Steroid injections, often referred to as cortisone shots, involve the administration of synthetic corticosteroids to help alleviate pain and reduce inflammation in targeted areas of the body.
These corticosteroids mimic cortisol, a natural hormone produced by the adrenal glands, but they differ from anabolic steroids used by some athletes.
Healthcare providers may recommend steroid injections to address joint inflammation, rheumatoid arthritis, lupus, severe allergies, asthma, and other inflammatory conditions.
Common corticosteroids used include prednisone, methylprednisolone, and cortisone.
Mechanism of Action
When the body sustains an injury or illness, the immune system triggers inflammation as a protective response.
Normally, this inflammation subsides once healing begins, but chronic conditions can result in persistent inflammation and discomfort.
Corticosteroid injections work by temporarily suppressing the immune response, thereby reducing inflammation and alleviating pain.
Although they do not heal the affected area directly, they enable individuals to participate in rehabilitation therapies, such as physical therapy, that facilitate long-term recovery.
How Are Steroid Injections Administered?
Steroid injections are delivered via a needle, with the process varying based on the treatment area.
Typically, the doctor injects the medication directly into the affected site, sometimes using a local anaesthetic to minimise discomfort.
For more complex procedures, imaging techniques like ultrasound or CT scans may guide needle placement to ensure precision.
In certain cases, steroids may be administered through an intravenous (IV) infusion, allowing the medication to circulate through the bloodstream.
Common Injection Sites
Steroid injections are often used to treat localised pain and inflammation. Some of the most common areas for these injections include:
- Feet
- Hands
- Hips
- Knees
- Shoulders
- Spine
When delivered intravenously, the injection is typically given in a vein in the arm, allowing the medication to reach multiple areas affected by inflammation.
Systemic vs. Local Steroids
Steroid treatments can be either systemic or localised. Systemic steroids circulate through the bloodstream to address widespread inflammation, often used for conditions like lupus and vasculitis.
These can be administered through:
- Intravenous (IV) infusion
- Intramuscular injection
- Oral tablets
Local steroid injections, on the other hand, target specific areas of inflammation, reducing the risk of systemic side effects. For example, arthritis in a particular joint may be treated with a direct injection into that joint rather than using systemic medication.
Conditions Treated with Steroid Injections
Steroid injections provide temporary relief for various inflammatory and pain-related conditions, including:
- Sciatica: Alleviates nerve pain caused by spinal compression, often administered up to three times annually.
- Plantar Fasciitis: Reduces inflammation in the connective tissue at the bottom of the foot, easing heel pain.
- Keloids: Helps shrink raised scar tissue resulting from surgeries, piercings, acne, or injuries.
- Bursitis: Treats inflammation of fluid-filled sacs (bursae) that cushion joints, commonly affecting shoulders, hips, knees, and elbows.
- Tendinitis: Relieves pain and swelling in tendons caused by overuse or strain, often affecting the elbows, shoulders, and knees.
- Arthritis: Eases joint inflammation in areas like the hands, feet, knees, spine, and hips.
- Autoimmune Diseases: Helps manage inflammation associated with lupus and multiple sclerosis.
- Back Pain: Addresses nerve-related spinal pain that radiates to the limbs.
- Carpal Tunnel Syndrome: Reduces swelling around the wrist’s median nerve.
- Trigger Finger/Thumb: Treats tendon-related issues causing stiffness and locking.
Benefits of Steroid Injections
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Steroid injections offer a safe and effective way to manage pain and inflammation.
Unlike oral or IV steroids that affect the entire body, localised injections deliver medication directly to the problem area, minimising systemic side effects.
Duration of Effectiveness
The relief provided by a steroid injection depends on several factors, including the condition being treated, its severity, and the location of the injection.
Many patients experience relief for three to six months or longer, though some may require additional treatments if symptoms return sooner.
Potential Side Effects
While steroid injections are generally safe, they can cause side effects, including:
- Temporary pain or swelling at the injection site
- Bruising
- Short-term increase in blood sugar levels, particularly for individuals with diabetes
- Skin discolouration at the injection site
- Insomnia or temporary hyperactivity
- Facial flushing for a few days
Less common side effects include:
- Infection at the injection site
- High blood pressure
- Fluid retention and swelling
- Hiccups
Risks of Frequent Steroid Use
Repeated steroid injections over time may lead to more serious risks, such as:
- Osteoporosis (weakened bones)
- Adrenal gland suppression, causing fatigue, dizziness, and muscle weakness
When to Avoid Steroid Injections
Steroid injections may not be suitable for everyone. Your doctor will assess your medical history to determine if they are a safe option for you.
You should avoid steroid injections if:
- You have a broken bone, as steroids may hinder healing.
- You have an upcoming surgery, as steroids can impact surgical outcomes and wound healing.
- You have a severe spinal condition causing numbness or weakness, as pain relief may mask worsening symptoms that require surgery.
- You have an infection, as steroids suppress the immune system and can make infections worse.
- You take blood thinners or have a bleeding disorder, increasing the risk of bruising and bleeding at the injection site.
How Often Can You Get Steroid Injections?
Doctors generally recommend waiting at least three months between injections and limiting them to no more than three per year.
Frequent use increases the risk of complications, such as osteoporosis.
Role of Steroid Injections in a Treatment Plan
Steroid injections are often used alongside other treatments, including pain medications, anti-inflammatory drugs, physical therapy, and supportive devices like braces or canes.
While they provide temporary relief, they work best when combined with other therapeutic approaches to address underlying conditions.
Key Takeaways
Steroid injections are a valuable tool for managing pain and inflammation. While effective for many conditions, they are not a permanent solution and must be used cautiously.
Consulting with a healthcare professional about your medical history and current treatments is essential before proceeding with steroid injections.
