Most people can have steroid injections. However, a clinician should always be consulted before treatment and you should inform them if you have experienced any of the following:

• Had a steroid injection in the last few weeks. You usually need to wait 6 weeks between injections

• Have had an allergic reaction to local anaesthetic previously

• Have an infection or soon to have any vaccinations

• Are pregnant, breast feeding or trying to fall pregnant

• Have any other pre-existing conditions

• Are taking any other forms of medication

• Taking warfarin or other blood thinning medication

Ultrasound is very useful to assess the joints, tendons and ligaments for any suspected injury or inflammation. In addition, it allows for direct visualisation of the needle to ensure the steroid medication is injected into the exact targeted site.

There is a significant evidence that ultrasound guided injections provide better levels of pain relief and longer effects compared with injections done without imaging guidance. This is because ultrasound guidance allows for accurate placement of the needle and thus delivery of the medicine to the exact site of pathology. Performing the injection under ultrasound guidance allows for visualisation of the adjacent structures and reduces the risk of tissues injury at the injection site.

A steroid injection usually takes a few days to start working, although some evidence suggests it can start working after a few hours.

There is a significant body of research which demonstrates that ultrasound guided injections give better outcomes such as improved levels of pain relief, longer lasting benefits, and improve the post-injection function of the injected area, compared with injections that are done without ultrasound guidance ( e.g.blind/surface marked injections). There is also growing evidence that guiding the injection reduces the risk of trauma to local tissues or misplacement of the needle and/or the injection substance. This improves the safety of the injection and reduces the risk of adverse events associated with injection therapy. Because the location of the injection is more precisely known it reduces the chances of having unnecessary injections. Many patients find ultrasound guided injections to be more comfortable as often the required depth of the injection can be reduced

Steroid injection can be very effective for an number of musculoskeletal pain conditions. For a more comprehensive see list below.  Common injections include frozen shoulder, carpal tunnel syndrome, osteoarthritis of the knee, trigger finger / thumb, osteoarthritis of any joint around foot or hand, localised soft tissue inflammation or tenosynovitis, such as de Quervains  or tendon inflammation at the shoulder. We also provide a range of Ostenil and Durolane (hyaluronic acid) injections which can be very beneficial to patients with degenerative joint pain (such as osteoarthritis) who are keen to keep moving and active.

Most people have intra articular steroid injections without any significant side effects.

Possible side effects from an intra articular steroid injection include:

• Pain and discomfort for a few days. This is sometimes referred to as a steroid flare. Simple pain killers like paracetamol can help with this.

• Temporary bruising due to small blood collection under the skin at the site of injection

• Infection. This is very rare but important to be aware of. It is reported to happen in less than 1 in 10000 of cases. The symptoms of infection are pain, swelling and redness at the site of injection. Sometimes patient may also have a fever. Get medical advice as soon as possible if you have these symptoms.

• Injury to structures close to the injection site. This is rare with ultrasound guidance.

• Local thinning of the fat at the injection site. This can cause dimples in the skin and can be permanent.

• Local change in colour (usually lightening) of the skin at the injection site. This can be permanent.

• if you have diabetes, your blood sugar level may temporarily increase.

• If you have high blood pressure, your blood pressure may temporarily increase.

• Temporary facial flushing.

• Other side effects like mood changes, increased appetite, difficulty in sleeping and menstrual disturbance are very rare with intra articular injections and more associated when the steroids are taken as tablets, injected into the muscle (intra muscular) or into the blood (intravenous).

You should discuss this with your doctor but repeated steroid injections can increase the risk of the side effects. There is also some concern that repeated intra articular steroid injection might cause damage to the cartilage. Therefore, steroid injections are usually not performed more than 3-4 times a year into the same body part.

It is a very safe procedure. All radiologists working for Prime Health are experienced, FRCR accredited clinicians and work within a sub-speciality area of interest.

In line with World Health Organisation guidelines, additional safety policies have been introduced by Prime Health and our clinicians must now consider any risks posed by COVID-19. You will be asked to complete a questionnaire and the healthcare professional will need to determine that the benefits of the steroid injection, especially if you are over 70 70 or with co-morbidities, outweigh any risk of infection.

Currently, we are primarily a self paid service. We are continuously liaising with the various health insurance providers and we will update this section accordingly.