Corticosteroid Injections

When Might Corticosteroid Be Considered?

A corticosteroid injection may be considered when inflammation or significant tissue irritability appears to be contributing to pain and loss of function. It may also be helpful when symptoms are preventing sleep, everyday activity or meaningful progress with rehabilitation.

The decision is based on the diagnosis, clinical findings, medical history, previous treatment and the balance of potential benefits and risks. An injection will not be recommended simply because pain has persisted or because a scan shows structural change.

Some presentations respond better to rehabilitation, activity modification, further investigation or another treatment pathway.

Conditions We Assess

Corticosteroid injection may be considered for selected cases of knee or shoulder osteoarthritis, subacromial pain and bursitis, De Quervain's syndrome, trigger finger, carpal tunnel syndrome, thumb-base osteoarthritis, big-toe osteoarthritis and Morton’s neuroma.

It may also be considered in carefully selected tendon-related or bursal presentations, including lateral hip pain, gluteal tendinopathy, tennis elbow and golfer’s elbow. Corticosteroid is not routinely appropriate for every tendon condition, and potential short-term benefit must be weighed against the possible effects on tendon health and longer-term outcomes. 

Although our team includes specialist spinal physiotherapists, we do not provide injections into the spine. Our injection service is limited to selected peripheral joints and soft-tissue structures, such as the shoulder, elbow, hand, hip, knee, foot and ankle.

We can still assess back or neck symptoms, review relevant imaging and help determine the most appropriate treatment pathway. If a spinal injection or specialist medical opinion appears necessary, we can advise you about appropriate onward referral.

Explore Conditions Treated With Injection Therapy →

Do I Need a Scan?

Imaging is not required before every corticosteroid injection. For many accessible joints and soft-tissue structures, the diagnosis and appropriate injection site can be established through a detailed history and specialist clinical assessment.

Our service provides clinically guided, also known as landmark-guided, injections. We do not currently provide ultrasound-guided injections. If imaging guidance would be clinically preferable, we will recommend an appropriate onward referral rather than proceeding.

Where existing X-rays, ultrasound or MRI scans are available, your specialist can review the findings alongside your symptoms and clinical examination. Further imaging may be requested when it would materially affect diagnosis or treatment.

Who May Not Be Suitable?

Corticosteroid injection may need to be avoided or postponed if there is an active infection, broken or infected skin near the proposed injection site, an allergy to any component of the injection or concern about an alternative diagnosis requiring investigation.

Additional consideration is required for people taking anticoagulant medication, those with a bleeding disorder or diabetes, anyone who is pregnant or breastfeeding, and people who have recently received a vaccination or have had or are awaiting certain surgery.

These circumstances do not always prevent treatment, but they must be discussed during the suitability process. Please do not stop prescribed medication unless advised by an appropriate healthcare professional.

Potential Risks and Side Effects

Most people experience no serious complications, but every injection carries potential risks. These will be discussed before consent is obtained.

Temporary discomfort or a post-injection flare may occur during the first few days. Bruising, bleeding, facial flushing, sleep or mood disturbance, menstrual disturbance and a temporary rise in blood glucose can also occur.

Less commonly, there may be skin discolouration, thinning of the skin or loss of fatty tissue around the injection site. Steroid exposure may weaken tendon tissue, and tendon rupture is a recognised risk in certain areas. Rare complications include infection, allergic reaction, nerve injury and damage to surrounding structures.

Repeated corticosteroid injections can increase the risk of local tissue effects and are not offered automatically. The number, timing and clinical justification for any previous injections will form part of your assessment.

What Happens After the Injection?

You will receive advice specific to the structure treated, your usual activities and the purpose of the injection. A short period of relative rest is commonly recommended before activity is gradually resumed.

Some people notice improvement within several days, while for others the response takes longer. The degree and duration of benefit vary, and some people experience little or no improvement.

You will be advised what symptoms may be expected and when to seek further medical help. Rehabilitation or graded activity may then be progressed according to your response.