Joint and Soft Tissue Injections Information for Patients Why have an injection? Joint injections can be an effective way of treating some problems of joints and ligaments that are caused by inflammation. Examples of conditions we sometimes treat with injections include:
Carpal Tunnel Syndrome (compression of a nerve as it passes through the wrist) Tennis Elbow and Golfer's Elbow Inflammation of the shoulder joint Plantar fasciitis (inflammation in the heel)
What is injected? We normally use a corticosteroid called Methylprednisolone (Depo-medroneTM). Steroids are very potent anti-inflammatory drugs. They can be associated with lots of side effects if used long term, but the amount we use in an injection is small and highly unlikely to cause problems.
With some injections, we also include a local anaesthetic called lidocaine.
Are there any problems associated with these injections? Complications are rare, but can occur:
Pain: many of the injections are painful at the time and for up to 48 hours
Infection: infection of the skin or joint is very rare. A little redness of the injection
site is normal, but if you develop a temperature, increasing pain, pain persisting more than 48 hours after the injection or worsening redness, you should seek advice from a doctor.
Ligament and soft tissue damage, including tendon rupture: This can occur as
a result of either the needle being inserted or the steroid itself. (For this reason, we would ordinarily only give a maximum of 3 injections at one site and leave at least 4 weeks between injections.)
Joint & Soft Tissue Injection Patient Information Leaflet
Skin Changes: inluding loss of the fat layer under the skin and loss of skin
pigment. This is more common in injections close to the skin, such as injections for golfer's elbow, tennis elbow and plantar fasciitis.
Loss of sensation: if we have used a local anaesthetic, some of this may leak into
one of the surrounding nerves resulting in an area of numbness or tingling. This is most common after an injection for golfer's elbow. The effect should wear off after about 6 hours.
Care after the injection If you do have any pain following the injection, we would recommend simply taking 2 paracetamol 500mg tablets up to four times a day as required.
Avoid activities that may increase pain in the injected area for 48-72 hours after the injection: For example, avoid carrying shopping if you have had a tennis elbow injection. This may require some people needing to take 2-3 days off work if their occupation has a direct impact on the injected site.
Don't try any of the painful movements for a couple of days, after which a slowly increase the amount of movement.
Authors: Dr Jonathan Harness; Dr Christopher Jewitt
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