Steroid Injection for Joints

Steroid Injection for Joint Pain

Overview

Cortisone injections are among the most frequently used treatments in the medical field for musculoskeletal and orthopedic conditions. Injections of corticosteroids are minimally invasive treatments that provide transient analgesic relief for joint inflammation-related pain. Injectable therapy serves two functions: first, it can be employed as a diagnostic instrument to ascertain whether the source of the discomfort is the joint itself. Cortisone injections also serve to alleviate pain, reduce inflammation, and modulate the immune system, all of which are adverse effects induced by a range of conditions such as shoulder, hip, and knee arthritis.

What is a steroid joint injection?

Cortisone injections, alternatively referred to as corticosteroid injections or steroid injections, are a fundamental component of conservative and non-surgical therapeutic approaches employed by pain management professionals to alleviate bodily inflammation and discomfort. Drugs that simulate the effects of cortisol, a hormone produced naturally by the adrenal glands, are called steroids. Steroids alleviate joint pain by decreasing joint inflammation, which includes redness, heat, and edema, as well as by inhibiting the activity of the immune system. A variety of inflammatory diseases and conditions are treated with steroids, which alleviate pain and inflammation in the soft tissue, joints, and muscles.

Who is a candidate?

Injections of corticosteroids are commonly administered to patients suffering from the following medical conditions:

arthritis, discomfort in the shoulder, hip, or knee, tendinitis of the rotator cuff, tennis elbow, and bursitis.

Patients who do not exhibit a satisfactory response to alternative conservative interventions, including physical therapy, oral anti-inflammatory drugs, or rest, are commonly advised to undergo joint injections.

What conditions can be treated with steroids?

Injections of corticosteroids administered directly into the site of pain, such as particular joints or tendons in the shoulder, hip, elbow, or knee, can effectively reduce inflammation and alleviate pain and edema. The analgesic effects may persist for several days to years, affording the opportunity to engage in physical therapy and an exercise regimen aimed at enhancing the biomechanics of the afflicted joint.

Regarding musculoskeletal disorders, steroid injections are administered to alleviate or eradicate discomfort that is linked to a diverse range of conditions, including:

• Facet joints of the spine
• Sacroiliac joint and coccyx
• Hip joint
• Shoulder, elbow, and hand
• Knee, ankle and foot
• Muscle strain
• Tendinitis and Tenosynovitis (such as plantar fasciitis, Tennis and Golfer’s elbow)
• Osteoarthritis
• Bursitis
• Nerve pain (such as carpal tunnel syndrome)

What happens before treatment?

The treatment plan will be reviewed by the pain specialist prior to administering a cortisone injection. The physician will examine your medical history and previous imaging during this consultation, as well as discuss your expectations regarding pain relief and whether additional medications, physical therapy, or lifestyle modifications will be required as follow-up care.

It is essential to consult with all of your physicians regarding your medications, including the prescribing physician and the physician who will administer the injection. Patients on aspirin or any other blood thinner are typically instructed to discontinue use of these medications several days prior to the procedure.

The procedure is typically conducted in a medical office environment with the assistance of fluoroscopy or ultrasonography.

What happens during treatment?

Injections of cortisone may be administered via a variety of routes. These consist of:

Intra-articular injections: a corticosteroid is injected directly into the joint by your physician. These are examples of local infusions.When performing intra-articular injections, it is customary to combine a local anesthetic with a steroid.

Intramuscular injections: involve the direct insertion of a corticosteroid into a muscle by your physician. Injections that target inflammation in multiple regions of the body are referred to as “systemic injections.”

Epidural injections: involve the administration of a corticosteroid by a physician in close proximity to the spinal canal with the aim of mitigating inflammation in the region of the spine. By doing so, pain associated with spinal conditions such as spinal stenosis, herniated disks, and injuries to the spinal nerves can be alleviated. This procedure resembles local injection. For epidural injections, your physician will likely combine a corticosteroid and a local anesthetic.

It is consistently advised to employ sterile technique when administering injections. Extra caution is required to reduce the potential for infection, and this is particularly critical when administering intra-articular injections.

The procedure consists of several steps:

Step 1:

To prepare the epidermis, an antiseptic agent is applied. Injecting a local anesthetic, such as lidocaine, into the area undergoing treatment to reduce pain and immobilize the area during the procedure.

Step 2:

Under the guidance of an ultrasound machine or fluoroscope (a specialized X-ray), your physician will insert the needle through the epidermis and into the painful area. The physician is able to monitor the needle’s trajectory in real-time using radiological equipment, such as a fluoroscopy or ultrasound monitor, to guarantee precise administration of the cortisone dose to the site of pain. Small needles are utilized, and local anesthetic is frequently combined with cortisone, resulting in minimal distress throughout the procedure. The majority of patients experience pressure rather than discomfort.

Step 3

The administration of anesthetic and corticosteroid medications into the joint capsule occurs when the catheter is appropriately positioned. A number of joints may be injected, contingent upon the site of the discomfort.

What happens after treatment?

When cortisone is injected, joint or tissue disease-related pain is frequently alleviated or reduced. A transient, moderate discomfort may occur at the site of injection following the procedure; nevertheless, patients frequently return home immediately following the injection. What are the effects of an injection of cortisone? Injecting a potent dosage of cortisone directly into the inflamed or sore tissues or joints induces an immediate reduction in inflammation. Patients may initially encounter pain for a limited duration of several days; however, as the pain subsides, they are able to resume certain activities that were previously unfeasible. Due to the risk factors associated with cortisone, physicians typically restrict injections to every six months.

What are the risks?

Similar to any medical procedure, the administration of cortisone is not devoid of potential risks.

Consequences and potential hazards associated with cortisone injections consist of:

• Traumatic effects of recurrent intra-articular injections on cartilage, tendons, and ligaments
• Pain resulting from a response to the steroid’s crystallized structure is referred to as post-injection steroid flare.
• Heat, tenderness, and inflammation at the injection site
• Adrenal suppression or adrenal gland dysfunction
• Bruising or bleeding
• Damage to cartilage or nerves
• Elevated glucose levels
• Infection
• Menstrual fluctuations
• Discoloration of the epidermis and atrophy (abnormal shrinkage) of the skin or fat
• Sleep issues
• Acute spinal pain induced by epidural sessions

What is the quantity of injections required?

While there is no scientifically established maximum number of cortisone injections an individual is permitted to receive, it is generally advised to limit administration to no more than three injections into the same body part within a twelve-month timeframe. Furthermore, it is improbable that additional cortisone injections will be efficacious if a sustained period of time has elapsed since the failure to respond to a sequence of three injections.

How long do the injections need to take effect?

How often do they last?

Localized inflammation can be effectively suppressed with cortisone injections for a duration of six weeks to six months. It will be contingent upon the patient, the treated condition, and subsequent care.