Cortisone Injections

What are cortisone injections/steroids used to treat?

Therapeutic

Cortisone injections are used for therapeutic treatment in reducing inflammation and pain in an area of need. Cortisone injections can be an effective form of treatment when treating a number of conditions including, but not limited to conditions such as back pain, bursitis, osteoarthritis, tendinitis and other forms of joint related pain and discomfort.

Diagnostic (+/- Therapeutic)

Sometimes it can be difficult to determine where pain originates from. In these instances, they can be used to confirm or exclude a suspected joint/region being the cause of the pain or contributing to the pain.

How long does a cortisone injection last?

Every patient reacts differently to the cortisone injection. The outcome of this depends on the treatment area, the patient, and how often cortisone injections are required.

How is the cortisone injection performed?

If you have not had a prior ultrasound, an expert musculo-skeletal Sonographer or Dr Berman (specialist musculo-skeletal radiologist) will usually start by taking a history, examining the painful area and scanning the area of concern.

Once the region of discomfort is identified the procedure is performed. The skin is cleaned with an antiseptic agent. Then under ultrasound control, the area of concern will be injected with a combination of steroid and local anaesthetic mixed together in a single syringe. Depending on the region to be treated, an initial injection of local anaesthetic into the skin and subcutaneous tissues will be performed first.

Will I experience any discomfort during the injection?

Overall, most patients experience minimal discomfort throughout the injection. However, the degree of discomfort during the injection varies depending on a number of factors such as the area to be injected, degree of inflammation in the area, number of injections required (usually one), previous experiences with injections and whether or not the patient has a fear of needles.

Will I experience discomfort after the injection?

There can also be a slight increase in pain in the injected area for a day or two afterwards. This usually occurs once the local anaesthetic has started to wear off, but the steroids have not yet had time to work. This discomfort is usually mild and is helped with the use of analgesia (such as Ibuprofen and Paracetamol) and cold packs.

How long does the cortisone injection take to work?

Usually it takes 2-3 days for the steroids to start taking effect. Patients will usually start to experience gradual improvements over 1-2 weeks, with the maximum effect at the 2-3 week mark. After the procedure what you will be able to do will depend on the area injected and reason for the treatment.

How long after a cortisone injection can I exercise or move freely?

Light duties and limited exercise will be recommended for about a week. This will be discussed at the time of treatment or you may be referred back to your referring medical practitioner for appropriate aftercare. If you have any questions or concerns after treatment please contact Dr Berman or your referring doctor.

How effective are steroid injections?

The response to treatment varies from patient to patient and depends on several factors including: the body part injected, background problems such as local inflammation in an otherwise normal joint versus a flare-up of an arthritic joint. Overall this can be a very effective treatment. This improvement can be quite dramatic in many cases.

What is injected?

The typically used is CELESTONE CHRONODOSE or DEXAMETHASONE (occasionally other agents such as Kenocort are used depending on different doctor’s preference). These are not “anabolic” agents. Their use in sport is permitted as long as they are not injected systemically (i.e. not intramuscular, intravenous, rectally or orally).

What are the risks and side effects of a cortisone injection?

For most patients the injection procedure is usually well tolerated and adverse reactions are rare. However, there are several risks and side effects to be aware of which include:

1. Redness of the skin:

• This is usually of nuisance value only. This usually affects the face (especially cheeks) and uncommonly the chest. The skin feels hot to the touch and the patient feels warm. This usually starts on day 1-2 and lasts for about 2 days. Very uncommonly, this can start about a week later and lasts for a couple of weeks. May feel “flu-like” symptoms. No treatment is usually required. Occasionally antihistamines are used.

2. Insulin Dependent Diabetics:

• Steroids can interfere with glucose control. Usually for a few days, but occasionally for a couple of weeks. Extra care regarding blood sugar monitoring and control is essential. If concerned with the control of your sugar levels please contact your regular treating physician (at times an alternative drug Ketoralac, an anti inflammatory, can be used).

3. Insomnia for one night:

• This is common for some patients and usually resolves within 24 hours after the procedure has been performed.

4. Infection:

• This is rare! Signs/symptoms include: pain (increasing after 2-3 days at injection site), redness, swelling, temperature and feeling of unwellness. If you experience any of these symptoms it is advised that you consult with your doctor as soon as possible.

5. Tendon Rupture:

• A reported risk if the steroid has been directly injected into the tendon.

6. Other side effects:

• These are uncommon or rare; Allergy to the cortisone or the anaesthetic, bandaid or antiseptic solution. Localised skin and subcutaneous fat atrophy (leads to skin dimpling) or hypo pigmentation at the injection site.

Contact Our Clinic

For more information about our cortisone injections or any of our other services please contact our team on 03 9561 5155 or email us at info@sportsradiology.com.au

Additional Information

Download a Patient Information Brochure
Patient Fact Sheet on Steroids/Cortisone