Steroid injections

What are steroid injections?

Steroid injections, are anti-inflammatory medicines used to treat a range of conditions.

They can be used to treat problems such as joint pain, arthritis and sciatica.

What are the benefits of steroid injections?

Steroid injections can’t treat the underlying cause of your condition, but they can treat the symptoms.

Some steroid injections start to relieve pain within hours and the effects should last about a week. Your consultant might call these short-acting soluble steroids. Soluble means that the drug dissolves quickly in your body and starts working quickly.

Other steroid injections take around a week to become effective but can ease your symptoms for two months or longer. These are described as less soluble, because the drug takes longer to get into your system.

How quickly the treatment works, and how long it lasts will also depend on your condition.

Are steroid injections right for me?

Steroid injections are often recommended for people with rheumatoid arthritis and other types of inflammatory arthritis.

They may also be recommended for osteoarthritis if your joints are very painful or if you need extra pain relief for a time. The injection can reduce inflammation, which in turn should reduce pain.

What happens during treatment with steroid injections?

Depending on where the pain and inflammation is, steroids can be injected:

• directly into an inflamed joint - this is known as an intra-articular injection
• into the soft tissue close to the joint - this is called a peri-articular injection
• into a muscle - this is called an intra-muscular injection.

Most injections are quick and easy to perform. They will be carried out by your consultant.

In some situations, you may need an image guided steroid injection to help ensure the steroid is injected into a precise spot and have maximum benefit. Many injections can be given without the need for ultrasound.

Sometimes you’ll be given a local anaesthetic with the steroid to reduce the discomfort of the injection. This would mean your pain should be relieved within minutes. The effects of local anaesthetics can wear off within half an hour, unless you’ve been given one that is long acting. You may have some numbness from the anaesthetic that could last up to 24 hours.

You might be advised to wait for 10 to 15 minutes in the clinic after your steroid injection. If you do have any kind of reaction to the injection, it would be helpful to be around healthcare professionals.

You may want to arrange transport home after the injection, especially if you’re going to have a local anaesthetic, because numbness from the anaesthetic can make it difficult to drive.

Loose-fitting clothes may be more comfortable if you’re going for a steroid injection.

Recovery from steroid injections

Most people have steroid injections without any side effects. They can be a little uncomfortable at the time of injection, but many people feel that this is not as bad as they feared.

Occasionally people notice a flare-up in their joint pain within the first 24 hours after an injection. This usually settles by itself within a couple of days, but taking simple painkillers like paracetamol will help.

Injections can occasionally cause some thinning or changes in the colour of the skin at the injection site, particularly with the stronger ones.

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.

People are often concerned about the possibility of other steroid-related side effects, such as weight gain. One of the advantages of steroid injections compared to tablets is that often the dose can be kept low. This means that these other side effects are very rare unless injections are given frequently, more than a few times per year.

Steroid injections can sometimes cause temporary changes to women’s periods. They can also cause changes in people’s mood – you may feel very high or very low. This may be more likely if you have a history of mood disturbance. If you’re worried, please discuss this with your consultant.