Steroid  Joint injections: FAQs

Corticosteroids are hormones naturally produced by our bodies and are crucial for normal daily physiological function. One of their many roles includes reducing inflammation, which they are incredibly good at. When you have a steroid injected directly into your joint, the medicine acts exactly where it is needed, and very little of it gets absorbed by the rest of the body - this means that there are minimal side effects. Steroid injections have been used for decades to reduce the inflammation and pain from arthritis, bursitis and several other musculoskeletal conditions.

Steroid injections reduce inflammation in a specific area of the body. They contain a synthetic version of cortisol – a hormone naturally produced by your adrenal glands. When injected into a joint or soft tissue, the steroid calms the immune response that causes swelling, pain, and stiffness. This can help relieve symptoms and improve movement, especially in conditions like arthritis, bursitis, or tendonitis.

How long do they take to work?

Some people feel relief within a day or two, especially if the inflammation is mild. For others, it can take up to a week to notice improvement. The response varies depending on the condition being treated, how long you’ve had it, and your overall health.

The effect can last anywhere from a few weeks to several months. If it wears off, that doesn’t necessarily mean the injection hasn’t helped – sometimes it gives enough of a window to make rehab, exercise, or other treatments more effective.

For most causes of joint or soft tissue pain or injury, rehabilitation (physiotherapy) will be the best long-term treatment because it addresses the root cause of the problem. Many people find this very hard to stick to or to get started with especially if the pain is too much. Steroid injections can give you enough relief to get started with your exercises.

Steroid injections are commonly used to treat joint and soft tissue problems caused by inflammation. These include:

• Osteoarthritis – especially in knees, hips, shoulders, hands and feet

• Rheumatoid arthritis and other inflammatory joint conditions

• Frozen shoulder

• Tennis elbow and golfer’s elbow

• Bursitis – such as hip or shoulder bursitis

• Trigger finger

• Carpal tunnel syndrome

• Plantar fasciitis and other foot pain

They can be a useful option when other treatments like rest, physiotherapy, or medication haven’t provided enough relief.

Steroid injections aren’t the right choice for everyone or every condition. They may not be suitable if:

• There’s an active infection near the injection site or elsewhere in the body

• You’ve had too many injections in the same area recently (there’s a limit to how often they can be used safely)

• The pain isn’t caused by inflammation – steroids work by reducing inflammation, so they’re most helpful when swelling or irritation is part of the problem. If your pain is due to something else such as structural damage or instability, alternative approaches are likely to be better

• You have certain medical conditions like uncontrolled diabetes or bleeding disorders

• You’re allergic to the steroid or any part of the injection

• You’re pregnant, in some cases (depending on the location and type of steroid used)

If a steroid injection isn’t suitable, there are often other ways to help manage your symptoms – including physiotherapy, tailored exercise, activity modifications, or other types of medical treatment. We’ll work with you to find the best approach for your situation.

Like any medical treatment, steroid injections can have some risks or side effects, although serious problems are rare. Most people tolerate them well, but possible side effects include:

• Temporary flare-up of pain for a day or two after the injection (this usually settles quickly)

• Skin changes at the injection site – such as thinning, dimpling, or lightening of the skin

• Increased blood sugar levels – especially in people with diabetes (usually temporary)

• Facial flushing or a warm feeling for a few hours

• Changes to menstrual cycles or mood (less common)

• Infection – very rare, but always a possibility with any injection

• Tendon weakening or rupture – if the injection is placed in or very near a tendon, which is why careful technique and correct diagnosis matter

• It may not work - this is a possibility with any treatment. You are a unique human being and what works well for one person may not work for you. This is why it is important to discuss your options with an experienced clinican who takes a personalised approach and tries to work out what is MOST LIKELY to work best for you.

Steroid injections are generally very safe when performed by an experienced clinician, for the right reasons. As a highly trained Doctor, I use a personally tailored, evidence-based approach to maximise benefit and minimise risk – and I’ll always talk you through the pros and cons of all options before proceeding.

There’s usually not much you need to do beforehand, but a few simple steps can help make the process smoother:

• Wear loose, comfortable clothing, e.g. shorts or a vest top, that allows easy access to the area being injected

• Bring a list of your medications, especially if you're on blood thinners, steroids, or diabetes medication

• Let us know if you have any allergies, recent infections, or health conditions like diabetes or a bleeding disorder

• Avoid strenuous activity on the day of the injection and for 24–48 hours afterwards

• Arrange for someone to drive you, if the injection may affect your mobility (e.g. foot or leg injection), or if you're nervous about needles

You don’t need to fast or stop eating. The procedure is usually quick and will be done in the clinic. We’ll talk you through everything on the day and make sure you’re comfortable throughout.

If for any reason you or I decide not to go through with the injection, you will only pay for the consultation fee.

What happens after the injection?

Most people can go home shortly after the injection and return to normal daily activities the same day. However, there are a few things to keep in mind:

• You might feel some soreness or a temporary increase in pain for a day or two – this is called a steroid flare and usually settles quickly.

• It’s best to rest the injected area for 24–48 hours, avoiding heavy lifting or high-impact activity. This gives the steroid its best chance of working in the area that it was injected.

• Use pain relief if needed, such as paracetamol.

• The full effect of the steroid may take a few days to kick in – sometimes up to a week.

• We’ll usually follow up to check how things are going and whether you’ve had any improvement.

If you develop significant redness, swelling, significantly increasing pain, or feel unwell after the injection, contact us or seek medical advice, as this could be a sign of infection (though it’s very rare).

What happens during the procedure?

Steroid injections are usually quick and straightforward, and most people find them only mildly uncomfortable. Here’s what to expect:

• First, we’ll identify the exact area to be treated and clean the skin

• You may receive a local anaesthetic to numb the area and make the injection more comfortable

• The steroid (often combined with anaesthetic) is then injected directly into the joint or soft tissue using a fine needle under sterile conditions

• The whole process typically takes just a few minutes

• Afterwards, we’ll apply a small dressing and give you time to rest before heading home

In most cases, we will use ultrasound guidance to ensure the steroid is delivered precisely where it’s needed. This improves accuracy, especially for smaller joints or more complex areas, and helps increase the chances of a successful outcome.

You might feel some pressure or a brief sting during the injection, but many people are surprised by how quick and manageable it is. You’ll be given clear aftercare instructions and have the chance to ask any questions before and after the procedure.

Some people feel relief within a day or two, especially if the inflammation is mild. For others, it can take up to a week to notice improvement. The response varies depending on the condition being treated, how long you’ve had it, and your overall health.

The effect can last anywhere from a few weeks to several months. If it wears off, that doesn’t necessarily mean the injection hasn’t helped – sometimes it gives enough of a window to make rehab, exercise, or other treatments more effective.

Most people find steroid injections only mildly uncomfortable, and some are surprised by how quick and manageable the experience is. You might feel:

• A brief sting or pinch as the needle goes in

• A sensation of pressure as the medication is injected

• Occasionally, a temporary increase in pain afterwards (a “steroid flare”), which usually settles within 24–48 hours

We often use a local anaesthetic to numb the area and make the injection more comfortable. If you're feeling nervous, let us know — we’ll talk you through each step and do everything we can to help you feel at ease.

Steroid injections can be very effective, but they need to be used carefully to avoid side effects or long-term tissue damage. As a general rule:

• You shouldn’t have more than 3–4 injections per year in the same joint or area

• There should usually be a gap of at least 3 months between injections in the same site

• The exact number and timing depend on your individual condition, response to treatment, and overall health

In some cases, a single injection may provide long-lasting relief. In others, an injection might be used to reduce inflammation enough to support physiotherapy, exercise, or other long-term treatments.

We’ll always weigh the risks and benefits before recommending repeat injections, and focus on helping you improve movement, reduce pain, and avoid relying on ongoing injections.

Most people can go home shortly after the injection and return to normal daily activities the same day. However, there are a few things to keep in mind:

• You might feel some soreness or a temporary increase in pain for a day or two – this is called a steroid flare and usually settles quickly.

• It’s best to rest the injected area for 24–48 hours, avoiding heavy lifting or high-impact activity.

• Use pain relief if needed, such as paracetamol or a cool pack on the area.

• The full effect of the steroid may take a few days to kick in – sometimes up to a week.

• We’ll usually follow up to check how things are going and whether you’ve had any improvement.

If you develop significant redness, swelling, significantly increasing pain, or feel unwell after the injection, contact us or seek medical advice, as this could be a sign of infection (though it’s very rare).

Steroid injections are safe and effective for many people, but they’re not suitable for absolutely everyone. Whether you can have one depends on your individual health, the nature of your symptoms, and the area being treated.

You may not be suitable for a steroid injection if you:

• Have a current infection (anywhere in the body or at the injection site)

• Have uncontrolled diabetes or other medical conditions that could be affected

• Are on certain blood-thinning medications or have a bleeding disorder

• Have had multiple injections in the same area in a short period

• Are pregnant or breastfeeding, depending on the type and location of the injection

• Are allergic to any of the components of the injection

• Are awaiting surgery or other significant medical procedure within 3 months

Before recommending treatment, we’ll take the time to understand your medical history, symptoms, and goals — and if an injection isn’t right for you, we’ll discuss other safe and effective options.

Not necessarily. Many people experience significant relief after just one steroid injection, especially if the underlying issue is mild or short-term. However, in some cases:

• The effect may wear off over time, and a repeat injection might be considered

• If the condition is chronic or recurring, injections may be used as part of a longer-term management plan

• Sometimes an injection is used to create a window of relief, allowing you to progress with physiotherapy, exercise, or other treatments more comfortably

The goal is always to minimise the need for repeated injections by addressing the root cause of your symptoms. If you do need more than one, we’ll space them out appropriately and monitor your response carefully.

At Active Medicine, we focus on helping you recover for the long term - not just offering a quick fix. If an injection is part of your treatment plan, we’ll combine it with expert guidance on movement, rehabilitation, and lifestyle strategies to support lasting results.

Yes - steroid injections are just one option for managing pain and inflammation. Depending on your condition, there may be several effective alternatives that we can help with, including:

• Physiotherapy – to improve strength, flexibility, and joint mechanics. This is the number 1 strategy for most musculoskeletal conditions and injuries, but it's sometimes hard to get started with it. Whilst I am not a physio, I know several absolutely superb physios who I can recommend to you in a heartbeat - we work well together and often refer each other clients because we respect each other's skills and we know our own limitations. Find a good physio and you will be set for life!

• Tailored exercise programs and exercise prescription - skilled personal trainers, coaches and rehabilitation experts can design training programs to work on several aspects of your fitness and health at the same time, which often improves people's pain in the long term. See our coaching packages for more information on this.

• Hyaluronic Acid injections - a synthetic version of a naturally occuring lubricant substance which lines the joints and encourages the body to produce more of its own (brand names include Ostenil, Cingal, Duralane, Hylavisc)

• Platelet-rich plasma (PRP) injections - we take a small sample of your own blood, and extract out the components which are responsible for natural regeneration and anti-inflammation, and inject them directly to where they're needed.

• Activity modification and pacing – to reduce strain on irritated joints or tissues. This can often link into exercise prescription

• Weight management – in cases where excess weight is contributing to joint load

• Oral medications – over-the-counter medications or prescribed. Not many people like taking medications long-term, not least because of the potential side-effects. Injection therapy can help to reduce the amount of medications that you need to take.

There are of course many other strategies to approach pain and inflammation - it is incredibly complex and personal. These are just the ones in which we can offer our expertise.

Steroid injections can be helpful for short to medium-term relief, especially if pain is limiting your ability to move or progress with rehab. But in many cases, a combination of strategies gives the best results.

We’ll work with you to find the right approach based on your goals, lifestyle, and medical needs.

Insurance coverage for steroid injections can vary depending on your provider, policy, and whether the treatment is done privately or through the NHS.

• If you're using private health insurance, many policies do cover steroid joint injections when they’re medically necessary - but you may need a GP referral or pre-authorisation

• Some policies cover the consultation only, while others include the procedure itself

• If you’re paying out of your own pocket, we’re happy to provide clear pricing upfront so there are no surprises

• We can also give you a detailed invoice or receipt if you’re planning to claim back costs

It’s a good idea to check with your insurer before booking to understand what’s included in your plan. And of course, we’re here to help with any paperwork or codes they might need.