What is it?
Steroids are substances that are naturally found in the body that perform many important and different functions. As medications, they can help with a variety of different problems from respiratory disease to autoimmune conditions.
In Sports and Musculoskeletal medicine, they can help with pain related to joints, tendons or nerves through their localised anti-inflammatory and immune-suppressing effects.
Usually, the steroid is combined with a local anaesthetic to help the clinician determine whether the site of injection is where your pain is coming from through the more rapidly actions of the anaesthetic.
What does it involve?
The injection is usually delivered through a hypodermic needle into the joint or tissue that requires treatment. To optimise delivery, ultrasound guidance can help the clinician ensure that the needle is directed to the exact site.
Your clinician will usually take your consent before the procedure, so that you understand why it is being performed, and ensure that the procedure is undertaken with a clean and safe approach.
What can be treated?
Different problems can be treated with a steroid injection, including
- Impingement (shoulder, knee, hip etc)
- Plantar fasciitis
- Joint pain (knee, shoulder, facet etc)
What are the benefits, risks, and side effects?
Benefits include reduction of pain and an improvement in function.
Risks include those common to all injections which are infection, pain and bleeding at the injection site.
Common side effects include a temporary flare of the pain (typically 48-72 hours), thinning and whitening of the overlying skin, there can be a temporary increase in blood glucose, gastric irritation and for women there may be a change in the menstrual cycle or spotting afterwards. Others are possible but these need to be discussed on an individual basis.
What do I need to do afterwards?
It is important to offload the injection site and rest from activities for a period of time. The time frame may vary according to where the injection was performed and for what reason.
For injections close to tendons or the plantar fascia, a more protracted offloading may be required, particularly with repeat injections.
What are the common misconceptions?
Steroids are often given bad press due to the association with body-wide side effects and their close cousin anabolic steroids. While they may share some commonalities, if they are used carefully, with due consideration and careful discussion with your clinician, these injections can be an important step in your treatment with minimal risks to the individual.