Why are steroid injections used in the upper limb?
These injections are usually used to treat a variety of inflammatory conditions. These conditions include trigger finger, deQuervain Tenosynovitis, lateral epicondylitis (Tennis elbow), Osteoarthritis, Carpal Tunnel Syndrome etc.
How does it work?
They contain a mixture of a synthetic cortisone and local anesthetic. Cortisone is a steroid normally produced by the body and it has powerful anti-inflammatory action. There are different preparations of the injections, all of which vary in strength and duration of action. The choice of medication is left to the surgeon as one preparation has not been found to be superior to any other. The steroid in these injections (cortisone) is different from the anabolic steroids abused by athletes and body builders. The local anesthetic is added to anesthetize the area and diminish discomfort following the injection.
When does it take effect and how long does it last?
The injection should take effect within a few days and the benefits can last for many weeks. Some patients may require more than one injection to completely get rid of the inflammation.
How many injections can one get?
There are no set guidelines. The response to the first injection is useful in determining whether to proceed with the second injection. Most surgeons restrict the number of injections to 2-3 to prevent damage to tendons or cartilage.
What are the common side effects?
These include thinning of the skin, skin discolouration(whitening of skin) and atrophy of the fat around the injection site. These side effects do not occur in everybody and it is difficult to determine whom it may occur. These side effects may not resolve completely. Some patients may have an increase in pain following a steroid injection (cortisone flare). This is usually a result of crystallization of the steroid and patients have pain. This resolves over a period of 1-2 days and can be treated with ice and immobilization.
The most serious complication from steroid injections is infection, especially if the injection is given into a joint or a tendon sheath. Infection presents as redness and warmth around the injection site and fever. If you have received a steroid injection and have these symptoms, you should visit the emergency department at the earliest. Infections are rare and can be prevented by carefully cleaning the skin before injection.
Rarely patients may experience an allergic reaction from the steroid or the local anesthetic. Diabetic patients may note a transient increase in the blood glucose level following a steroid injection.
This information provided is meant purely for educational purposes and may not be used as a substitute for medical diagnosis or treatment. You should seek the advice of your doctor or qualified healthcare provider before starting any treatment or if you have any questions related to your health, physical fitness or medical conditions.
Hand & Reconstructive Microsurgery Center