Joint Injections (Steroid And Viscosupplementation)
What is a Steroid Joint Injection?
A steroid injection involves the use of a corticosteroid along with an anesthetic numbing agent, such as bupivacaine or lidocaine, in the joint capsule of the painful joint. Corticosteroid injections are intended to reduce inflammation in the region and relief can from days to years.
Injections can be performed in the following areas:
- Knee, ankle, and foot
- Shoulder, elbow, and hand
- Hip joint
- Sacroiliac joint and coccyx
- Facet joints of the spine
Who can receive a steroid joint injection?
Joint injections may be given to treat conditions that result in an inflammation of the joint e.g. gout, osteoarthritis, bursitis, tendonitis, psoriatic arthritis, rheumatoid arthritis, etc. This procedure is usually recommended for those who do not respond to other, more conservative, treatments e.g. rest, physical therapy, oral anti-inflammatory medications, etc.
Steroid joint injections should not be performed on individuals who are pregnant, have bleeding problems, or have an infection. This procedure may also elevate the blood sugar levels of diabetics, and it can also temporarily increase blood pressure or eye pressure for patients with glaucoma, so it is important to consult with the physician prior to having it done.
What happens during the procedure?
This procedure can last between 15-45 minutes. The patient is first administered a local anesthetic at the injections site. With aid from a fluoroscope, a form of an x-ray machine, the doctor guides the needle through the skin and into the site responsible for the pain. A contrast solution may or may not be injected to confirm that the needle is in the right location. Although there may be some discomfort during this process, patients often feel the pressure more than the pain. After the needle is correctly positioned, the corticosteroid medications are injected into the joint (or joints), along with the local anesthetic.
What happens after the procedure?
Most patients can walk around immediately after the procedure and they can typically resume full activity the next day. You may experience some pain as the numbing medication wears off and before the corticosteroid takes effect, but any soreness around the injection site can be treated with Tylenol and ice.
What are the risks?
Steroid joint injections are a nonsurgical treatment with very few risks. The risks associated with inserting a needle into the skin include headache, bleeding, infection, allergic reaction, and nerve damage (extremely rare).
Corticosteroids may also cause temporary weight gain, hot flashes, insomnia, mood swings, water retention, and elevated blood sugar levels for diabetics.
Individuals who have chronic conditions –diabetes, heart disease, glaucoma, rheumatoid arthritis, uncontrolled blood pressure, etc.—or are on anti-clotting medications should consult with the physician for a risk assessment prior to having anything done.