Your doctor may recommend an injection of cortisone into your joint if you have sustained an injury or if you are suffering from a condition that causes painful, swollen joints. In this blog we look at what cortisone injections are, what they are used for and who might be offered them.

What are joint injections?

Cortisone or hydrocortisone injections, also known as corticosteroid or steroid injections, are used to relieve pain and reduce inflammation associated with traumatic injuries and degenerative conditions like arthritis. The steroid is injected directly into the painful joint, most often the hip, shoulder, elbow, knee or wrist. This helps to relieve pain and swelling and to improve function and movement of the joint. The benefits normally last for several months, depending on the type of steroid that is injected and the condition it is being used to treat.

Learn about ultrasound-guided joint injections which we offer at Ravenscroft Health.

What are joint injections used for?

The procedure is commonly used for sporting injuries like rotator cuff tendonitis; tennis or golfer’s elbow; runner’s knee, shoulder bursitis and other ligament and tendon sprains, strains and tears. It is also used to treat painful degenerative conditions like arthritis. You may be offered a joint injection by a specialist pain management and sports injury clinic like ours or by a GP, orthopaedic surgeon or physiotherapist.

Who can have them?

Steroid injections may be given to adults and children, however they are not suitable for everyone. You may not be able to have them if you have ever had an allergic reaction to hydrocortisone, if you are pregnant or trying to conceive, or if you have ever had depression or manic depression. People with infections or who have recently come into contact with infections like measles or chickenpox will also be unable to have joint injections. If you are at all unsure, talk to your doctor.

How do they help?

Steroid injections help by easing symptoms like pain, inflammation and loss of movement and flexibility in the joint. They do not treat the underlying problem, but may help to relieve symptoms, allowing you to move around more freely. This is beneficial both in terms of keeping the joint flexible and lubricated and enabling you to do physiotherapy or other types of exercises which helps to prevent stiffness and further deterioration of the joint.

You may be offered steroid injections to help you cope better with your symptoms or to delay surgery for as long as possible. This is because all surgery carries risk and it is only recommended for the most severe symptoms.

Are there any risks?

Steroid injections can cause damage to the joint if you have them too frequently. For this reason, doctors recommend a maximum of four in a year, regularly spaced at three-monthly intervals. They can also affect your immune systems so you may be at higher risk of contracting infections like chickenpox, measles or shingles.

The injection may produce mild side-effects such as an increase in pain and swelling for a few days afterwards or a flushed face. More serious complication, which are generally rare, include: an infection which may require antibiotic treatment, damage to the cartilage or tendons, thinning of the skin around the injection site and mood fluctuations. Talk to your doctor if you experience any of these or if you are concerned after having the injection.

What can I expect at my appointment?

Your doctor will explain the procedure to you and may ask about other conditions which could increase your risk – for example, if you are taking a drug like warfarin to thin your blood you may be at increased risk of bleeding into the joint. You should also tell your doctor if you are diabetic as the injection may raise your blood sugar level.

The skin above the affected joint will be cleaned and sterilised before the injection. Joint injections contain a mix of steroid medication (cortisone) and local anaesthetic to relieve pain and swelling. You may also be given an injection of local anaesthetic into your skin to reduce the pain of the steroid injection. If fluid has collected in your joint you may be given a treatment called aspiration to remove it prior to the steroid injection.

Once the local anaesthetic has taken effect you will be given an injection directly into your joint. You will normally be able to go home shortly after treatment but it is better not to drive afterwards.

You may not notice an improvement in your symptoms immediately and, in some cases, the pain may actually worsen. Using an ice pack or pain killing medication can help. It is advisable to rest the affected joint for a few days. Your doctor will give you individual advice about the best time to start using it again and the type of exercise that can help. As the steroids begin to take effect you should notice a reduction in pain and swelling and greater movement in the affected joint.

Joint injections are not a replacement for surgery if you have sustained a serious injury. However, they can postpone it and provide a welcome relief from symptoms. Talk to us if you are unsure whether you might be able to have steroid injections to treat joint-related injuries or disease.