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Steroid (Cortisone) Joint Injection Advice

Steroid (cortisone) joint infection advice

Locally injected steroids can be useful in the treatment of inflamed joints and inflammation of soft tissue.

They do this by potently suppressing the inflammation, reducing pain and swelling and shrinking the swollen tissue particularly in the short term.

They are called local because they act only in the injected area.

  • Common conditions treated
    • Inflammation of soft tissue: ligaments (including plantar fasciitis), nerve irritation (including neuroma/ tarsal tunnel syndrome) tendon (tenosynovitis), soft tissue lumps and bumps (including ganglions/ bursitis) and scar pain/ sensitivity


    • Joint pain: localised joint inflammation (synovitis), arthritis (including osteo/ rheumatoid/ gout/ pseudogout)
  • Will the injection be painful?

    The podiatrist may include a local anaesthetic to make the injection more comfortable, but nevertheless it may still be painful at the time and may give rise to pain after the local anaesthetic has worn off. You may get a flare of pain for up to 48 hours after the injection. This is unusual and it will wear off in a couple of days.

  • How quickly will it work?

    Most people will find the pain easier within the first 24 – 48hrs and this can last from a few weeks to a few months.

  • Frequency of injections

    There is no absolute rule regarding the maximum number of injections but we recommend no more than two injections into one area and only if there is an appropriate clinical response.

  • What are the alternatives to an injection?

    Your podiatrist will discuss the different treatment options available to you.

  • Post injection advice

    It is advisable to rest the joint or affected part for two to three days after injection. Try not to undertake any of the previous movements or activities that you know irritates the problem. After this, a slow return to normal activity is recommended. It is advised not to return to vigorous sporting activity for at least 2-3 weeks after your injection.

  • Side effects

    Side effects are very unlikely, but regular and frequent injections may result in the increased likelihood of undesirable effects occurring.

  • Possible side effects of steroid injections

    Although very rare, some side effects include:

    • Some thinning of skin at the injection site
    • Some loss of colour at the injection site
    • Flushing of the face
    • Your symptoms may flare up for 24-48 hours. This will settle quickly.
    • Menstrual cycle change
    • Joint swelling
    • Mood changes (feeling low or high)
    • Tendon rupture (remember to rest if told to do so)
    • Fainting at time of injection
    • Lowering of your immune system
    • Bleeding: this could be a bruise or could be a bleed inside the joint
    • Infection: very rare, but if you get any of the following within 3 weeks after the injection, you should get in touch with ED or doctor straight away: worsening pain at injection site, the area is red, hot, swollen or tender, you get a temperature or feel unwell.
    • Allergy: patients can very rarely have a severe shock reaction to the injected drugs.
    • Diabetic: If you are diabetic it may alter your sugar levels, so increased monitoring may be necessary.
    • Anticoagulants: If you are on anticoagulants (e.g. warfarin), you have an increased risk of bleeding. Please bring your yellow card to your appointment with you. You will need to have an INR reading within a week of your planned injection and should have your INRs closely monitored post injection.
    • Live vaccines: Patients should not have a live vaccine within 2 months of receiving the steroid injection (eg. MMR, varicellar-zoster)