

What are the possible side effects? 

  • You may notice that your face is flushed for a few hours. 
  • There may be some menstrual irregularity for a couple of cycles.
  • With injections close to the surface of the skin you may notice a lightening of the
    colour or thinning of the skin at the injection site. 
  • As with any procedure where the skin is pierced with a needle there is a risk of bruising from broken blood vessels or infection. If the area becomes hot, swollen and painful for more than 24 hours or you feel unwell you should contact the MansfieldClinic.

Can I go straight home after the injection? 

You may be asked to sit in the waiting area for a little while after your injection, but normally you will be able to go home shortly after your injection.

How is the injection done?
The skin is cleaned with an antiseptic swab. The procedure may consist of two injections, firstly a local anaesthetic to numb the skin, and secondly a slow release steroid (such as Triamcinolone) into the affected part. The skin is covered with a sticking plaster which should be kept on for 24 hours. 

I’ve always heard that steroid injections are painful. Are they?
Not normally. Dr Allfree has many years’ experience in the injection therapy, and prides himself on giving injections as painlessly as possible. Sometimes it can be sore afterwards and you should take pain tablets for this. 

How fast does the injection work?

The local anaesthetic will numb the pain within a few minutes and last for about 1 hour or so. The steroid usually starts to work after about 24-48 hours, but may take longer, sometimes a few weeks. Occasionally, the effects can be very dramatic.

How long does the effect last?

This varies from person to person but an injection may take up to 6 weeks to work. Do not worry if your pain does not improve in the first couple of weeks or so.

How many injections can I have?

This depends on the part of the body being treated. Usually one injection is sufficient but if the pain is severe or has been there for a long time you may need more. As a general rule of thumb, Dr Allfree will advise that the same joint should not be injected more than four times in twelve months.

What should I do after the injection?

Rest the part for 48 hours. You will be advised when you can begin to increase both your day to day activities.

When will I have to be seen again?

You will be given a follow up appointment to review progress, usually in about three weeks. Whilst inflammation can recur, with appropriate aftercare advice and exercises, steroids may provide months to years of pain relief.