Corticosteroid injection

 

What is a Corticosteroid injection (CSI)?

CSI is an anti-inflammatory medicine that is injected directly into the affected area, providing treatment as part of a wider rehabilitation programme that helps ‘break the cycle’ of pain and inflammation, offering temporary relief from various musculoskeletal conditions which allows early return to normal activities, as pain and discomfort can have a detrimental effect on both physical and mental well-being.

Who is it for? 

  • Hip, knee, shoulder, back, hand/foot arthritic pain
  • Tendinopathy, plantar fasciopathy, 
  • Bursitis, 
  • Greater Trochanteric Pain Syndrome, 
  • Rotator-related shoulder pain and Subacromial pain syndrome. 

You should not have the injection if you have:

  • Infection
  • Allergies
  • Early trauma 
  • Has metal plates 
  • Ages <18 years old 

You should discuss with your clinician if you have: 

  • Poorly controlled diabetes 
  • Immunocompromised 
  • Bleeding disorder or anticoagulation 
  • Pregnant or breastfeeding 
  • Anxious
  • Upcoming surgery 
  • Recent vaccination 

Risks and Side Effects:

  • Infection susceptibility for 6 weeks
  • Steroid flare-up- face flushing
  • Abnormal bleeding for women
  • Temporary bruising or bleeding 
  • Fat atrophy (indentation or dimple) 
  • Skin dyspigmentation
  • Increase blood sugar levels 
  • Allergic reaction
  • Tendon rupture

What to expect during the procedure

  • Procedures may vary depending on the situation and practitioner. Every effort is made to reduce infection risk by aseptic technique, hand washing, and a sterile workspace. The practice maintains dosages at the recommended levels, and side effects are kept to a minimum by careful examination and technique. 
  • You will be placed in a comfortable position. 
  • The skin is cleaned with an antiseptic. 
  • A needle is gently positioned into the affected area, and the solution is injected through the needle. 
  • A local anaesthetic may be injected at the same time, which gives immediate pain relief.
  • A plaster will be placed over the site to keep it clean. 

Essential post-cortisone Injection Advice:

  • Rest: Avoid strenuous activity/weight-bearing for 24-48 hours. Gentle movement is usually okay.
  • Be aware that a pain flare-up, 3-4 hours post-injection, is possible. 
  • Simple painkillers would suffice, like paracetamol or co-codamol, avoid ibuprofen-like medications as they might worsen bruising. 
  • Keep area Clean/Dry: No soaking (baths/pools) for 24-48 hours. Showering post bandage removal is okay.
  • During Pain-Free Window: best time to do gentle rehabilitation exercises. DO NOT overdo activity as the problem isn't healed.
  • Watch for Infection: Contact GP urgently for increasing pain, redness, warmth, swelling, fever, or pus.
  • Results Take Time: Full effect may take from several days to 1-2 weeks.