Corticosteroid Joint and Soft-Tissue Injection

Your symptoms, examination findings, previous treatment, diabetes, anticoagulants, infection risk, planned surgery and other medical factors are reviewed. The injection site is prepared using strict aseptic technique and the medicine, dose, route, batch and expiry are documented. Rehabilitation or exercise is still needed, because the injection does not correct the underlying mechanical cause.

It may be considered for selected osteoarthritis pain when other treatments are unsuitable or ineffective, subacromial bursitis in appropriate cases, trochanteric pain syndrome in selected patients, trigger finger or selected tenosynovitis, and other clearly diagnosed inflammatory periarticular conditions within clinician competence.

For osteoarthritis, NICE guidance (NG226) advises that intra-articular corticosteroid injections may be considered when other pharmacological treatments are ineffective or unsuitable, or to support therapeutic exercise, with expected benefit generally short term, around two to ten weeks. The exact response varies by diagnosis and individual.

Suspected septic arthritis, local cellulitis, systemic infection, uncontrolled bleeding disorder, serious allergy, unstable joint, fracture, injection directly into certain major tendons or an uncertain diagnosis are reasons not to inject. Diabetes, anticoagulation, immunosuppression, recent vaccination, planned surgery and poorly controlled hypertension require individual consideration.