You may be offered an injection by your doctor to help manage your pain. We are going to look at what they are, how they work and if they are effective.

Corticosteroid is a prescription only anti-inflammatory drug and is different to anabolic steroids used by body builders and athletes.
It is frequently used to treat joint pain, arthritis and soft tissue disorders such as tendon pain or bursitis.

It is administered by a doctor or specially trained physiotherapist or nurse. It is usually combined with a local anaesthetic to numb the area before the steroid is given via the same needle.


How do steroid injections work and how effective is it?

The drug is released slowly into the local area and reduces inflammation which in turn reduces the pain and swelling associated with it. The length of time it works for is variable from a few days to many months and often this depends upon what is causing the pain.

We generally find that if the pain and swelling are relieved this makes it much easier to move the affected area which gives a window of opportunity to allow you to exercise and rehabilitate to gain a longer lasting improvement.


What are the side effects of steroid injections?

  • Pain and swelling in the local area on average lasting up to 48 hours
  • Local bruising
  • There are a few very rare side effects which include infection, allergic reaction and alteration in blood sugar levels.
  • What are the alternatives to steroid injections?
  • Other drugs such as oral anti-inflammatory and painkillers
  • Improving your general fitness can have a profound effect on how you move and feel. If you are new to exercise or returning after injury you may wish to consider Pilates, swimming or walking.
  • Specific exercises to increase the muscle strength around a joint. Physiotherapists are the experts at designing a tailor made exercise programmes.


What does the steroid injection research show?


Knee arthritis pain reduction with steroid injections?

There are very few trials comparing injection to other treatments but the OARSI trial showed that physiotherapy and weight reduction were just as effective as injections and have less side effects.


Tennis Elbow pain reduction with steroid injections?

A trial in Australia found that injection was better than physio in the short term (6 weeks) but in the mid to long term physiotherapy was more effective as there was a high recurrence in the injection group.


Shoulder Pain reduction with steroid injections?

Injections appear to give a significant reduction in pain in the short term but was no more effective than physiotherapy, In the mid to long term physiotherapy was found to be more effective.


In summary – Are steroid injections a shot in the dark?

Injections can be useful in reducing pain and swelling which may give the patient a window in which to move better and rehabilitate to gain a longer lasting improvement. However, they may have side effects which should be taken into consideration when deciding upon treatment options.