Steroid injections are useful in the treatment in a range of musculoskeletal problems. The injection of a steroid into a joint or tendon sheath seeks to reduce inflammation and swelling which is causing pain and restricting activity. This is certainly the most commonly used injection in the UK. Typically this would provide three to six months of relief, with the hope that due to the increased activity there is some muscle build up and strengthening of tendons and ligaments witch provided longer term healing. We would usually advocate physiotherapy before considering joint injection, and continuing with this afterwards.
Bursitis is a fluid filled swelling over the joint. These are most common in knees, elbows and hips, but can be over any joint. Possibly the most widely known bursitis is housemaids knee, or prepatellar bursitis. The name may give an indication of one of the common causes, as historically housemaids would spend long periods on their knees scrubbing floor, equally in the elbow this is often termed students elbow, to represent the damage caused by students leaning elbows on a desk. This can also be caused by repetitive stress, such as in runners or if an underlying weakness caused by arthritis. We will inject a steroid with local anaesthetic to reduce the swelling causing pain. At the same time, we may be able to aspirate fluid too.
Osteoarthritis is a wearing of joints. It is often said that this begins at around 21 years old, but often doesn’t cause any problems until much later. Maintaining strength in the joints is protective and highly recommended which a physiotherapist can help with. Steroid injection will reduce the inflammation in the joint seeking to reduce pain and enable activity to be maximised.
Tendinopathies such as tennis elbow, golfers elbow plantar fasciitis and rotator cuff problems are usually caused by repetitive activity, which leads to their names. These may be caused by other repetitive activies such as using a hammer, or may be caused by a one off strain such as lifting a heavy weight. Steroid reduces the inflammation after injection into the tendon sheath, so after a period of rest, recovery can begin. The aim would be for complete healing from a single injection, although this is not always the case.
Carpal tunnel syndrome is an inflammation of the passage the radial and ulna nerve travel into the hand. This can often cause pain in the wrist, with pins and needles into part of the hand. This often disturbs sleep. Splinting can help this, which many people just wear at night, but where this is not successful, a steroid (without local anaesthetic) will reduce the inflammation in the carpal tunnel which prevents the compression of the nerves.
Corticosteroids, steroids and cortisone are all common interchangeable terms. Where appropriate, we will administer a local anaesthetic in the same injection. This will offer short term relief of pain, while the steroid is reducing the inflammation. It is important to rest the area after the injection. At the time of injection, it is important to be otherwise well and we are unable to inject pregnant people.
Steroid Injections
Steroid injections are useful in the treatment of
- Osteoarthritis
- Bursitis
- Tendinopathies (inflammation and pain from the tendon) such as tennis or golfer’s elbow, rotator cuff problems
- Carpal tunnel syndrome
- Trigger finger or thumb
- Shoulder problems such as impingement, rotator cuff sprains, frozen shoulder
- Shoulder problems such as impingement, rotator cuff sprains, frozen shoulder
- Plantar fasciitis
- Bursitis
Areas We can offer injections
- Shoulders
- Elbows
- Fingers & thumbs
- Carpal tunnel
- Wrists
- Hips
- Knees
- Plantar fasciitis
