Cortisone Injections
What is a cortisone injection?
A cortisone injection, also known as a steroid injection, is a procedure where a synthetic form of cortisol (a naturally occurring hormone) is injected directly into a specific area of the body to reduce pain and inflammation.
Why are cortisone injections used?
Cortisone injections are commonly used to treat a variety of conditions that cause localized pain and inflammation, including:
- Arthritis: Osteoarthritis, rheumatoid arthritis, psoriatic arthritis, and gout.
- Tendonitis: Inflammation of a tendon.
- Bursitis: Inflammation of a bursa (a fluid-filled sac that cushions joints).
- Back pain: Often related to nerve inflammation or joint issues in the spine.
- Carpal tunnel syndrome: Compression of a nerve in the wrist.
- Tennis elbow: Pain on the outside of the elbow.
- Trigger finger/thumb: A condition affecting tendons in the fingers or thumb.
- Autoimmune diseases: In some cases, to manage localized inflammation.
The anti-inflammatory is long lasting - with the effects up to 3 months - however it may not begin working for several (2-7) days following the injection.
How do I prepare for a cortisone injection?
You should wear comfortable clothes that are easy to remove. You may be asked to change into an examination gown and remove any jewellery or other metallic objects around the examination area.
When you make your appointment, please inform our staff if you are taking any blood thinning medication (e.g. Warfarin, Eliquis, Pradaxa, Xarelto, Plavix, Aspirin). Blood thinners may need to be stopped for a short period of time before certain procedures are carried out. It is very important that you do not stop taking them without being instructed to do so by your referring practitioner. You will be advised of any such instructions when making your appointment.
It may be necessary for somebody to drive you home, but you may eat and drink normally. Our staff can advise you on what you will need.
What happens during the procedure?
The interventional radiologist will clean the injection site and may use a local anesthetic to numb the area. The cortisone medication, often mixed with a local anesthetic for immediate pain relief, is then injected. Ultrasound or CT guidance will be used to ensure accurate placement of the needle. You might feel some pressure or stinging during the injection. For epidural and nerve root injections, IV contrast may be used to confirm the correct site before the medication is administered.
What happens afterwards?
You'll likely be advised to rest the injected area for a day or two. Avoid strenuous activity for at least 48 hours after the injection. For those that undergo a nerve root injection, numbness in the legs or arms may occur for several hours but will resolve once the local anaesthetic in injection wears off.
The local anaesthetic may give pain relief initially but will wear off after a few hours and the pain may return.
The effect of the steroid can last for a week, several months or years. Sometimes there is no pain relief from the injection. It can take several days for the steroid to begin to work and may take up to 2 weeks for it to have maximum effect.
If required, a simple analgesic such as paracetamol (Panadol) or anti-inflammatory should be sufficient. An ice pack may also provide some relief.
Your results
You'll receive a written report via your doctor as soon as possible. To help your doctor understand if the injection targeted the source of your pain, please pay attention to your pain levels both before and after the procedure and inform them of any improvement.
Important considerations
Cortisone injections primarily treat the symptoms (pain and inflammation) and not the underlying cause of the condition.
The number of cortisone injections a person can receive in a year is generally limited due to potential side effects, such as cartilage damage with repeated injections.
Side effects can occur, although they are often mild and temporary. Common side effects include pain at the injection site, temporary increase in swelling, bruising, facial flushing, and sleep disturbances. Less common but more serious side effects include infection, nerve damage, tendon weakening, and skin changes at the injection site.
It's important to discuss the potential benefits and risks of a cortisone injection with your doctor to determine if it's the right treatment option for your specific condition.
