Cortisone Injection

What to know

Cortisone is the name used to describe a group of drugs commonly known as corticosteroids. Cortisone is used to treat pain in various parts of the body where inflammation is felt to be the cause of this pain. The reason why cortisone is effective in treating this pain is because it is a powerful anti-inflammatory.

Does any of the following apply to you? If so please contact us as soon as possible.

You suspect or know that you may be pregnant
You have ever experienced a severe reaction to a previous injection of contrast media
You suffer from asthma or have kidney disease
You are a diabetic

Do you require an interpreter?
Is the patient non-english speaking? If so, we can arrange for an interpreter to be present during the appointment. Please let us know as soon as possible so we can make the relevant arrangements.

Cortisone and local anaesthetic are injected under CT or ultrasound imaging guidance to allow accurate delivery to the area required.

You will need to complete an injection consent form in the clinic, prior to the procedure
Depending on the area requiring the injection, you may lie or sit on the bed for the procedure
Most injections will take around 5 to 20 minutes to complete
The local anaesthetic helps to confirm that the injected area is the source of your symptoms. The anaesthetic should relieve these symptoms for several hours. It is important to keep notes or fill in a pain diary following the injection to give to your referring doctor, as it could help confirm if the area injected is the cause of your pain
The steroid reduces inflammation in the injected area and can take several weeks to take its full effect
If more than one injection has been requested, it is normal practice to perform these on separate visits to help confirm which area is responsible for your symptoms. This can help avoid multiple recurrent injections
Separate appointments also make it easier to rest the injected side. For example, if bilateral (both sides) knee injections are required, it can be hard to rest both left and right knees at the same time.

Cortisone injections are performed in order to reduce or even eliminate pain associated with a variety of conditions such as:

Bursitis (inflammation of the bursa most commonly shoulder and hip)
Arthritis (any joint may be injected, including joints of the spine)
Nerve pain (most commonly for sciatica and carpal tunnel syndrome)
Tendinopathy and tenosynovitis (such as trigger finger, DeQuervain’s tenosynovitis, tennis, and golfer’s elbow)
Other miscellaneous conditions where inflammation is a contributor to the pain, for example plantar fasciitis, frozen shoulder/adhesive capsulitis, Morton’s neuroma, and ganglion cyst injections

As for all medical procedures, there are risks associated with the administration of any medication, including cortisone. The chances of cortisone providing you with the benefit of pain relief in most patients outweighs the risk of experiencing any side effects. The decision to inject cortisone is not taken lightly and is carefully made by your referring doctor and based on prior medical imagining, your specific diagnosis and past medical history. Sometimes where the diagnosis is not clear, a ”diagnostic” injection is given into the body region that is suspected of causing your pain.

The side effects and risks of a cortisone injection include:

Soreness or bruising at the site of injection
If a contrast injection is used to confirm the location of the needle within the joint, there may be an allergy or adverse reaction to iodine contrast. This is usually mild but may rarely be severe
Side effects of the steroid injection may include flushing, insomnia, and increased blood sugar levels in diabetic patients
Infection is an extremely rare but serious complication which can occur.

Yes. Since a cortisone injection is used for treating pain, it is an optional procedure. Other options should be discussed with your referring doctor and may include anti-inflammatory medications, exercise, physiotherapy, and surgery. The role of our specialist radiologist is to perform the procedure requested by your referring doctor and, therefore, ensure that the cortisone is injected safely and into the correct location.

There is no scientifically proven limit for cortisone injections, however as a general rule, three injections into the same body part are permitted over a twelve-month period. Injections more frequent than this could place the injected tissue at risk of softening/weakening, which may be an issue in a joint for example, as this may accelerate arthritis. Also, if you have failed to respond to a series of three injections, then it is probably time your condition was reassessed to find out if the diagnosis is correct.

If you do require more than three injections in a year, then the risk of the injection must be carefully balanced against the benefits of pain relief. Your referring doctor or the doctor at our clinic will be happy to discuss your condition and address any concerns that you may have.