What is injection therapy?

The aim of a steroid injection is to reduce inflammation, swelling and pain in the affected area.

This will help you use and exercise the affected area more normally and aid your recovery. The medication used is a corticosteroid, which is an anti-inflammatory drug. This may be used in conjunction with a local anaesthetic or normal saline to help spread the steroid around the tissues.

You will need to tell us if you:

• have any allergies to medication, especially local anaesthetic
• are taking anticoagulants (blood thinners like warfarin or aspirin) or are on immunosuppressants,
  such as oral steroids
• have any infections or are unwell and/or feeling feverish
• are diabetic or epileptic
• have had surgery or are about to have surgery in the affected area
• are pregnant and/or breast feeding
• do not want the injection
• are taking amphotericin (an antifungal drug), cimetidine (for treatment of a peptic ulcer) or suxanthonium (a nerve blocking drug).

Side effects

Occasionally there are side effects from the type of injection, which are mild and very rare, for example:

• an increase in pain may be felt for 24 to 48 hours. You can take pain killers if required to relieve your discomfort
• menstrual cycle alteration
• bruising may appear where you had the injection
• mild facial flushing. This may last up to 48 hours and will settle naturally
• diabetics may find that their blood sugar levels rise slightly over the next few days
• skin discolouration and/or fat atrophy where you had the injection
• very occasionally, a rupture may occur in the tendon. To minimise this small risk it is important to follow the advice to rest.

If you experience any side effects, please let us know. Infection and allergic reactions are rare but may occur. If the injected area becomes red, hot, swollen, tender and/or you feel feverish, you must seek medical advice immediately and inform us.

Anaphylactic shock occurs very rarely as an extreme reaction to local anaesthetic so we recommend that you remain in the waiting area for up to 30 minutes following your injection. Please let a member of staff know if you feel unwell.

Side effects are kept to a minimum by careful technique, examination and keeping drug doses to recommended levels. Every effort is made to prevent infection by hand washing, cleaning of the area and use of sterile equipment.

After your injection

• Please wait in the designated area for 15 to 30 minutes after your injection (as advised by your clinician), in case you experience an adverse reaction. Please let a member of staff know if you start to feel unwell.
• Please rest the injected area for the next two or three days, or as recommended
  by your healthcare professional.
• Continue to monitor the site for any signs of infection for three weeks.
• Start your exercise programme as prescribed by your healthcare professional.

You can continue taking pain killers after your injection as you are likely to get some soreness from the needle.

After your injection, a follow up appointment will be made. Please contact us if you have any queries about this.

If you have any queries after your injection, please contact the service you are seeing, either the Community Orthopaedics Service or Physiotherapy Service.