Corticosteroid Injections in Santa Rosa, CA
In some patients, a tendon or bursa has become inflamed and is causing a fair amount of ongoing discomfort when performing simple tasks, such as opening a doorknob or lifting a cup of coffee. For these patients, along with others with chronic inflammatory diseases such as rheumatoid arthritis, sometimes one of the best treatment options for immediate relief is the injection of a corticosteroid. These work to calm the inflammation that is behind their pain, and they can provide relief for months.
What are steroid injections?
People confuse the “steroids” they hear about in a news story about a professional athlete or a weightlifter with steroids that can help with their tennis elbow. They are not the same thing.
The steroids abused by athletes to gain muscle mass and recover from injury are “anabolic” steroids. These are synthetic variations of the natural male sex hormones known as androgens. Prolonged use of anabolic steroids can have serious side effects, everything from developing breasts to shortened life expectancy.
The steroid injections we use at Redwood Orthopedic Associates are “corticosteroids.” These are sometimes also referred to as cortisone. These are naturally occurring steroids found in nature, where their job is to regulate immune function and the balance of electrolytes. Corticosteroids have an anti-inflammatory effect when injected into an area where a tendon or bursa has become inflamed and painful.
What areas of the body do corticosteroid injections help manage pain?
At Redwood Orthopaedic, we most commonly inject corticosteroids into the joints, such as the ankles, knees, elbows, hips, shoulders, wrists, and the spine. These are the major joints, but even small joints, such as those in your hands and feet, can benefit from these injections.
What conditions can be treated with corticosteroid injections?
Corticosteroid injections are used to treat conditions such as rheumatoid arthritis (which inflames the joints), gout, or other inflammatory diseases. These are chronic conditions.
They are also used to address the pain that has developed due to overuse or from joint degeneration from osteoarthritis (wear and tear arthritis). To alleviate pain, these steroid injections are made into inflamed bursae, or around tendons near the shoulder, elbow, hip, knee, hand, or wrist.
These are the conditions where steroid injections could be helpful:
- Back pain
- Psoriatic arthritis
- Reactive arthritis
- Rheumatoid arthritis
How long do corticosteroid injections last?
The results of these injections provide vary dramatically by the patient. Some patients experience relief for 4-6 months. Others feel relief for only a period of weeks. In some patients, one corticosteroid injection calms the inflamed tendon to a degree that the condition completely clears.
Can I receive more than one injection of corticosteroids?
You can’t continually repeat corticosteroid injections, much as you may be tempted due to their pain relief. This is because repeated steroid injections have the potential to damage the cartilage in the joint.
At Redwood Orthopaedic, we limit our corticosteroid injections, so they are not more often than every six weeks. We want to limit the number of injections in one year to four of less.
What are the potential risks with corticosteroid injections?
In general, we won’t provide these injections to patients more often than every six weeks. Over the year, we don’t want to give more than four total injections. This is because using these injections too often or for too long can lead to numerous side effects:
- Cartilage damage
- Death of nearby bone
- Joint injection
- Nerve damage
- Tendon weakening or rupture
- Thinning of nearby bone (osteoporosis)
- Thinning of skin and soft tissue around the injection site
- Whitening or lightening of the skin around the injection site
- A temporary flare of pain and inflammation in the joint
- Temporary facial flushing
- Temporary increase in blood sugar
How can corticosteroids be administered?
No. They can be delivered orally, nasally, or topically, in addition to injections. But for joint pain injection is far and away the best delivery method. Injection ensures that the maximum amount of corticosteroid is placed directly where the inflammation is. We include local anesthetic with the corticosteroid, so these injections are not overly painful, plus the anesthetic provides instant pain relief to help bridge until the corticosteroid starts calming the inflammation.
Do you need to rest after a corticosteroid injection?
You don’t need to rest, per se, but you do need to pay some attention to protect the injection area for a day or two. This will mean not engaging the joint or area injected as much as possible. This allows the corticosteroid to begin working more quickly and effectively.
When will I see injection results?
These injections can cause a temporary flare-up of pain for up to 48 hours. From there, the inflammation and pain in the joint should decrease.
How do corticosteroid injections alleviate my joint pain or tendonitis?
Corticosteroids act on the immune system by blocking the production of substances that trigger allergic or inflammatory responses. Corticosteroids mimic the effects of hormones your body’s adrenal glands produce naturally. These injections, however, are delivered in doses that exceed your body’s production levels, so they then act to suppress inflammation.
Is there anything I shouldn’t do after having a corticosteroid injection?
You need to not use the joint or area or your injection. For instance, if we inject the corticosteroid into a painful shoulder, you need to avoid heavy lifting. The same would hold true for a knee and not running or doing squats and the like.
You’ll also need to stay out of hot tubs, Jacuzzis, bathtubs, and saunas for two days. You can shower, but don’t keep the temperature excessively high.
Is there recovery after having corticosteroid injections?
There isn’t any recovery or necessary downtime. As mentioned above, you will need to be cognizant of not using the joint where your injections were placed as much as possible. While you can, of course, bend your knee and walk around the house if you have an injection there, this simply means to not overuse the joint as you would in exercise. You just need to wait a day or two, nothing drastic.
Some people are frustrated at first after receiving their corticosteroid injection, as initially cortisone injections commonly cause a temporary flare in pain and inflammation for up to 48 hours after the injection. But this is just the steroid getting to work. After that initial phase, your pain and inflammation should decrease. These improvements can last for as long as a period of several months.