Cortisone injections (also called steroid injections) are used for joint problems and arthritis. It involves the injection of cortisone medication such as triamcinolone, dexamethasone or methylprednisolone directly into a joint space, to reduce inflammation (swelling) and pain.
When are cortisone injections given?
Cortisone is a substance similar to a natural steroid hormone produced by the body. Cortisone injections are given into a painful joint to reduce pain and swelling in conditions such as gout, rheumatoid arthritis, osteoarthritis, tendinitis and tennis elbow.
They are used when:
- there is a flare-up or the pain in the joint is not responsive to other treatments
- other medications cannot be used.
They provide short-term pain relief, usually for up to a month, but do not improve joint function or stiffness.
Avoid regular repeated injections
Cortisone injections are used as short-term relief and regular. Repeated steroid injections are not recommended. Frequent injections into the same area can cause the bone, ligaments and tendons to weaken over time. Generally, cortisone injections are not given more often than 3 or 4 times a year and they are at least 6 weeks apart.
Cortisone injections available in New Zealand
The following are examples of cortisone injections available in New Zealand:
- betamethasone (Celestone Chronodose®)
- dexamethasone (DBL Dexamethasone Sodium Phosphate®)
- methylprednisolone (Depo-Medrol®)
- triamcinolone (Kenacort-A®).
The injection procedure
- Before giving the cortisone injection, your doctor will remove excess fluid from the joint using a syringe and needle.
- The fluid is examined by your doctor and a sample is sent to the laboratory for diagnosis.
- Removing the fluid reduces pressure in the joint. This helps relieve pain and may encourage the joint to heal.
- A separate syringe and needle are then used to give the cortisone injection.
- The cortisone slowly starts to act over 24-36 hours. The beneficial effects may last for days or months.
- A local anaesthetic may also be given. This helps relieve pain immediately and lasts for 3 to 4 hours while the cortisone is beginning to take effect.
Care after the injection
- After you've had a cortisone injection, rest the joint for about 24 hours and avoid excessive movement or stress on the joint for about one week.
- Sometimes there is increased pain in the joint after the injection, which settles within 24 hours. To relieve the discomfort you should rest, apply ice and take pain relievers such as paracetamol (or as advised by your doctor).
Possible side effects
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The following links have more information on steroid injections. Be aware that websites from other countries may have information that differs from New Zealand recommendations.
Celestone Chronodose Medsafe Consumer Information, NZ
Kenacort-A Medsafe Consumer Information, NZ
Local steroid injections Arthritis Research, UK
Steroid Injections Patient Info, UK
Joint injections (joint aspirations) American College of Rheumatology, US
- Local corticosteroid injections New Zealand Formulary