Steroid Injection Patient Information Leaflet

You have been referred by your GP to undergo a steroid injection procedure. A steroid injection is given to reduce pain, swelling and improve function, either in a joint or surrounding tendons or ligaments. The GP Surgeon will discuss the nature of the procedure, options and associated risks and benefits beforehand. You will also be informed of postoperative care.

There are a number of different steroid injections. They all work as targeted long-acting anti-inflammatories. The most commonly used is Depo-Medrone (Methylprednisolone) which also comes in combination with a local anaesthetic, Lidocaine. When used together the Lidocaine results in almost immediate but temporary pain relief, for approximately 1 hour. It is more useful as an aid to diagnosis rather than an anaesthetic for the injection itself.

An anaesthetic is not usually required, as this would essentially involve a needle and injection for yet another needle and injection. Despite this we do possess a short acting freeze spray which can be utilised if required.

The effect of the steroid injection takes 1 day to begin but it can improve symptoms for weeks to months. It can also lead to complete resolution of symptoms.

Please inform the GP Surgeon if you:

  • Are taking any medication especially those to thin your blood e.g. Aspirin, Clopidogrel, Dipyridamole or Warfarin
  • Have any known allergies especially to anaesthetics
  • Have a pacemaker or similar implanted device
  • Have any metalwork or joint replacements in the vicinity of the injection
  • Have problems with lying flat for up to ten minutes
  • Have problems with wound healing or suffer with any medical conditions that may affect a wound e.g. Diabetes or Rheumatoid Arthritis
  • Would prefer a chaperone

After the steroid injection you may have a dressing over the wound. Please keep the dressing clean and dry for 1 day after which time it can be removed. Please avoid soaking the dressing in the bath.

Although the vast majority of people have no problems after a steroid injection, the following may occur:

  • Pain / discomfort / heat

Occasionally the pain can worsen for the first 2 days (post-injection flare). Take some paracetamol, ibuprofen or co-codamol unless you are allergic or have problems with this medication. Please avoid aspirin. Sometimes the injection site can also feel hot for this time. Here an ice pack can be very useful.

  • Bleeding

It is not unusual for a small amount of bleeding to occur immediately after a steroid injection. If there is excessive bleeding please apply firm pressure directly to the injection site for 10 minutes. If the bleeding persists contact your GP, the Out of Hours Service (through your normal GP practice’s number), the Walk in Centre or the Casualty Department as appropriate.

  • Infection

If you have any worsening stiffness, swelling or redness after the steroid injection or green / yellow discharge then you may have an infection. Please contact your GP, the Out of Hours Service (through your normal GP practice’s number), the Walk in Centre or the Casualty Department as appropriate. You do not always require antibiotics for a mild infection.

  • Damage to underlying structures

Depending on the site of the injection there may be a small risk of damage to structures under the skin. You will be fully informed if your injection is close to any vital structures. Rarely a steroid injection in close proximity to a tendon could lead to its rupture. This is more common if post-injection advice is not followed.

  • Skin change

A steroid injection can sometimes cause depigmentation and thinning of the overlying skin.

Even less frequent side effects are:

  • Facial flushing for 2 days
  • Disturbed diabetic control for 2 weeks
  • Menstrual irregularity for 1 month
  • Allergy is very rare but you will be asked to remain in the waiting room for a short time after the injection.

You should not drive immediately after the steroid injection. You should also take things easy for 2 days, keep active and the joint moving but avoid heavy tasks. If possible, please do not undertake the repetitive activity, which caused the symptoms for 1 week as this exacerbates the pain.

Steroid injections can be repeated for the same condition no more than 3 times a year. Please be aware that too frequent steroid injections into weight bearing joints can damage the joint cartilage.

We occasionally send out questionnaires to ask your opinions of the service. This helps us to improve. I thank you for your attention in advance. If you have visual difficulty please ask the receptionist for this leaflet in an alternative format.

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