Steroid injections are a type of treatment that delivers a high dose of medication directly to a problem spot in the body. Corticosteroids can help reduce inflammation. Injections can be helpful in treating conditions like tendinitis or bursitis.
Steroid injections are man-made drugs very similar to cortisol, a hormone your body makes in your adrenal glands. “Steroid” is short for corticosteroid, which is different from the hormone-related steroid compounds that some athletes use. You may hear them called cortisone injections, cortisone shots, steroid shots, or corticosteroid injections.
Steroids ease inflammation and slow your immune system. They can treat many kinds of inflammatory conditions.
What can you expect when you get a steroid injection?
Before your injection, you may need to stop taking certain medications. Talk to your doctor about what medications you take. Don’t make changes unless they tell you to.
Steroid injections must be done in a doctor’s office or hospital. Once you get to your appointment, your doctor will go over the procedure and have you sign a consent form. Then they’ll have you lie in a way that allows them to access the injection site.
Your doctor may then use an ultrasound to figure out where exactly to give you the injection. Once they have the right place, they’ll inject a mix of the steroid and a numbing medication. The shot may be uncomfortable, but the numbing medication will take effect quickly.
Injections can be given into:
- muscles or tendons
- your spine (an epidural)
- bursae, which are fluid-filled sacs between some tendons and joints
You’ll need to keep the injection site clean and dry for the next 24 hours.
The site may be sore for a few days. You can use a cold pack on the injection site if you need to, for up to 10 minutes at a time. Wait at least 24 hours before using heat on the injection site.
Steroids can also be given through the veins (intravenously). This method is usually used for autoimmune flares.
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How are steroids given?
Steroid medications are available in several forms that vary in how easily they dissolve or how long they stay in the body.
Steroids may be given systemically, which means throughout the system or body, or locally to the precise place where a problem exists.
Systemic steroids can be given either through a vein (intravenously), into a muscle (intramuscularly) or by mouth (orally). Local steroids can be given as eye drops, ear drops, or skin creams and by direct injection into joints, bursae (lubricating sacs between certain tendons and the bones beneath them), or around tendons or other soft tissue areas.
The steroid is injected with a syringe and small needle into the targeted area. There is generally some form of anesthesia beforehand with lidocaine or a spray. Some brief and typically minor pain with the procedure is common. The degree of pain will vary on the location of the shot and the individual patient.
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How quickly do they work?
Most steroid injections take a few days to start working. In some cases, they can start working even sooner, within a few hours.
How long do they last?
Steroid shots usually last up to one or two months. However, they can last longer, especially when used with other treatments such as physical therapy. Injections for certain conditions, such as acute joint pain, may also last longer.
It’s best to limit steroid injections to three or four times a year. More frequent injections can cause the skin and bone around the injection site to weaken.
When will my doctor prescribe steroid injections?
The decision to prescribe steroids is always made on an individual basis. Your doctor will consider your age, physical activity and other medications you are taking. Your doctor will also make sure you understand the potential benefits and risks of steroid injections.
What are the expected benefits of steroid injections?
The main benefits to the patient are to decrease pain and increase function. Steroid injections often reduce joint inflammation, helping preserve joint structure and function.
Local injections are generally well-tolerated and are less likely to produce serious side effects than other forms of steroid medications.
Steroid injections may help avoid the need for oral steroids or increased doses of oral steroids, which could have greater side effects.
What happens when I have a local steroid injection?
The clinician who will be performing your injection will choose the most appropriate steroid medicines and dose for your condition and symptoms. They will usually inject the steroid directly into the area that is inflamed, such into the joint or around the soft tissue, where the pain is felt. Most injections are quick and easy to perform.
Normally an ultrasound scan is used to find out more about where the inflammation is and also to deliver the injection more precisely. For safety reasons your clinician may delay your injection if you have unstable blood pressure or unstable blood sugars due to diabetes to get consent from your GP.
What happens after the injection?
If you have local anaesthetic, your pain will be relieved within minutes but may wear off after an hour or two. It usually takes several days for the effect of the steroid to fully begin to work.
You may wish to arrange alternative transport home after your injection, especially if you are having local anaesthetic which can cause some numbness and make it difficult to drive.
If you have any injection into the joint you should try to avoid strenuous exercise for two days afterwards. If you are having an injection around a tendon, you may be asked to avoid heavy impact and loading activities for two or three weeks.
Will I need another injection?
If you find the injection helpful, and other treatments unsuitable, the injection may be repeated. However, injections are most often used to provide a window of opportunity to engage in exercise and rehabilitation or whilst finding a more suitable program of treatment. Once your pain is better controlled, the need for injection should be reduced.
Local steroid injections can give rapid and effective reduction in pain and inflammation; however, improvements are usually temporary. As with all medicines, some people may experience side effects. The aim of this patient information leaflet is to provide you with the information that you need to know.