Injection Therapy

There are two types of injection therapy with proven benefits for a wide range of pain conditions – Corticosteroid and Ostenil injections.

Cortisone is an anti-inflammatory steroid (very different from anabolic steroids used illegally to gain muscle mass!) that occurs naturally in the body. Steroid injections (aka Corticosteroid injections) are administered by highly trained healthcare professionals (such as clinical specialist physiotherapists) and use a small dose of synthetic cortisone to provide quick and effective relief of pain and stiffness which is being caused by inflammation, such as in arthritis, bursitis, tendinopathy and frozen shoulder (adhesive capsulitis). Steroid injections often provide patients with the first bit of pain relief in months (even years in some cases!) and gives them the chance to progress their rehabilitation and strengthen the surrounding areas to create long term gains.

Ostenil is a solution containing hyaluronic acid developed specifically to help ease joint pain and stiffness associated with osteoarthritis, by helping to preserve joint health. The ostenil is injected into the affected joint once a week for 3 weeks until you have had 3 injections.

While injection therapy can provide significant relief for many, it isn’t always right for everyone! A clinical specialist physiotherapist will complete a full assessment to ensure that an injection is the most appropriate option for you, taking into account

The injection process is then quick and easy to perform within clinic and you will be able to go home shortly after. You will also be given an individualised rehabilitation programme to enable the most effective recovery. While you may need to rest the joint for a few days following the injection, you will be able to do all normal activities of daily living.
As well as assessment by your clinical specialist, you should also make sure that you feel that an injection is right for you and your circumstances. To help you in this, your specialist will ensure that they have answered all questions you may have. However, here are a few of the commonly asked questions surrounding the use of injections.

How long do the effects last?

With steroid injections you should notice a benefit only a few days after your injection (if not hours!). Some people feel completely pain free! Unfortunately, this benefit often wears off after 3-4 months unless you persist with rehabilitation to address the initial causes of your symptoms. It might also be the case that the short-term benefits will help you live a more mobile pain-free life while you wait for joint surgery or other orthopaedic appointments. You should be aware, however, that while for the majority of people steroid injections provide fast and significant pain relief, results can vary and it is not always possible to predict who will respond best.

With an ostenil injection, you may not notice any improvement after the first injection, however after the 2nd and 3rd injection you should gradually start to notice less pain and stiffness and the benefit from the full course of 3 injections can last up to 9 months. When the effects do wear off, you can continue to have new courses of injections whenever necessary and top ups may only require a single dose. Typically you may have an injection every 4-6 months.

Are there any side effects to injection therapy?

There are rarely any significant side effects from steroid or ostensil injections, however, following your injection you should look out for any sign of infection (such as redness, swelling and pain). In this instance you should get medical advice as soon as possible.

There are, however, a few minor side effects of steroid injections to be aware of that usually last for up to 7 days…

Slight discomfort during the injection
Slight bleeding at the injection site
Pain or discomfort for a few days – basic painkillers should help with this
Temporary bruising or a collection of blood under the skin
Flushing of the face for a few hours
Dimples, paleness or thinning of the skin around the site of the injection – this may be permanent
Headaches, dizziness or drowsiness
nausea
Itching and skin irritation around the injection site
If you have diabetes – your blood sugar level may go up for a few days
If you have high blood pressure, your blood pressure may go up for a few days

Is there any reason I may not be able to have an injection?

There are a number of conditions that may increase the risk to you following a steroid injection, and so if you are considering a steroid injection, please read through this list and make your therapist aware if you….

Have had a steroid injection in the last 6 weeks
Have had 3 steroid injections in the same area over the past 12 months
Have any severe allegies
Have an ongoing infection
Have recently had, or are about to have, any vaccinations
Are pregnant, breastfeeding or trying for a baby
Have any other conditions, such as diabetes, epilepsy, high blood pressure, or problems with your liver, heart or kidneys
Are taking any other medications, such as blood thinners.
If you have any laser treatment, chemical peeling or other dermal procedure due following the injection
If you have excessive scarring (eg hypertrophic scarring or keloid formation) or pigmentation disorders