Cortisone injection

What is a Cortisone injection?

Cortisone is also commonly known as steroid or corticosteroid injection. Being a powerful anti-inflammatory, it is used to treat painful conditions caused by inflammation. At Perth Medical Imaging, ultrasound is used to guide the placement of a needle directly into the region of interest, with an injection of corticosteroid (‘cortisone’ or ‘steroid’) and local anaesthetic medication.

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Why would my doctor refer me to have this procedure?

Cortisone injections are performed to reduce or eliminate pain associated with a variety of disorders, such as:

  • Bursitis-inflammation of a bursa in the shoulder, hip, knee, foot, or elbow.
  • Arthritis- Any joint may be injected
  • Tendinitis/Tenosynovitis- Tendons of the fingers, wrist, elbow, knee, or ankle
  • Nerve pain- Carpal tunnel and Morton’s neuroma

How do I prepare for a Cortisone injection?

No specific preparation is needed. You should take any previous X-rays, ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) scans to the appointment.

When you make your appointment for the Cortisone injection, you need to let the radiology facility know if you are taking any blood-thinning medication, particularly warfarin. Continue with pain medication and other medications as usual.

What happens during a Cortisone injection?

You will lie on a scanning bed or sit in a chair in a comfortable position, usually in an ultrasound room. A radiologist (specialist doctor) and/or the sonographer (ultrasound technician) will explain the procedure to you. You will be able to ask any questions.

The area to be injected is imaged. The skin is then cleaned with antiseptic liquid. A fine needle is passed directly into the area using ultrasound images to guide the placement of the needle. A small amount of corticosteroid and local anaesthetic (usually just a few millilitres) is injected and the needle is removed. The needle is generally in and out again within a minute. Most people are surprised by how quick the procedure is.

Are there any aftereffects of a Cortisone injection?

As with any injection, there is sometimes a dull ache for a few hours after the procedure. There might be an area of numbness around the injection site, for 1 or 2 hours, due to the local anaesthetic. Some bruising and a few spots of blood at the site of the injection might occur.

The corticosteroid does not usually start working for 24 hours, and sometimes this takes up to 3 days. During this time, the normal symptoms might continue or occasionally worsen. If symptoms are much worse, it generally indicates a reaction to part of the injected medication or to the injection itself. If you find this worrying or distressing, you should see your own doctor or contact the radiology facility where the procedure was carried out.

Sometimes people can experience general reactions, such as flushing and redness of the body and face, related to the absorption of the corticosteroid into the body. These occur over the first few days. In diabetics, the absorption of the corticosteroid can increase the blood sugar levels (BSL) for a few days and the BSL should generally be checked several hours after the procedure.

What are the risks of a Cortisone injection?

This is a very safe procedure with few significant risks. Few people complain of side-effects, but occasionally problems are experienced.

What are the benefits of a Cortisone injection?

The aim of a Cortisone injection is primarily to reduce any inflammation in or around the bursa by injecting a small dose of corticosteroid and local anaesthetic. This should result in pain relief and swelling reduction.

Sometimes the injection is carried out to assess if the bursa is the cause of your pain. A good response to the injection confirms that the source of pain is the bursa that was injected. If there is no improvement in your pain, it is unlikely to be arising from the bursa or the adjacent structures. This can be helpful information for your own doctor, as it means that other causes need to be investigated.

Further management after Cortisone injection:

The relief of symptoms from the Cortisone injection might last a few weeks to several months. It is therefore only part of an overall plan for managing your symptoms. You would most likely have been advised to rest the affected area and change the way you carry out some of your activities. It is very important you follow up with your doctor after the cortisone injection for further management.

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Perth Medical Imaging

Your Trusted Imaging Service in Ellenbrook, Perth