What are Corticosteroids and How do They Help With Arthritis Pain?

Injections of corticosteroids are used to treat inflammation in your joints or tendons. We commonly offer them for osteoarthritis, which is a degenerative disease caused by the breakdown of cartilage that protects the ends of the bones and allow them to glide smoothly over each other as you move. Your doctor may also recommend a corticosteroid injection for conditions like tendinitis, bursitis or plantar fasciitis. Sometimes they may be used to treat more widespread inflammation in the body, such as that associated with rheumatoid arthritis or allergic reactions. While steroids don’t treat the underlying causes of arthritis, they can help to relieve the symptoms in the short-term.

Corticosteroid injections are less invasive than other treatments for joint pain, such as key-hole arthroscopic  or joint replacement surgery, and the risks are far lower. They can provide fast, effective reduction in inflammation and can be highly targeted at the affected area to bring about short-term pain relief. Such injections do, however, carry a very small risk of infection and rarely you may develop a flare-up of inflammation/irritation if you react badly to the medication. When used for soft tissue problems, the site of the injection may become sore afterwards and the skin may become lighter. There can sometimes be bleeding from a broken blood vessel in the skin or muscle. Injections into the tendons may cause weakness and rarely the tendon may rupture.

The risk of side-effects increases the more frequently you have an injection or the higher the dose or steroid used. Injection of steroid into a joint is generally accepted to remain more localised to the area being treated, however systemic delivery within the body (tablets or depot preparations into muscle often used for inflammatory rheumatological conditions) can be associated with potential problems include weight-gain, increased blood pressure, thinning of the skin and/or bones, cataracts and increased bruising.

Receiving an injection of corticosteroids is quick and straightforward. The injection, which normally contains both steroid and a local anaesthetic, and can be used in conjunction with hyaluronic acid lubricating type preparations, is given in an outpatient setting and you will normally be able to go home straight away. The skin above the affected joint or tendon will be cleaned and you may be given a numbing spray to reduce any skin sensation. The doctor may use an ultrasound scanner to guide the position of the injection and ensure it reaches the affected area. You will normally have to wait 10-15 minutes after the injection to make sure there is no adverse reaction before you are able to go home. You should avoid strenuous exercise for a few days afterwards.

How quickly do they work?

With some corticosteroid injections you will start to feel the benefits within a few days and these benefits may last for months or longer, depending on the severity and the type of condition being treated . If you receive short-acting soluble steroids, you should feel a reduction in pain within a few hours and this should last around a week.  In some cases, the steroids are mixed with local anaesthetic which means the pain relief will be immediate but start to wear off in around 30 minutes to about 8 hours, depending on the drug used.