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I am worried about having a steroid injection!

This is a common fear patients have so we have put some information down to assist you in deciding as to whether to have such a treatment.

We produce steroid naturally within our body and it works effectively to reduce inflammation. However, too much steroid is bad for your body.

Why would you consider having a steroid injection?

Steroid injections can work fantastically as they deliver steroid (a powerful anti-inflammatory) directly to the inflamed area within your body, which is exactly where we would like the steroid to be. The steroid is delivered in an effective dose and in a form which is designed to stay maximally in the location into which it was injected.
An alternative is of course to take an anti-inflammatory medication such as Ibuprofen or Diclofenac. These treatments so have their rightful places, but do deliver a much smaller effective dose of anti-inflammatory to where they are needed and also deliver the medication to your entire body to places where it is not needed. Some patients with generalised conditions do take steroid tablets and for these conditions they are very valuable and the benefits outweigh the disadvantages. However, these disadvantages are considerable so the types of conditions primarily treated by Orthopaedic Surgeons rarely are prescribed steroid tablets.

Is the steroid injection bad for my whole body?

There is a very small amount of steroid which will enter your whole body due to an injection but it is a very small amount indeed as the injected steroid is designed to stay where it is injected. This naturally makes sense: we want the steroid where it is needed and not anywhere else. Therefore, the effects on your whole body are minimal and certainly considerably less than taking steroid tablets or anti-inflammatory tablets over a longer period.

Is the steroid injection bad for the area where it is injected?

The steroid does have the risk of accelerating “wear and tear” type changes in the area where it is injected. However, the benefits to the injected area usually outweigh the disadvantages as reducing the inflammation is often good for the body tissues involved.
The adverse effects of the steroid are dose dependent and therefore we only injected a modest amount of steroid and most commonly only perform one injection. Certainly, repeated multiple injections aren’t advisable – not only would that be too much of a disadvantage but clearly, if you have had several injections and they haven’t produce a long-term improvement, then it sound unlikely that further injections of steroid will produce that long-term outcome you are after.

Is the steroid injection a “temporary band-aid”?

I think of any treatment I am offering as trying to produce a long term, preferably permanent outcome. There is always a risk of a steroid injection not working, and a risk of it working and then wearing off after a period, however for most patients we are aiming for a resolution of the problem with the injection.
Often you can have a tendon running in a tunnel which is inflamed and swollen and therefore is being irritated which causes further inflammation and swelling and so you get a vicious circle set up. Often a steroid injection can break that vicious circle causing the problem to get better.
Occasionally, a steroid injection may not be used to provide a long-term benefit but to work out if the location of the injection is where the problem is. In such a scenario, I would let you know that the injection is less likely to be a solution to your problem but to help us work out what your exact condition is causing your symptoms.

Are there other risks of an injection?

Yes of course. Everything in life has some risks attached to it but the risks of an injection are certainly considerably less than for instance surgery. The biggest risks are of the injection not working and of infection, although the latter is uncommon.

My friend or family member had a steroid injection and it didn’t work!

All steroid injections have a chance of not working adequately or working for a period of some days / weeks or months and then wearing off. Some areas of the body which are injected are more prone to not working and therefore we are less likely to consider doing injections and some areas injected tend to work well and are well worth trying.

An example I would propose is trigger fingers. If you have a trigger finger, then a single injection has a really good chance of getting rid of your problem. However, if you also have diabetes this halves your chance of the injection working and may alter your blood sugar levels for a period so we would be less likely to injected a diabetic person’s trigger finger but it would still be worth considering. However, if you have a trigger finger and in the past, have had a carpal tunnel decompression on that hand then an injection is very unlikely to work and would be best avoided.

In Summary

So, as you can see we use science and logic in deciding who and where and when an injection would be worth considering. Ultimately, in a consultation we can discuss all the issues relevant to your condition and your needs and decide what is right for you. If you would like to discuss steroid injection and how it might assist with your condition please contact our rooms to make an appointment.