Corticosteroid Injections - A guide to this procedure

Corticosteroid Injections Information for Patients

This information page answers some of the questions that you may have about having a corticosteroid injection.

It explains the benefits, risks and alternatives and what you can expect when you come to hospital.

If you have any queries or concerns please speak to your referrer or the person treating you.

What is a corticosteroid injection?

Corticosteroid – often known as steroids – is an anti-inflammatory medicine prescribed for lots of different conditions. It is injected directly into the tissues that are causing your symptoms. The person treating you will explain why you need this. You may also have a local anaesthetic at the same time, for temporary pain relief.

Corticosteriods are not the same as steroids taken by bodybuilders.

Tell the person treating you if you:

• Have a severe infection
• Are allergic to plasters, dressings, local anaesthetic or steroids
• Feel unwell
• Are pregnant or breastfeeding
• Are diabetic
• Take warfarin or other blood thinning medications
• Take anti retroviral medication
• Feel your symptoms have improved significantly since being referred for the injection.
• Do not want the injection.

Who will give me the injection?

A consultant radiologist specialist trained to do the procedure.

What are the benefits?

It can help relieve:

• swelling
• pain
• stiffness.

These may help you to start your rehabilitation and return to normal activities sooner by relieving your pain and inflammation. If it is not clear which structures are causing you pain, the injection can help to diagnose your condition.

What are the risks?

Common:

• A ‘steroid flare’ - this means the pain may get worse for a few days before it gets better
• A flushed face for a few hours after the injection.
• Temporary bruising or bleeding, especially if you are taking blood thinning tablets such as aspirin or warfarin.
• Losing a small area of fat or change in skin colour around the injection site.
• Light vaginal bleeding or irregular periods.
• The injection may not work. If this happens, your referrer may need to consider other treatment options. They will discuss this with you. If it was only partially or temporarily successful, we may need to give you another injection.
• If you are diabetic, your blood sugar levels may increase temporarily

Rare:

• Infection. This is very rare (about 1 in 15,000)

If the area becomes hot, swollen and painful for more than three-four days, or if you generally feel unwell, contact your referrer immediately. If they are unavailable, go to your GP or local Accident & Emergency (A&E) department.

Are there any alternatives?

• Avoid activities that may have caused the injury
• Anti-inflammatory medicines
• Physiotherapy.
• Surgery. You need to talk to your specialist about this.

Consent

We must by law obtain your verbal consent to any operation and some other procedures beforehand. Staff will explain the risks, benefits and alternatives before they ask you to consent. If you are unsure about any aspect of the procedure or treatment proposed, please do not hesitate to speak with a senior member of staff again.

What happens before I have the injection?

The person treating you will explain the procedure and the benefits and risks.

What happens during the injection?

The person treating you will clean your skin with antiseptic and using image guidance (usually ultrasound but sometimes CT scan or X-ray) positions a needle into the affected area and gently injects the solution. Following this a plaster will be used to cover the injection site to keep it clean.

Will it hurt?

You may feel some pain during the injection. Where possible, we will give you a local anaesthetic for pain relief.

What happens after the injection?

If we used a local anaesthetic, the pain may start to improve a few minutes after the injection, but it may comeback when the anaesthetic has worn off (similar to the dentist).

The steroid usually starts to work after two-three days, but it may take a bit longer. It can take up to two months for you to feel the benefit. If you follow the advice we give you, you shouldn’t have any problems.

What happens when I go home?

After your injection, do not drive or cycle for the rest of the day.

We may ask you to keep the area raised and rest it for a few days depending on what area was injected. Avoid doing any activities that will make the pain worse and gradually return to activities that are normal for you. This helps you get the full benefit of the injection.

If the area becomes swollen or painful in the first two - three days, use an ice pack. Do no put the ice in direct contact with your skin - wrap it in a tea towel or pillow case before putting it on. Do not leave it on for more than 10 minutes.

For the first two-three days, you can take painkillers to ease the pain.

Exercises

We may give you some exercises to do at home. We will show you how to do these while you are in the clinic, or advise referral for physiotherapy.

If you are having any other medical treatment within six week of your injection, you should tell the clinician that you have had a corticosteroid injection.

Will I have a follow-up appointment?

You may have a follow up appointment separately arranged with your referrer. In some cases, you may need another injection. You can talk to your referrer about this.

In case of any problems what do I do?

Please try to contact the department that you had your injection performed at:

• 136 Harley Street - London - 0207 371 2790
• Sloane Diagnostic Imaging - Beckenham - 0208 464 8197

Please communicate with the administrator about your concern and they will liaise with the specialist who performed or going to perform the injection. He or she will get back to you when it is possible.

Please be aware there may be a few hours before someone gets back to you but we shall try and make it as quick as possible.

If there is pain control issue then the option is to see your GP or attend the nearest A&E to get stronger pain killers.

Contacting us

If you need any more information please contact us on the details below.

If you require this information in a different format please let us know via customercare@alliance.co.uk