A steroid is the name for a class of hormone that is naturally produced in your body. Cortisol which is your body’s natural steroid hormone and has anti-inflammatory property to it.
Humans managed to engineer synthetic steroids such as hydrocortisone which mimic the body’s own natural steroids. Other steroids such as Depo-medrone or Kenalog are also very powerful synthetic steroid hormone injections that can be used for inflammatory conditions. There are over half a million steroid injections performed in the UK each year, often for conditions such as arthritis and tendinitis.
Are steroid injections safe?
On the whole steroid injections are very safe and effective. However, the scope of use for steroid injections is slowly narrowing with other injectable products coming to the market such as hyaluronic acid or PRP. The main risk with any injection is an infection. However, this risk is still relatively small. You shouldn’t have a steroid injection if you have any allergies to the steroid, and you all also need to be cautious if you are taking blood thinning medication, diabetes medication or have any significant liver or kidney disease. There are some other side-effects that include some fat atrophy around the injection site (this can lead to a small dimple in the skin), as well as skin discolouration. The side-effects can resolve in time however sometimes they may be permanent.
What are steroid injections used for?
Steroid injections are best used for inflammatory conditions, anything termed – itis. One of the most common conditions we use steroid injections for is arthritis of joints. Steroid injections are particularly useful for knee arthritis, hip arthritis and arthritis of the smaller joints such as the fingers and toes. The term tendinitis is not used anymore and therefore we do not inject steroids into tendons. There is a risk of tendon rupture and we recommend that you avoid this treatment.
However, you can get an inflammatory condition of the tendon sheath called a tenosynovitis or a paratenonitis. These conditions do respond quite well to a small amount of steroid injected into them. Another condition that responds well to steroid injections is bursitis. You can develop a bursitis in the shoulder or on the outer side of the hip and having a steroid injection is very useful for reducing the pain of these conditions.
Is it true I can only have three steroid injections in my lifetime?
No, this is a myth. You should probably limit yourself to 2 or 3 steroid injections into the same area each year if required. However, there is really no limit on the number of steroid injections you can have in your body throughout your lifetime. It is worth remembering though that if you have had one steroid injection into a body part and it hasn’t been very successful perhaps a second injection is warranted but after that any further injections that are not helping your problem will be a waste of time.
Are there any alternatives to steroid injections?
Yes, there is evolving evidence that other products are useful for injections. These include hyaluronic acid into arthritic joints, and PRP into arthritic joints and into painful tendons.