Ultrasound Guided Cortisone Injections

An ultrasound-guided steroid injection is also known as a corticosteroid injection or a steroid injection. Many inflammatory and arthritis conditions use this strong anti-inflammatory medication to control pain, swelling, stiffness, and improve function. Corticosteroid injections are not the same as those used by bodybuilders.

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A corticosteroid injection can help to relieve inflammatory signs, such as pain, swelling, and stiffness. These may, in turn, help you return to normal activities or hobbies, carry out exercises to strengthen the muscles or improve cardiorespiratory fitness. If you struggle to carry out a prescribed rehab by a therapist because of pain, you should try a steroid injection.

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Ultrasound enables the clinician to visualise the needle and its tip in real-time as it enters the body, which aids in accurately navigating the needle to the desired location. This guarantees the precise injection of the steroid into the pain source. Thus, the success rate is extremely high.

Even in the most experienced hands, injections performed without imaging guidance are not always accurate and, in some cases (ex: hip joint injection), technically not possible or safer. Despite the best of intentions, this may lead you to believe that corticosteroid injections are not effective for you.

In addition, some ultrasound-guided injections are less painful than blind injections. This is under ultrasound guidance; we avoid touching the bone or passing the needle through tendons (unless unavoidable).

There are many different types of imaging-guided injections. However, ultrasound offers several distinct advantages over other image-guided methods, such as fluoroscopy or X-ray guidance.

• No radiation.
• Quick and simple.
• Ultrasound is a real-time dynamic tool.

We also recommend ultrasound-guided injections when the traditional method, also known as blind or anatomical-guided injections, fails to achieve the optimal outcome.

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The majority of the patients do not experience side effects/risk factors. Our pre-injection screening helps to identify the potential risks

Common :

• Flushed face for a few hours after the steroid injection. May last up to 48-72 hours.
• Steroid flare-up: Pain may be worse for a few days (up to 2 weeks) before feels better. 
• Temporary bruising and/or bleeding, especially if you are on blood-thinning medications.
• A temporary rise in blood sugar levels, in diabetics.
• Fat atrophy: thinning of the fat at the site of injection.
• Change in the skin colour around the steroid injection site (depigmentation of skin).
• A transient feeling of fainting or dizziness.
• Light vaginal bleeding or irregular menstruation cycle. Usually corrects by 2 or 3 cycles.
• The injection may not work. Sometimes it can be a partial success or temporarily successful, where another injection may need to be considered. 
• Weakening/damage/tear to the tendons and neurovascular bundle.

Rare :

• Infection is very rare (about 1 in 10,000).  If the injected area becomes swollen, painful and hot, or if you become generally unwell, contact your GP or Accident & Emergency (A&E) department, without a delay.

However, pre-injection screening, hand washing, and sterile techniques are employed to minimise the side effects.  

• There could be an infection at the injection site or in other parts of the body.
• If you are undergoing antibiotic therapy for an ongoing infection, it can be more secure. Prophylactic antibiotics can be safer than performing steroids injections.
• If you have an allergy to steroids or local anesthetic drugs,
• If your INR is excessively high while on anticoagulant therapy,
• If you are feeling unwell.
• The injection targets the metal area. Ex: joint replacement, metal plate.
• The injection site will soon undergo surgery.

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• Rest.
• Physiotherapy.
• Pain medication.
• Avoid exposing the activities that caused the injury.
• Hyaluronic Acid or Platelet Rich Plasma injections are an alternative to corticosteroid therapy. A new and natural way of treating the condition.
• Surgery: speak to your GP or a specialist.

Cortisone Steroid Injections UK

To minimise the risk of injection, we will clean the injection site with an aseptic material, gently introduce a tiny needle to give local anaesthesia under the skin, and then advance to the target site under ultrasound guidance. If the patient is not allergic to plasters, we apply a plaster to the injection site to maintain its cleanliness. If you prefer, you can watch the whole procedure on the ultrasound screen, and we can explain it throughout.

Discomfort from the needle insertion can be minimised by using local anaesthesia.

If your clinician uses local anaesthesia, you may be pain-free for up to 2 hours; after that, you may start experiencing pain until the steroid starts working. You can continue taking the regular pain medication your doctor prescribed during this period.

There is no guarantee that a steroid works for everyone. Steroids, if they work, may take anywhere from 2-3 days to 2 weeks. It is not possible to estimate how long the steroid injection is effective in controlling the symptoms, usually 3-5 months.

It is not advisable to drive for the remainder of the day. Your motor insurance may not be valid for at least 3 hours following the injection. For the first 2 days, avoid carrying out any activities that make the pain worse and gradually return to normal duties. We recommend 2 weeks of relative rest, especially when injecting weight-bearing joints.

If the injected area is swollen or painful, apply ice packs in a wrapped towel to the injection site for 10 minutes each time, twice or thrice a day.

You may have a follow-up appointment with your referrer. In some cases, you may need another injection; if that is the case, you can talk to your referrer about it. We do not recommend administering more than three steroid injections to the same area of the body in a year. If we saw you directly, we will schedule a follow-up appointment for you.

Fast pain relief with Cortisone Injections, clinics across the UK

We have a number of clinics across the UK, please check our contact page for the clinic that is nearest to you.