What are steroids?
Steroids are a type of medicine, which can be given as tablets or injections. Steroid injections come in
different formulations – some act very quickly, others are slower-acting but longer lasting.
What do steroid injections do?
They reduce inflammation, which helps to ease pain and reduce stiffness.
What are they used for?
They’re used for any inflammatory arthritis and sometimes for severe osteoarthritis, for gout and
conditions caused by calcium crystals, and for conditions affecting the muscles, tendons and other soft
Are there any side-effects?
Side-effects can include a allergic reactions, temporary flare-up of joint pain, infection, changes in mood, tendon ruptures, bleeding, bruising and thinning of the skin.
When and how do I have local steroid injections?
Your physiotherapist will choose the most appropriate steroid mixture and dose for your condition and symptoms. Most injections are quick and easy to perform. If you have an injection into a joint, you should rest it, or at least avoid strenuous exercise, for the first 1–2 days. However, it’s also important not to rest for too long. If you’re having a course of physiotherapy, the physiotherapist may be keen to give more intensive mobilisation treatment 7-10days after the injection, while your joint is less painful. If the injection is very helpful, and other treatments are either unsuitable or less effective for you, then the injection may be repeated, if necessary.
How long do local steroid injections take to work?
Short-acting soluble steroids can give relief within hours and should last for at least a week. The longer-acting, less soluble steroids may take around a week to become effective within 5-6 weeks and up to for two months or longer. Sometimes you’ll be given a local anaesthetic with the steroid to reduce the discomfort of the injection, although the anaesthetic won’t have any effect on the inflammation. If you do have a local anaesthetic, your pain should be relieved within minutes but it’ll usually wear off within half an hour unless the anaesthetic selected is long acting. You may have some numbness from the
anaesthetic which may last up to 24 hours. If the joint is painful after the injection simple painkillers like paracetamol should help.
What are the possible side-effects?
Side-effects are very unlikely but occasionally people notice a flare-up in their joint pain within the first 24 hours after an injection. This usually settles on its own within a couple of days but taking simple painkillers like paracetamol will help. The risk of side-effects is greatest with the stronger mixtures. The mildest mixture is hydrocortisone. Methylprednisolone and triamcinolone are stronger and tend to be less soluble (dissolve less easily), so they stay in your joint for longer. Local steroid injections may sometimes cause facial flushing or interfere with the menstrual cycle. Other steroid-related side-effects are rare unless injections are given frequently (more than a few times per year). Any treatment with steroids may cause changes in mood – you may feel very high or very low. This may be more common in people with a previous history of mood disturbance. If you’re worried please discuss this with your doctor. It’s usual to see a rise in blood sugar levels for a few days after the injection, if you have diabetes.
What are the risks?
Very rarely you may get an infection in the joint at the time of an injection. If your joint becomes more painful and hot you should see your doctor immediately, especially if you feel unwell. Injections can occasionally cause some thinning or changes in the colour of the skin at the injection site, particularly with stronger preparations. In very rare cases, an injection of steroids into the muscle can lead to an indentation in the skin around the area.
Will it affect vaccinations?
You can have vaccinations 2 weeks after after local steroid injections.
Can I drink alcohol while on local steroid injections?
There’s no particular reason to avoid alcohol after local steroid injections.
Do local steroid injections affect fertility or pregnancy?
Single steroid injections shouldn’t affect fertility or pregnancy and are often useful treatments in this
situation. However, if you’re pregnant you should discuss this with your clinician before having a local
Do steroids affect breastfeeding?
Many women benefit from steroid injections while breastfeeding. Although small amounts of steroid may
pass into the breast milk, this is very unlikely to be harmful to your baby. However, as always, you should
discuss the risks with your clinician, if you’re concerned.
What else should I know about local steroid injections?
The person giving you the injection may decide to use an ultrasound scan so they can find exactly where
the inflammation is and inject the steroid into a precise spot.
May I drive after the injection? Yes, you may drive after the injection.
Are there any alternatives?
A number of other drugs are used in the treatment of arthritis. Different treatments, including physiotherapy, may also be useful. Your clinician will discuss these other options with you.
Will I need any special checks while on local steroid injections?
Your clinician may want to check your blood pressure and blood sugar before your first injection as steroid
injections can cause these to rise. You might need to delay the injection if either is raised.
Can I take other medicines along with local steroid injections?
You can take other medicines with local steroid injections. However, if you’re taking an anticoagulant (a
drug that thins the blood) such as warfarin, it’s less likely that you’ll be offered an injection because of the
risk of bleeding into the joint. You should mention that you take anticoagulants to the person giving the
injection to make sure that they’re aware of this. It’s best to discuss this beforehand, as you may be
advised to adjust your warfarin dose before having the steroid injection.
Steroid Injections | Side-effects, uses, time to work (versusarthritis.org) updated 09/07/2023
Steroid injections – NHS (www.nhs.uk) updated 09/07/2023
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