• Reference Number: HEY-039/2019
• Departments: Physiotherapy
• Last Updated: 27 February 2019

Introduction

This leaflet has been produced to give you general information about the benefits and risks associated with shoulder joint steroid injections.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your physiotherapist, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is a corticosteroid?

This is a medicine which can relieve swelling, stiffness and pain by reducing inflammation.

Is this the same drug that athletes and bodybuilders take?

No.  The steroids we inject are completely different and are extremely safe.

Why do I need a corticosteroid injection?

It will help reduce your pain so that you can start rehabilitation sooner; have fewer treatment sessions and return to normal activities more quickly.

Can I just take anti-inflammatory pills?

You can but the side effects of these are much more common and can cause stomach upsets and bleeding.  These injections bypass the stomach.

Are there any times I should not have an injection?

You should not have an injection if you:

• Have any infection on your skin or anywhere else in your body
• Are allergic to local anaesthetic or steroid
• Feel unwell
• Are due to have surgery in that area soon
• Are pregnant
• Are under 18 years of age
• Do not want the injection

What are the possible side-effects?

• Flushing of the face for a few hours
• Small area of fat loss or a change in colour of the skin around the injection site
• Slight vaginal bleeding
• Diabetic patients may notice a temporary increase in blood sugar levels
• If you are taking blood thinning drugs there may be some temporary bruising
• Infection: if the area becomes hot, swollen and painful for more than 24 hours you should contact your physiotherapist or doctor immediately.

You will be asked to wait for 30 minutes after the injection to ensure there is no allergic reaction to the drug.

If you have any concerns please contact your physiotherapist (Monday – Friday 8.00 a.m. – 4.00 p.m.) on telephone number (01482) 674880

How is the injection done?

The skin is cleaned with antiseptic.  A needle is gently put into the affected part and the solution is injected through the needle.  Shortly after, you will be examined again.

Is the injection painful?

Not particularly, your physiotherapist has had intensive training in the technique.  Sometimes it can be sore for a few hours but you will be told what to do about this.

How fast does the injection work?

If local anaesthetic is also used the pain should be less within a few minutes, though it may return after about an hour.  The steroid usually starts to work within 24 – 48 hours but may take longer.

How long does the effect last?

This varies from person to person and the condition which is being treated, but the steroid usually continues working for 3 – 6 weeks.

How many injections can I have?

This depends on the part of the body involved and will be decided by your therapist and yourself.  Usually one injection is sufficient, but if the pain is severe or has been there for a long time, you may need more.

What should I do after the injection?

If the problem was caused by overuse, you will probably be told to rest the area for about a week: if it is a joint pain, you may start early gentle movement.

When will I have to be seen again?

You may be referred for physiotherapy so that you can be shown appropriate exercises to do at home.

You will usually be reviewed a month / few months after the injection to monitor the long-term effect of the treatment.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.