Steroid Injections London | Joint & Tendon Pain Clinics

Steroids belong to a class of medications which are prescribed for a wide range of conditions across the healthcare spectrum. Steroids as a class of medication are hormones and are utilized to enhance, reduce or alter a range of physiological functions and bodily responses. Within the field of musculoskeletal and orthopaedic medicine, corticosteroid medication, which is used to reduce inflammation, is commonly used to treat a wide variety of conditions.

Steroids in this form are sometimes called steroids, corticosteroids, or hydrocortisone, but in this context they all mean the same thing, with hydrocortisone simply referring to the medication being in an injectable liquid form. There are two main groups of steroids: triamcinolone and methylprednisolone, both of which are branded differently in every country. The aim of these medications is the same, and there is no significant difference seen in the literature on treatment efficacy across most conditions we treat within musculoskeletal medicine. Occasionally, patient factors or specific injection sites may be better suited to one over the other, but this will be discussed at your appointment as needed.

Depending on the target site for a corticosteroid injection, which may be within a joint capsule, a tendon sheath, or occasionally superficial to these structures for various reasons, a different dose of corticosteroid may be used. For example, for a large joint such as the hip joint, a greater dose of corticosteroid will be used compared with a small joint of the fingers. Additionally, corticosteroid injections will often be mixed with a fast-acting local anaesthetic, which not only provides pain relief immediately after the injection but also helps distribute the medication more effectively. For example, in a large hip joint with a large capsule, we need to distribute the steroid throughout the joint, so we use a larger volume of local anaesthetic to mix with the steroid. In a small finger joint, very little local anaesthetic is used because the joint space simply will not allow for a large volume.

The types of conditions which respond most favourably to corticosteroid ultrasound-guided injections are those characterised by high levels of inflammation. Common examples include frozen shoulder, De Quervain’s tenosynovitis of the wrist, and flares of inflammatory arthritis such as rheumatoid arthritis in specific joints. Degenerative osteoarthritis can also flare up with a high degree of inflammation and swelling, and corticosteroid injections can help, though they should be used sparingly and usually only when awaiting joint replacement surgery, in order to maintain mobility until surgery takes place. In cases of mild to moderate osteoarthritis in younger and more active individuals, we often favour a hyaluronic acid injection, as repeated steroid injections have been shown to potentially accelerate long-term, age-related changes to cartilage and other tissues within joints. Additionally, tendon pain is typically not caused by high levels of inflammation but rather by disruption to the tendon fibre structure and chronic changes within the tendon itself. Your individual circumstances can be discussed at any time by messaging me below with any query.