What are Steroids?
Corticosteroids are a class of medications that are related to cortisone.  Cortisone is a naturally occurring corticosteroid hormone produced by your adrenal glands.

Where are Steroids (Cortisone) Injected?
Steroids can be injected directly into the joints (intra-articular) or around the joints (peri-articular) or tendons.
How do Steroid (Cortisone) Injections Work?
After injection, corticosteroids work to reduce inflammation (heat, redness, swelling, & pain) in and around the joint.  As a result you should feel less pain, swelling, stiffness and warmth and be able to function a little easier.

Why are Steroids (Cortisone) Injected Locally?
A steroid injection into or around the joint is an effective way to reduce inflammation in or around a single joint.  The goal is to deliver the medication directly to the site where it is needed aiming to reduce the need for systemic treatment (pills).

How is a Steroid (Cortisone) Injection given?
A steroid injection into a joint or around a joint is much like an injection into the arm.  Most injections are safely and routinely performed in a physician’s office.  For joints in the spine or hip, injections are usually given by a radiologist under x-ray or ultrasound guidance.  Local anesthetic is sometimes used prior to the injection or can be mixed with the steroid and injected directly into the joint to give immediate relief.

Does a Steroid (Cortisone) Injection Hurt?
In the hands of a skilled physician, the injections are relatively comfortable and as pain free as a simple blood test or injection into the muscle in the arm.

How long does it take for a Steroid (Cortisone) Injection to Work and how long will it Last?
Most injections typically take 24-48 hours to take full effect.  If local anesthetic was given with the steroid injection, you may feel improvement relatively quickly.  The duration of improvement varies. Some patients report months of relief whereas others find only a few days of relief.

If the first Steroid (Cortisone) Injection doesn’t work, can I try a second Injection?
In general, most patients, if they are going to respond, will respond after the first injection.  Patients who have gained no symptom relief or functional benefit from two injections should probably not continue with repeat injections as the likelihood of improvement is small.
How often can I have repeat Steroid (Cortisone) Injections?
If a significant benefit is achieved after the first injection then an argument can be made for a repeat injection.  There is some controversy that  too many injections may weaken tendons, ligaments, and accelerate the loss of cartilage but other studies have found that injections can slow joint damage and help preserve the joint.  As a general rule a reasonable approach is to limit the frequency of injections to 3-4 for a single joint per year.

Are Steroid (Cortisone) Injections safe in Pregnancy?
It is generally advisable to avoid all medications during pregnancy and while you are trying to become pregnant.  However, local steroid injections are believed to be one of the safer treatments for arthritis during pregnancy.


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