What is a steroid (corticosteroid) injection?

Steroid injections are a type of anti-inflammatory treatment. They are also called corticosteroid injections.

Steroid injections are not the same medicine as anabolic steroids.

Corticosteroid injections are only available with a prescription from your doctor. They are usually given by a doctor.

What conditions can steroid (corticosteroid) injections treat?

Steroid injections can be used to treat joint and muscle conditions such as:

• osteoarthritis — a common condition that causes stiff and painful joints
• bursitis — when the fluid-filled sac that cushions a joint becomes inflamed
• carpal tunnel syndrome — caused by pressure on a nerve in your wrist
• sciatica — a type of pain that starts in your back and goes down your leg
• tendonitis — when you have an inflamed tendon or tendons, such as in your shoulder, elbow or wrist

This article focuses on steroid injections given into joints. These are called ‘intra-articular injections’.

Other uses for steroid injections

Steroid injections can also be used to treat a range of other conditions. These include autoimmune conditions such as multiple sclerosis — an illness that damages your nerves.

Injections for these other conditions may be given into a muscle or intravenously (through a drip into a vein).

Steroid injections are also sometimes given during pregnancy if you are at risk of having a premature baby. This helps your baby’s lungs to develop.

How are steroid (corticosteroid) injections given?

Steroid injections can be given into your joints and surrounding soft tissues. This can help relieve pain and swelling and make movement easier.

Before you get a steroid injection into a joint, your doctor will explain the procedure and any risks involved. They will check if you have any conditions that would mean a corticosteroid injection would be unsuitable.

Your doctor may ask you to sign a consent form.

Your steroid injection can be given by a doctor in:

• a clinic
• an imaging (x-ray) department
• a hospital

The injection may also contain a local anaesthetic. This will give you immediate pain relief that will last a few hours.

X-ray or image-guided joint injections

Sometimes, steroid joint injections are done with imaging guidance. That means an ultrasound or CT scan is used to help guide the needle into the right place.

This may be needed for joints that are hard to access, such as your hip joint. A radiologist would usually give the injection in this case.

These procedures may take about one hour. You should be able to go home soon after you get the injection.

How does a steroid (corticosteroid) injection work?

Corticosteroid injections into or around joints help reduce inflammation. They can help relieve pain, swelling and stiffness in your joint.

Corticosteroid injections work in the same way as the hormone cortisol. This hormone is naturally produced by your adrenal glands.

Steroid injections normally take a few days to start working. Their effect usually wears off after a few weeks to months.

What types of medicines might I be prescribed?

Examples of steroid medicines that are commonly used for intra-articular injections (steroid injections into joints) include:

• Betamethasone acetate plus betamethasone sodium phosphate
• Methylprednisolone acetate
• Triamcinolone acetonide

You doctor will decide which medicine is right for you.

You can usually take pain-relief medicines such as paracetamol or ibuprofen after having a steroid injection.

These medicines can help treat some of the common side effects of steroid injections.

What are the side effects or risks of a steroid (corticosteroid) injection?

There are several possible side effects from corticosteroid injections.

Side effects at the site of the injection

The most common side effects of steroid injections where the injection was given are:

• pain
• swelling
• bruising

These side effects should also go away after a few days.

It helps to rest your joint for 24 hours after the injection and avoid heavy exercise.

Some people also have changes in the colour of the skin at the site of the injection.

A joint infection — called septic arthritis — is a rare, but serious, complication.

Other side effects from steroid injections

Even though the injection is given into your joint, you can still have some general side effects from corticosteroids. They can include:

• raised blood sugar levels for a few days after the injection, especially if you have diabetes
• sleep problems
• flushing of your skin (often the face)

If you have high blood pressure, your blood pressure may go up for a few days after the injection.

These side effects are more common if you take corticosteroids by mouth or have them injected into your bloodstream.

Long-term side effects of steroid injections

There are concerns that repeat injections can increase the loss of cartilage in a joint. Also, repeat steroid injections do not improve your symptoms when given long-term.

Your doctor will consider these factors before suggesting a corticosteroid injection.

When should I see my doctor?

Talk to your doctor if you have questions about the benefits and risks of steroid injections.

Choosing Wisely Australia suggests that you ask your doctor the following 5 questions before any procedure:

1. Do I really need this treatment?
2. What are the risks?
3. Are there simpler, safer options?
4. What happens if I don’t do anything?
5. What are the costs?

Are there any alternatives to this medicine?

There are other things you can do to help sore or swollen joints.

It might help to:

• exercise more
• use hot and cold treatments on your joint
• use a walking aid, such as a stick or frame, if your walking is affected
• use a TENS (transcutaneous electrical nerve stimulation) machine

If you are overweight and have knee pain due to arthritis, losing some weight (even a small amount) can help improve the pain. You could also ask a physiotherapist or occupational therapist for advice.

Other medicines

Depending on your condition, there may be other medicines and treatments that can help with your joint pain.

Pain-relief medicines can help with painful joints. These medicines include:

• paracetamol
• anti-inflammatory medicines (NSAIDs)

You can buy these over-the-counter (without a prescription). NSAIDs are available as tablets or capsules that you swallow. You can also use a cream or gel that you apply to the skin over the painful joint. Always talk to your doctor or pharmacist before starting a new medicine.

Resources and support

Call 1300 MEDICINE on 1300 633 424 to talk with a pharmacist about steroid (corticosteroid) injections.

The Pain Management Network has information to help you develop the skills and knowledge to self-manage your pain. They also have resources for Aboriginal people.

Arthritis Australia has information about arthritis, including in languages other than English. You can also call the Arthritis Infoline on 1800 011 041.

MyJointPain is a free resource to help relieve symptoms of osteoarthritis (OA) or joint pain and better manage your condition.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.