Steroid Injection

Steroid injections are used to help relieve the pain and swelling associated with many types of arthritic conditions, including both inflammatory arthritis and osteoarthritis. Injecting a steroid in or around the joint is an effective way to locally reduce pain and swelling.

Steroid injections are injected directly into a joint or around a tendon.

If the first injection works well then you may benefit from another. There is some debate that too many injections may weaken tendons and ligaments and damage cartilage. As a general rule, the number of injections is limited to three or four for any single joint per year.

Corticosteroids are a class of medications that are synthetic forms of cortisone, a naturally occurring hormone in the body. Cortisone plays a role in reducing inflammation. When corticosteroids are injected directly into a joint, they can help to reduce swelling, redness, and pain at that site. 

Most injections typically take full effect in 24 to 48 hours. If local anesthetic (“freezing”) is given with the injection, you may feel improvement rapidly. After the injection, it is normal to feel a temporary increase in discomfort in the joint, which should be resolved within 24 hours. If possible, it is best to rest the joint for 24 to 48 hours after an injection, as studies have shown this may improve the effect of the injection.

The length of time an injection will last is variable. Some patients can feel better for months while others find only a few days of relief.

For the most part, steroid injections are very safe and suitable for most people. Anyone who has had a serious allergic reaction to steroids and those with an infection in the joint or surrounding the joints (e.g., skin or soft tissues), should not receive injections.

If the injected area becomes very painful, red or swollen, call your health-care provider. If your health-care provider is not available, seek medical attention as these symptoms suggest infection (a rare side effect of steroid injections).

Steroid injections can rarely cause injury to a joint or tendon. Please discuss these risks with your health-care provider.

After an injection some patients feel “flushed.” This usually isn’t serious, but let your health-care provider know if this should happen.

Steroid injections can sometimes cause a rise in blood sugar, particularly if you have diabetes. If you have diabetes make sure you test your glucose levels regularly for a few days after the injection and let your prescriber know if there are any abnormal changes.

Steroid injections rarely cause changes to the skin where the medication was injected. One rare change is the loss of pigment in the skin (skin turns white). This is more common in individuals with dark skin. Another rare change is the loss of the fat layer below the skin, causing the skin to turn a purple colour.

If possible, rest the joint for 24 to 48 hours after the injection.

If you experience discomfort in the joint after the injection, you may treat the discomfort by applying a cold pack or by using medications, such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs) — check with your health-care provider.

On occasion, your health-care provider may request routine blood tests after you have been given a steroid injection. If you have diabetes your prescriber may recommend monitoring your blood sugars regularly for a few days after the injection.

Your health-care provider may meet with you regularly to ensure that the steroid injection is adequately controlling your pain and not causing adverse effects.

Store this medication at room temperature (15 to 30 degrees Celsius) and keep it out of reach of children.