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Leaflet: Corticosteroid injections

Musculoskeletal (MSK) Services

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Last updated: September 2023

Next review: September 2025

Corticosteroid injections

The aim of this information sheet is to help answer some of the questions you may have about having a corticosteroid injection. It explains the benefits, risks
and alternatives of the procedure as well as what you can expect when you come to hospital.

If you have any questions or concerns, please speak to the doctor, nurse or physiotherapist caring for you. This sheet does not list all of the uses and side
effects of the medicines we use – please see the manufacturer’s patient information leaflet that comes with the medicine for further information.

What is a corticosteroid injection?

A corticosteroid (or ‘cortisone’) is an antiinflammatory medicine, which can be injected directly into the tissues that are causing your symptoms.

It is a safer alternative to taking anti-inflammatory medication by mouth. It acts directly in the area injected and is not the same as the steroids taken by bodybuilders or athletes.

What are the benefits – why should I have a corticosteroid injection?

The injection can help to relieve swelling, pain and stiffness caused by inflammation. This may in turn help you to start your rehabilitation and return to normal activities sooner by ‘breaking the cycle’ of pain and inflammation. It can also be helpful to aid in the diagnosis of your condition if it is not clear which structures are responsible for your pain. You may also have a local anaesthetic injected at the same time, which allows for temporary pain relief.

What are the risks?

The possible side effects of the injection are rare and

  • Flushing of the face for a few hours.
  • Small area of fat loss or change in skin colour around the injection site.
  • An increase in pain 24-48 hours after the injection.
  • Diabetic patients may notice a temporary increase in blood sugar levels.
  • Temporary bruising or bleeding if you are taking blood thinning tablets (such as aspirin or warfarin).
  • Change in menstruation. It is advised that you speak to your GP to exclude other causes if you are concerned regarding this.
  • Tendon rupture: this is very rare, however it is vital that you follow the specific advice that you are given after the injection.
  • Nerve problems: possible temporary severe pain or pins and needles/numbness if the needle touches a nerve.
  • Infection: if the area becomes hot, swollen and painful for more than 24 hours, or if you feel generally unwell, you should contact your physiotherapist or doctor immediately. If they are unavailable, you should seek advice from your GP or Accident & Emergency (A&E) department.
  • Allergic reaction to the drug: You will be asked to wait in the department for 30 minutes after your injection to check for any reactions.

You should not have the injection carried out if you:

  • Have any infection in the area or anywhere else in your body.
  • Are allergic to local anaesthetic or steroid.
  • Feel unwell.
  • Are due to have surgery in that area soon.
  • Are pregnant or breast feeding.
  • Have poorly controlled diabetes.
  • Do not want the injection.

Are there any other alternatives?

Alternatives to the injection include lifestyle changes, use of anti-inflammatory medicines and physiotherapy. Occasionally, a surgical opinion may be helpful.

What happens during the injection?

The benefits and risks of the injection will be explained to you in detail. You will then be placed in a comfortable position. The skin is cleaned with antiseptic. A needle is gently positioned into the affected area and the solution is injected through the needle. A plaster will be placed over the site to keep it clean. A few minutes after the injection you will be examined again.

Will I feel any pain?

The injection is not particularly painful as the doctor or physiotherapist is thoroughly trained in this procedure. Sometimes it can be sore for a few hours after the procedure.

What happens after the procedure?

If local anaesthetic is also used in the injection, your pain may start to improve within a few minutes although this may return when it wears off (similar to when you visit the dentist). The steroid usually starts to work after 24–48 hours, but it may take a little longer. The effect of the injection varies from person to person and usually continues to last for about six weeks. This does not necessarily mean that you will need a second injection, so long as you follow the advice given to you after the injection.

What do I need to do after I go home?

Depending on the cause of your pain, you may be asked to rest the area for a short period after the injection. This does not usually mean total rest, but
refraining from activities that make your pain worse, after which you should try to gradually return to full function. This is to maximise the benefit given by the injection. You may also be shown some exercises to do whilst you are in the clinic, or referred for physiotherapy treatment. If you are having other medical treatment within six weeks, you should tell the treating clinician that you have received a corticosteroid injection.

Will I have a follow-up appointment?

You may be asked to attend a follow up appointment a few weeks after your injection to check your progress. Occasionally, more than one injection is needed and this can be discussed at this appointment.

Contact us

If you have any questions or concerns, Please contact The MSK Interface Service on 0300 125 6555 on a Monday to Friday between the hours of 08.30am – 4.30pm.