Guided Corticosteroid Injections

The injection will help to confirm that your symptoms arise from the area injected. The steroid is a long-acting anti-inflammatory and aims to provide relief from your symptoms.

Preparation

No specific preparation is required, and you may eat and drink before and after the procedure. If you are on any regular medication or have diabetes and are on insulin, take your usual medicines and diet.

Please tell us if you are on medication to thin your blood (e.g. Warfarin, Aspirin or Clopidogrel), or are pregnant or breastfeeding.

It is a good idea to wear clothing that allows easy access to the area that is being imaged.

Procedure

The skin and covered ultrasound probe will be cleaned with antiseptic. A fine needle will be inserted using an aseptic technique. With the use of the ultrasound, the needle is guided into the area that your doctor has asked us to inject. A long-lasting anaesthetic (e.g. Ropivacaine) and a long-acting steroid (e.g. Celestone) are most commonly injected together, meaning there is only one needle insertion.

Risks / Side effects

Ultrasound guided injections are generally safe.

Potential risks include infection within the soft tissues or joints. Occasionally there may be a reduction in the skin pigmentation at the needle site or thinning of the fat pad.

Repeated injections may weaken the tendon or cartilage.

Side effects include:

• Increase in symptoms (pain) for up to 48 hours which will then settle.
• Increased blood sugar levels in diabetics.
• Local bruising.
• Insomnia, flushing and palpitations.

You may experience some benefit from the local anaesthetic immediately following the injection, which will usually wear off after 2-3 hours. It can take several days for the steroid to begin to work and may take up to 2-3 weeks for it to have maximum effect.

The effect of the steroid can last for a week, several months or years. Sometimes, there is no pain relief from the injection.

Avoid strenuous activity for at least 48 hours after the injection. Further rest of the area may help. Follow the advice of your referring doctor or physiotherapist.

If required, a simple analgesic such as paracetamol (Panadol) or anti-inflammatory should be sufficient. An ice-pack may also provide some relief.

Infection is uncommon, but it is a serious side effect. If you notice any fever or redness, swelling, or increased pain at the injection site after the first two days, notify your referring doctor or immediately call the clinic where the injection was performed.