Corticosteroid/local anaesthetic injection

What is in the injection?

The injection is normally a combination of a corticosteroid and a local anaesthetic. A corticosteroid is a medicine which can relieve swelling, stiffness and pain in an area. This is often combined with some local anaesthetic to help with pain relief. This may be administered as a combined injection or as two separate injections.

What are these injections used for?

They are used to help reduce the pain and swelling in conditions affecting the muscles, tendons and other soft tissues, as well as for arthritic conditions such as rheumatoid or osteoarthritis.

How do I have a corticosteroid injection?

Your clinician will choose the most appropriate dosage of medication for your condition and symptoms. The injection is performed in the clinic and is normally a quick and easy process.

What are the possible side effects or risks of these injections?

Side effects are very rare. Your clinician will discuss them with you. They can include:

• Allergic reaction.
• Temporary flare-up of your symptoms .
• Flushing of the face for a few hours.
• Small area of fat loss or a change in colour of the skin around the injection site.
• Diabetic patients may notice a temporary increase in blood sugar levels.
• If you are taking blood thinning drugs there may be some temporary bruising.
• Infection: if the area becomes hot, swollen and painful for more than 24 hours you should contact your doctor immediately.
• Slight vaginal bleeding.
• Tendon weakening or rupture.
• Stomach pain or vomiting.
• Chest pain or breathlessness.
• Headaches or fatigue.
• Painful or swollen veins.
• Visual disturbances.
• Psychiatric effects or abnormal thoughts or behaviour.
• Pneumothorax (if having suprascapular nerve injection).

If you experience any of the above side effects, or notice any other unusual effects not mentioned in this leaflet, tell your doctor immediately.

Are there any times I should not have an injection?

You should not have an injection if you:

• have any infection on your skin or anywhere else in your body
• have had an allergic reaction to local anaesthetic or steroid or any of the excipients
• feel unwell
• are due to have surgery at the area soon
• are pregnant
• are under 18
• do not want an injection
• have had a recent injury to the area
• are already taking oral steroid drugs

How long do the injections take to work?

The injections can work immediately in some people, although can take up to one to two weeks to provide some relief in others. If the joint is painful after the injection, often a simple painkiller such as paracetamol should help at this time.

How long do they work for?

On average eight weeks.

Can I have more than one injection?

You can have more than one injection, but we recommend no more than two within a two year period. The first injection is usually most effective.

What will happen after the injection?

• You may be asked to wait for a few minutes after the injection to ensure you have no allergic reaction to the drug.
• You will be given a steroid card if you have more than two injections or are on multiple routes of steroids (this includes via oral and inhaled routes).
• You may wish to avoid any strenuous activity with the injected joint for the first one to two days. It is important though that you continue to perform any exercises given to you by your physiotherapist or doctor.
• You will be asked to arrange a further appointment within the clinic so that the clinicians can review the benefits of the injection.

Who do I contact if I am concerned following the injection?

If you are feeling unwell following your injection, it is advisable to contact your GP. Alternatively, the patient advice and liaison service (PALS) are able to give some advice on 01223 216756.