Steroid Injections

Corticosteroid (cortisone), are hormones located within the body and are responsible for the regulation of inflammation, metabolism, immune function, as well as salt and water balance. When a joint/soft tissue becomes inflamed and the body cannot respond to reduce the inflammation, steroid injections can be used to assist in reducing inflammation and swelling at the structure.

Steroid injection consists of small amount of corticosteroid that has an anti-inflammatory action and local anaesthetic which numbs the area temporarily. Injections into soft tissues and joints can be very effective in giving pain relief when the tissue is inflamed. It is known as a local injection because it acts only in that area and does not travel around the body.

A cortisone injection can be used at any point during a treatment plan but generally are used when conservative first line treatments such as footwear advice, stretching, low level laser therapy, mobilisation or bespoke orthoses have had only limited success.

Cortisone injections can be used on the following conditions

  • Neuromas
  • Joint pain
  • Arthritis
  • Plantar Fasciitis and other heel pains excluding Achilles Tendonitis.
  • Sinus Tarsi Syndrome

The effect of the steroid is usually felt within 1 to 2 days but can be up to 10 days after the injection. The steroid provides up to six months of relief, however this duration is dependent on each patient.

Patient Information

What is a corticosteroid?

A medicine which can relieve swelling, stiffness and pain by reducing inflammation.

Why don’t I just take anti-inflammatory pills?

You can, but the side effects of these are much more common and can cause stomach upsets and bleeding. These injections bypass the stomach and are much more effective.

Are there any times I should not have an injection?

Yes, if you:

  • Are hypersensitivity or allergy to any of the drugs used: risk of anaphylaxis
  • Have sepsis – local or systemic infection
  • Are reluctant to have the injection
  • If you are under 18
  • Had a recent fracture
  • Have a prosthetic joint
  • Are pregnant
What are the possible side-effects?

These are very rare and your clinician will discuss them with you:

  • Post injection flare
  • Skin atrophy/depigmentation/bleeding
  • Tendon atrophy/rupture
  • Infection – if the area becomes hot, swollen and painful for more than 24 hours you should contact your clinician or doctor immediately
  • Facial flushing
  • Menstrual irregularity
  • Impaired diabetic control
  • Temporary bruising if you are taking blood thinning medication

You will be asked to wait for 30 minutes after the injection to ensure there is no allergic reaction to the drug

Is the injection painful?

Not particularly, as your podiatrist has had intensive training in the technique. Sometimes it can be sore for a few hours, but you will be told what to do about this.

How fast does the injection work?

If local anaesthetic is also used the pain should be less within a few minutes, though it may return after about an hour. The steroid usually starts to work within 24-48 hours but may take longer.

How long does the effect last?

This varies from person to person and the condition being treated, but the steroid usually continues working for 3 to 6 weeks.

How many injections can I have?

This depends on the part of the body involved and will be decided by your podiatrist and yourself. Usually one injection is sufficient, but if the pain is severe or has been there for a long time, you may need more.

What should I do after the injection?

If the problem was caused by overuse, you will probably be told to rest the area for about a week; if it is a joint pain, you may start early gentle movement.

When will I have to be seen again?

Usually your podiatrist will want to see you again about a week or ten days after the injection. You will then be given appropriate exercises for you to do at home. You will also usually be reviewed a month after the injection to monitor the long term effect of the treatment.