Corticosteroid Injections

Corticosteroid Injections

What Are Corticosteroid Injections?

Corticosteroid injections (often referred to as “steroid injections” or “cortisone injections”) are anti-inflammatory medications that can be injected into a joint, tendon sheath, bursa, or around other soft tissues to help reduce inflammation and pain.

Corticosteroids are synthetic versions of cortisol, a hormone naturally produced by the body. When delivered directly to the affected area, they can help reduce local inflammation, decrease pain, and improve movement and function.

Steroid injections are not a cure for the underlying condition, but they can provide a valuable window of pain relief that allows patients to engage more effectively with rehabilitation, exercise, and self-management strategies. Evidence suggests that corticosteroid injections can be effective in reducing pain and improving function in selected musculoskeletal conditions, particularly where inflammation is a significant contributor to symptoms. (Guy’s & St Thomas’ NHS Trust)

What Are the Benefits of Corticosteroid Injections?

For appropriately selected patients, corticosteroid injections may provide:

• Reduced pain and inflammation
• Improved joint movement and function
• Reduced stiffness
• Improved ability to participate in rehabilitation and exercise programmes
• Improved quality of life and daily function
• Reduced reliance on pain medication
• In some cases, diagnostic information by helping determine the source of symptoms

Many patients experience symptom improvement within a few days, although the timing and duration of benefit vary between individuals and conditions. Relief may last from several weeks to several months. (nhs.uk)

Conditions Commonly Treated

Corticosteroid injections may be considered for a variety of musculoskeletal conditions, including:

Shoulder

• Frozen shoulder (adhesive capsulitis)
• Subacromial pain syndrome
• Rotator cuff-related shoulder pain
• Acromioclavicular joint pain

Elbow

• Tennis elbow (lateral epicondylalgia)
• Golfer’s elbow (medial epicondylalgia)

Hand and Wrist

• Trigger finger
• De Quervain’s tenosynovitis
• Thumb base osteoarthritis

Hip

• Greater trochanteric pain syndrome (gluteal tendinopathy/bursitis)

Knee

• Osteoarthritis
• Pes anserine bursitis (Baker’s Cyst)

Foot and Ankle

• Plantar fasciopathy
• Certain inflammatory tendon and soft tissue conditions

Not all musculoskeletal conditions benefit from corticosteroid injections, and treatment recommendations are based on a detailed clinical assessment and current evidence. (Bupa)

Risks and Potential Side Effects

Corticosteroid injections are generally considered safe when performed by appropriately trained healthcare professionals, but as with any medical procedure, risks and side effects can occur.

Common and Temporary Side Effects

• Mild discomfort during the injection
• Temporary increase in pain (“post-injection flare”) for 24–72 hours
• Facial flushing
• Temporary changes in blood glucose levels in people with diabetes
• Temporary increase in blood pressure

Less Common Risks

• Skin thinning or changes in skin pigmentation around the injection site
• Fat atrophy (small depression beneath the skin)
• Bleeding or bruising
• Infection
• Allergic reaction

Tendon and Soft Tissue Considerations

Corticosteroids can temporarily weaken tendon and soft tissue structures. For this reason, patients are advised to follow post-injection activity guidance carefully, and injections are not recommended into certain tendons because of the risk of tendon rupture. Repeated injections into the same area may increase this risk. (United Lincolnshire Hospitals)

Limitations of Corticosteroid Injections

While corticosteroid injections can be highly effective for some patients, they have limitations:

• They do not correct underlying structural problems.
• Benefits are often temporary and vary between individuals.
• Some conditions respond better than others.
• Repeated injections into the same area may not be appropriate.
• Injections should be considered as part of a broader treatment plan rather than a standalone solution.

At the Clinic of Musculoskeletal Medicine and Injection Therapy, injection therapy is integrated with exercise prescription, education, and self-management advice to maximise long-term outcomes.

When Might a Corticosteroid Injection Not Be Suitable?

A corticosteroid injection may not be recommended if you:

• Have an active infection
• Have a suspected infection within a joint
• Have a known allergy to the medication being used
• Have certain uncontrolled medical conditions
• Have significant bleeding disorders or are taking certain anticoagulant medications
• Have recently received certain vaccinations
• Are pregnant or breastfeeding (individual assessment required)
• Have had surgery within the last 6 weeks or are due for surgery in the next 6 weeks
• Are considering surgery in the local area of injection within the next 6 months
• Where metalwork/prosthetic is present in the local area

Patients with diabetes may experience a temporary rise in blood glucose levels following injection and should discuss this during assessment. All potential risks, benefits, and alternatives will be discussed before treatment. (nhs.uk)

Our Approach

Every patient receives a comprehensive musculoskeletal assessment before any injection is considered. This ensures that treatment recommendations are tailored to the individual and based on the best available evidence.

Where appropriate, corticosteroid injections are combined with exercise prescription, and self-management strategies to support long-term recovery, improve function, and help patients return to the activities that matter most to them.