Steroid injections are a well-established treatment used to help reduce pain and improve movement in joints, tendons and soft tissues.
At The London Ultrasound Clinic, steroid injections are offered as part of a careful musculoskeletal assessment. Where appropriate, injections are performed using real-time ultrasound guidance to improve accuracy, comfort and safety.
This leaflet explains what a steroid injection is, what happens during your appointment, what to expect afterwards, and how to look after yourself following treatment.
What Is a Steroid Injection?
A steroid injection uses a corticosteroid medication, which is a type of anti-inflammatory medicine designed to calm irritation and reduce pain in a specific area of the body.
Pain in joints and tendons is often related to local inflammation rather than damage alone. By placing the medication directly into or around the painful structure, treatment targets the problem area rather than affecting the whole body.
Steroid injections can help reduce pain, ease stiffness and make everyday activities such as walking, dressing, sleeping and working more comfortable.
They are commonly used for conditions such as osteoarthritis, frozen shoulder, bursitis, tendon-related pain, plantar fasciitis, carpal tunnel syndrome, trigger finger and shoulder impingement.
Relief often begins within a few days, although for some people it can take longer. The duration of benefit varies. Some people experience relief for weeks or months, while others may notice little or no improvement.
Your Appointment
Your appointment is designed to be calm, thorough and efficient.
It usually includes a detailed discussion about your symptoms, medical history and how pain is affecting your daily life, followed by a hands-on examination of the area causing concern. An ultrasound scan may be used to assess joints, tendons and surrounding soft tissues and to help confirm the cause of your symptoms.
If a steroid injection is appropriate, it can often be carried out during the same visit. Not everyone needs an injection. If it is not the right option for you, this will be explained clearly and alternative advice will be provided.
Why Ultrasound Guidance Is Used
Ultrasound allows the clinician to see exactly where the medication needs to be placed.
Using ultrasound guidance helps to improve accuracy, avoid nearby nerves and blood vessels, and make the procedure more comfortable. It also increases confidence that treatment is delivered to the correct area.
What Is Injected?
The injection usually contains a corticosteroid medication to help reduce pain and inflammation, along with a small amount of local anaesthetic to numb the area and improve comfort. The medication used is selected based on your condition and medical history.
What Does the Injection Feel Like?
Most patients describe the injection as a brief sharp sensation similar to a blood test, followed by some pressure. Any discomfort usually settles quickly. The area may feel numb or heavy for a few hours if local anaesthetic is used.
Possible Risks and Side Effects
Steroid injections are generally very safe. Most side effects are mild and temporary.
Possible effects include mild bruising or soreness at the injection site, a temporary increase in pain within the first 6 to 12 hours known as a post-injection flare, and temporary skin changes such as lightening or thinning around the injection area.
Some people notice short-term changes in mood, sleep or facial flushing. People with diabetes may experience a temporary rise in blood sugar levels.
Repeated injections into the same area may increase the risk of local tissue weakening. Severe allergic reactions are extremely rare. For safety, patients remain in the clinic briefly after the injection.
Please tell your physiotherapist if you have previously reacted to steroids or local anaesthetic, have diabetes, take blood-thinning medication, are pregnant or breastfeeding, or are feeling unwell or have an active infection.
Breastfeeding
If you are breastfeeding, steroid injections are generally considered safe. The amount of steroid that passes into breast milk after a local injection is very small and is not expected to cause harm to your baby.
If you have any concerns, please discuss them with your physiotherapist before the injection.
Further information is available from the Breastfeeding Network. https://www.breastfeedingnetwork.org.uk/factsheet/steroid-injections/
After the Injection
Patients are usually asked to remain in the clinic for a short period after the injection as a precaution, although serious reactions are extremely rare.
After leaving the clinic, some soreness is normal and can be managed with ice and simple pain relief if needed. Improvement often begins within a few days but may take up to two weeks.
Activity and Rest
Resting the treated area helps the injection work effectively.
You will usually be advised to rest the area injected for 24 to 48 hours. For joint injections, strenuous or high-impact activity should be avoided for around 7 to 10 days. For tendon injections, heavy or repetitive loading should be avoided for 10 to 14 days. A gradual return to activity is recommended.
Your clinician will guide you on rehabilitation and next steps.
Driving After an Injection
Driving advice depends on the area treated and how you feel.
After upper limb injections, driving is usually safe once normal movement and sensation return. After lower limb injections, it is generally advised to avoid driving for 24 to 48 hours. Do not drive if you feel uncomfortable, weak or unsure of your control.
When to Seek Medical Advice
Please contact the clinic, your GP or NHS 111 if you experience increasing pain, redness, swelling or warmth after several days, or if you feel unwell or develop a fever.
Seek urgent medical attention if you develop symptoms of a severe allergic reaction such as difficulty breathing, swelling of the lips or throat, dizziness or collapse.
Questions or Concerns
If you have any questions before or after your appointment, please contact The London Ultrasound Clinic. We are always happy to help and support you through your care.
References
- Uson J, RodrÃguez-GarcÃa SC, Castellanos-Moreira R, OâNeill TW, Doherty M, Boesen M, et al. EULAR recommendations for intra-articular therapies. Annals of the Rheumatic Diseases. 2021;80(10):1299â1305.
- MacMahon PJ, Eustace SJ, Kavanagh EC. Injectable corticosteroid and local anaesthetic preparations: a review for musculoskeletal practice. Radiology. 2009;252(3):647â661.
- Cushman DM, Kobayashi JK, Wheelwright JC, English J, Monson N, Teramoto M, et al. Prospective evaluation of pain flares and time until pain relief following musculoskeletal corticosteroid injections. Sports Health. 2023;15(2):227â233.
- McMorrow K, Allahabadi S, Frazier L, Quigley R, Serrano B, Cole BJ. One to two days of rest is recommended before returning to sport after intra-articular corticosteroid injection in the high-level athlete. Arthroscopy, Sports Medicine, and Rehabilitation. 2023;5(5):100763.
- Chakravarty K, Pharoah PD, Scott DG. A randomised controlled study of post-injection rest following intra-articular steroid therapy for knee synovitis. Rheumatology. 1994;33(5):464â468.
- Derendorf H, MÃļllmann H, GrÃŧner A, Haack D, Gyselby G. Pharmacokinetics and pharmacodynamics of glucocorticoids after intra-articular administration. Clinical Pharmacology & Therapeutics. 1986;39(3):313â317.
- Choudhry MN, Malik RA, Charalambous CP. Blood glucose levels following intra-articular steroid injections in patients with diabetes: a systematic review. JBJS Reviews. 2016;4(3):e5.
- Versus Arthritis. Steroid injections: patient information booklet. Available at: www.versusarthritis.org
- Chartered Society of Physiotherapy. Therapeutic Injection Therapy in Physiotherapy Practice. 6th edition. London: CSP; 2021.
- British Orthopaedic Association. Guidance on intra-articular injections and post-injection activity. BOA Clinical Guidance.