Steroid injections (cortisone shots) at Derby Hospital

What are steroid injections?

Steroid injections, also known as corticosteroid injections or cortisone shots, are anti-inflammatory medicines used to treat a range of conditions.

They contain manufactured drugs that act similarly to cortisol, a hormone naturally produced by the adrenal glands. These injections work by reducing inflammation, pain, swelling and stiffness in a specific area of the body.

What can steroid injections treat?

Steroids can be injected into different areas of the body to treat a range of conditions, such as:

Joint and musculoskeletal conditions

• Osteoarthritis and rheumatoid arthritis
• Bursitis
• Gout
• Frozen shoulder
• Tendonitis
• Plantar fasciitis
• Carpal tunnel syndrome
• Trigger finger/thumb
• Sciatica
• Back pain

Nerve-related conditions

• Nerve entrapments
• Radiculopathy

Autoimmune and inflammatory conditions

• Lupus
• Ankylosing spondylitis
• Uveitis
• Inflammatory Bowel Disease (IBD), including Crohn’s disease and ulcerative colitis.

Skin disorders

• Eczema
• Keloid scarring

How do steroid injections work

Steroid injections contain corticosteroids, which are medicines that work in a similar way to cortisol, a hormone naturally produced by the adrenal glands. Cortisol plays an important role in managing inflammation and supporting your immune system.

When a part of your body is injured or fighting infection, your immune system releases chemicals and sends cells to the area to protect and heal it. This response can cause swelling, pain and inflammation. If the inflammation becomes long-lasting (chronic) – as in arthritis, tendon problems, or some spinal conditions – the pain will be ongoing and limit your range of movement.

What the steroid injection does

A steroid injection into the affected area calms the local inflammatory response. It reduces the activity of immune cells and the release of inflammatory chemicals, which in turn helps ease swelling, pain, and stiffness.

While steroid injections do not cure the underlying condition or heal the tissue, they can make it easier for you to move, exercise, and take part in rehabilitation (like physiotherapy) – all of which can support longer-term recovery and better function.

Do all steroid injections use hydrocortisone?

No, not all steroid injections use hydrocortisone. Several types of corticosteroids can be used, and while they all work to reduce inflammation and relieve pain, each one has slightly different strengths and durations of action. Your doctor will recommend the most suitable option based on your condition, the area being treated and how long they want the effects of the steroid to last.

Common types of steroid injections:

• Hydrocortisone: A mild steroid that works quickly but doesn’t last as long/the effects are shorter-term. It is often used in smaller joints (like the fingers and toes) and in more sensitive areas, such as the face.
• Prednisolone: Prednisolone works for a medium length of time. It is often used for joints like the wrist or ankle, and for treating autoimmune conditions.
• Methylprednisolone: This is a stronger, longer-lasting steroid, making it ideal for larger, hard-working joints such as the knee or shoulder.
• Triamcinolone: A strong, long-acting steroid that can provide relief for many weeks or months. It is commonly used for persistent joint inflammation, skin conditions like cystic acne, or raised (keloid) scars.
• Dexamethasone: The most powerful of these steroids, dexamethasone is often the best option for treating spinal pain or nerve-related issues such as sciatica due to its strong and long-lasting effect.

What is the difference between steroid injections and cortisone shots?

There is no difference between steroid injections and cortisone shots.

Steroid injections and cortisone shots both refer to an injection that contains a corticosteroid (a medication to reduce inflammation and relieve pain).

Are steroid injections right for me?

A steroid injection can be a very effective treatment for pain and swelling, as its main purpose is to deliver a strong anti-inflammatory medication directly to the source of the problem. By reducing the inflammation, the injection can significantly reduce pain and improve movement.

However, steroid injections aren’t suitable for everyone or for every condition. Your doctor will help you decide if steroid injections are the right choice for you.

What happens during treatment with steroid injections?

Preparing for steroid injection treatment

Your doctor and the healthcare team will give you instructions on how to prepare for your steroid injection. This may include advice on whether to continue or temporarily stop any medications beforehand.

In most cases, you don’t have to fast beforehand, and you can eat and drink as normal, unless your doctor or healthcare team have instructed not to.

You may need to arrange transport home, especially if you’re going to have a local anaesthetic or sedation, as the numbness from the anaesthetic can make it difficult to drive.

Wear loose-fitting, comfortable clothing that allows easy access to the area being injected.

Before your steroid injection, please let your doctor or healthcare team know if you:

• Have an infection or are feeling unwell.
• Are pregnant or breastfeeding.
• Have diabetes (as steroids can affect blood sugar).
• Take blood-thinning medications or have a bleeding disorder.
• Have had a reaction to steroids in the past.

During the procedure

Your doctor will use an antiseptic to clean the area and may inject a local anaesthetic to numb the area.

Your doctor will then carefully insert the needle for injection. It is important to keep still whilst they insert the needle.

Depending on where the pain and inflammation are, steroids can be injected:

• Directly into the inflamed joint - this is known as an intra-articular injection.
• Into the soft tissue close to the joint - this is called a peri-articular injection.
• Into a muscle - this is called an intramuscular injection.

Most steroid injections are not painful, but they can be uncomfortable. If you feel pain, let your doctor know immediately.

In some situations, particularly for joints that are deep or difficult to locate, you may need an image-guided steroid injection to help ensure the steroid is injected into a precise spot and has maximum benefit.

After the steroid injection

After the steroid injection, you’ll remain in the clinic for 10 to 20 minutes. This is a safety precaution to ensure you don't have any immediate reactions.

Steroid injections do not always work straight away. You can expect to start feeling the effects of the steroid within 2 to 7 days.

It is common to feel some tenderness and pain at the injection site once the anaesthetic wears off.

You may also feel an increase in pain in the joint for 24 to 48 hours after the injection. This is called a steroid flare and is a normal reaction as your body responds to the steroids. Taking simple painkillers like paracetamol can help, or using ice packs can help manage the pain.

Recovery from steroid injections

Most people recover quickly after a steroid injection. You may experience some soreness or bruising around the site of the injection, but this will get better within a few days. You can use painkillers or an ice pack to help reduce any discomfort.

It is important to rest and avoid any strenuous activity or heavy lifting for the first few days after the injections – especially if the injection was given in a joint. You can usually return to work and normal activities the next day, unless advised otherwise.

If you develop signs of infection, such as increased redness, warmth, swelling or fever, contact your doctor and healthcare team as soon as possible.

What are the benefits of steroid injections?

Steroid injections are anti-inflammatory medicines that help reduce swelling and pain in specific areas of the body, such as joints, tendons or soft tissues. Benefits of steroid injections include:

1. Pain relief: By reducing inflammation, steroid injections can significantly ease pain and discomfort in the affected area.
2. Improved movement and function: As pain decreases, you may notice better movement, flexibility and function – making it easier to do everyday activities.
3. Delay or avoid surgery: In some cases, steroid injections can help manage symptoms well enough to delay or even avoid the need of more invasive procedures such as surgery.
4. Makes physiotherapy more effective: By reducing pain and inflammation, steroid injections can make it easier to take part in exercises that will help to strengthen the area.

How long do the benefits of steroid injections last?

The benefits of steroid injections can last from a few weeks to several months, depending on the type of corticosteroids your doctor uses and your response to them.

What are the risks of steroids?

Most people have steroid injections without any side effects and recover well. However, complications can occur, especially if you are overweight, are a smoker or have health problems such as diabetes, heart disease or lung disease.

Your consultant and healthcare team will discuss all the risks and complications at your consultation.

Common side effects of steroid injections

• Pain, bruising or swelling at the injection site: This will usually settle within a few days.
• Infection where the needle was inserted: If you experience redness, warmth or pus, please contact your doctor or healthcare team immediately.
• No improvement in symptoms: Sometimes the steroid injection may not reduce pain or inflammation as expected.
• Worsening pain: This is also known as a steroid flare. It is temporary and will settle after a few days.
• Allergic reaction: To the steroid, anaesthetic or equipment used during the procedure.
• Facial flushing: A temporary side effect where your face, neck or chest feels warm and appears red.
• Skin changes: Possible thinning or lightening of the skin around the injection site.
• Temporary menstrual changes: Periods may be longer or shorter, or you may bleed between periods.
• Raised blood sugar levels: Steroids can cause a temporary rise in blood sugar, especially in people with diabetes.
• Nerve injury: Nerve injury is rare and usually temporary. In very rare cases, nerve injury may be permanent.

Alternatives to steroid injections

Steroid injections aren't always the only or best treatment option. Depending on your condition, symptoms, and overall health, your doctor may recommend one or more of the following alternatives:

• Lifestyle changes: Weight loss, exercise or avoiding activities that aggravate your condition can improve symptoms.
• Physiotherapy: Can help to strengthen weak muscles, improve flexibility and restore movement in the affected area.
• Oral medication or topical creams: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help manage pain and inflammation.
• Braces or supports: Wearing a brace or support device can help to stabilise the area, reduce irritation and promote healing.
• Other types of injections, Such as Platelet-Rich Plasma (PRP) injections or hyaluronic acid injections, may be helpful for certain conditions.
• Surgery: If other treatments do not work and your condition significantly affects your daily life, surgery may be the best option for you.

Your doctor will discuss the most appropriate alternatives based on your condition, medical history, and treatment goals.

How much do steroid injections cost?

For pricing information, please contact your local hospital.