Steroid Injection Information Leaflet providephysiotherapy.org.uk
This leaflet contains all the information you may require about undergoing a steroid injection. This will have been discussed with your physiotherapist and you will have been given this to help with your decision making. Your appointment with one of our injection practitioners is always an assessment for the suitability of having a steroid injection so you may not necessarily receive one if the physiotherapist does not feel an injection would be appropriate or safe.
At the appointment, the injection practitioner will discuss the possible risks, benefits, contraindications, and precautions related to having an injection. This information leaflet will help you understand some of these considerations and allow for an informed discussion to take place.
Steroid injections can be a useful addition to your overall management of your musculoskeletal condition and normally allow for a pain free window for your exercises to be more manageable and effective. However, there are some small risks to consider, which are explained further in this leaflet. For some conditions, steroid injections can resolve the issue completely and will be offered early on as a part of your treatment.
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Before having an injection
What is a steroid injection?
Corticosteroids act as an anti-inflammatory (similar to ibuprofen but stronger) and can help reduce inflammation caused by a specific condition. You can take these both as tablets, as topical gels and as a steroid injection. The benefit of a steroid injection is that it targets the area of inflammation directly Steroid injections can be recommended for a range of conditions and your physiotherapist will be able to discuss this with you as a part of your treatment plan. They won’t usually be able to cure the underlying condition but can help with the management of some of the symptoms associated with this.
How long will they last?
Some steroids can start to relieve symptoms fairly quickly and can continue to have an impact for up to six weeks after the injection date so do not worry if you have not felt an improvement after a few days. The steroid used in this service is Kenalog (Triamcinolone Acetonide) and has a longer acting property to it. The effectiveness of the steroid injection can rely on many factors including your condition, how your body uptakes the steroid and the type of steroid used. Sometimes a local anesthetic will also be used by your injection practitioner, which can have a rapid relief of pain but as this wears off, the pain may return to some extent whilst waiting for the steroid to take effect.
The longer term benefits you may gain from a steroid injection will not be affected depending on whether you receive a local anaesthetic or not.
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Vaccines
If you are planning to have your flu or COVID-19 vaccine make sure you leave at least two weeks either side of a steroid injection. This is due to the short-term effects that steroid injections have on your immune system and can therefore impact upon the effectiveness of the vaccine.
If you are due to have any travel vaccines, which are instructed as being a live vaccine, please leave at least four weeks either side of your steroid injection.
Alcohol
You do not need to avoid alcohol after having a steroid injection. It is recommended that adults in the United Kingdom do not consume more than 14 units of alcohol spread across three or more days. It is also recommended to have at least two days free from alcohol in a week
Breastfeeding, Fertility and Pregnancy
It is recognised as safe to have a steroid injection whilst you are pregnant, breastfeeding or undergoing fertility treatment. Having a single injection can be a useful treatment for some musculoskeletal symptoms however it is recommended that you discuss with your doctor prior to having a steroid injection.
If you are concerned please discuss this with your injection practitioner at your appointment who will be able to advise on further benefits and risks specific for you.
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What will happen at my appointment?
The injection practitioner will complete a quick re-assessment of your condition to make sure agreement is made with the potential diagnosis. Once confirmed they will then check you are well in yourself, you do not have any signs of injection at that time and do not meet any of the contraindications (reasons that you cannot have a steroid injection) within our service.
You will also not be offered an injection if you are currently on antibiotics. If you have diabetes, having an injection may raise your blood sugars for a few days so it’s a good idea to monitor this. They will also discuss the possible side effects and risks related to injection and these are detailed below.
You do not always need to have a scan/X-ray prior to injection and the majority of the injections are reasonably quick and relatively comfortable. This will be carried out within the clinic or department.
There is also evidence which shows having too many injections in a particular joint or soft tissue could have a negative impact upon longer term outcomes and have adverse effects on tissue health. It is also important to monitor how much steroid is in your system, but this will be discussed with your injection practitioner.
We would also recommend a period of rest of between 2-7 days postinjection to allow time for this to take effect. You will then be able to gradually increase activity and get back to your exercises again.
If an injection is administered, you will be asked to wait in the reception area for up to 30 minutes to ensure that you do not have any adverse reactions to the steroid. You can drive after the injection although as there is a possibility your pain may temporarily worsen you might want to arrange for someone to bring you to this appointment.
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After my injection
We have provided this information below to help you understand what to expect after your injection and what to look out for between now and your next follow up appointment.
Local Side Effects (close to site of injection)
Post injection flare of pain/bruising – This is normal, but easily managed with simple pain relief if needed and will likely settle within 24-48 hours. Bruising may be more common if you are taking blood thinning medication.
Skin depigmentation (lightening) around site of injection – Although rare, can be permanent.
Infection – If you notice any signs of increased swelling, redness, heat, and pain following your injection – Contact your GP or 111 for further advice.
Tendon rupture and atrophy (weakening) – Very rare and more likely to occur after several injections in same area.
Systemic Side Effects
(general)
Anaphylaxis/Allergic reaction – Extremely rare but can require urgent medical attention. Please remain in department for 30 minutes and let us know if you start to feel any unwarranted symptoms.
Feeling faint, anxious, lightheaded, nauseous – More common if needle phobic.
Facial flushing – May come on within 24-48 hours and last 1-2 days. Elevated blood sugar levels – If you have diabetes, you may temporarily notice a rise in your blood sugars. Please discuss this further with your GP or diabetes nurse as your diabetes medication may need to be briefly altered.
Menstrual disruption – Premenopausal and postmenopausal bleeding may occur.
Digestive system disturbance – If you experience any abdominal pains, please contact your GP.
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PBO-5079-2250-01 Part of the If you need this leaflet in: braille large print audio another language Please contact our Customer Service Team: 0300 303 9952 (9am-5pm) provide.customerservices@nhs.net If you would like to know more about the specific drugs that we are using then please use scan the QR code below. If you are unable to access this please let your clinician know and we can provide you with a paper copy of this. Physiotherapy Kenalog: Lidocaine: If you have any questions before your appointment please do not hesitate to contact the Care Co-ordination Centre on: 0300 131 0111 /ProvidePhysiotherapy @ProvidePhysio @ProvidePhysiotherapy
