Injection Therapy

Injection Therapy

Steroid Injection Therapy

Steroid injections provide an effective anti-inflammatory and pain relieving treatment directly to the joint or soft tissues causing pain. The most common sites of injection are the shoulder and knee but any joint which is arthritic could be injected. Normally only one injection is required to gain sufficient pain relief and restore normal range of movement.

If you would like to discuss treatment further please email charlie@joylaneclinic.co.uk or call 01227 266439.

Hyaluronic Acid Injections

Hyaluronic acid injections are normally used for the treatment of osteoarthritis by reducing pain and improving the function of our joints. It can be used in the knee, or in any of the other joints in the body that are classified as synovial.

A synovial joint is one in which the ends of the bones are enclosed in a capsule containing a thick, slippery liquid called synovial fluid. The bone ends are covered in a smooth layer of a tough, rubbery substance called cartilage. The synovial fluid helps protect the cartilage from wear and tear by keeping the bones slightly apart and by acting as a shock absorber and lubricant. It also acts as a filter, letting nutrients reach the cartilage, but blocking the passage of harmful cells and substances.

The most important component of synovial fluid is a substance called hyaluronic acid. It is this substance that allows the synovial fluid to perform its cartilage saving properties. Hyaluronic acid is continuously broken down and replaced. Normally, there is an exact balance between the breakdown of old hyaluronic acid and the production of new hyaluronic acid. In osteoarthritis, however, this balance is disturbed and breakdown happens faster than production. As a result, the synovial fluid becomes watery and stops working properly. As a result the cartilage in the joint gradually wears away. The thinning of the synovial fluid and wearing away of the cartilage leads to symptoms of osteoarthritis, which include pain, stiffness and swelling.

Ostenil is a solution containing hyaluronic acid. It is injected into the space in the joint that contains synovial fluid and works by restoring the normal balance between the breakdown and production of hyaluronic acid. This effect of Ostenil means that it can decrease pain and stiffness and improve the other symptoms of osteoarthritis.

A course of Ostenil normally gives relief for 9-12 months and involves an injection once a week for 3 weeks until you have had 3 injections. They can be used on regular basis if required as they have no known side effects and they are not known to be detrimental to the bodies tissues in any way. Hyalonronic acid is classed as a ‘medical device’ rather than a drug such is its level of safety. For optimal affect, chronically swollen joints can be injected first with steroid to reduce inflammation and then injected with hyaluronic acid around 4 weeks later reducing the need for repeated steroid injections.

To discuss further please email Charlie at charlie@joylaneclinic.co.uk or call 01227 266439.

Patient Information

Q: What is a corticosteroid?
A: A medicine which can relieve swelling, stiffness and pain by reducing inflammation.

Q: Why don’t I just take anti-inflammatory pills?
A: You can, but the side effects of these are much more common and can cause stomach upsets and bleeding. These injections bypass the stomach and are much more effective.

Q: Are there any times I should not have an injection?
A: Yes, if you:

  • Are hypersensitivity or allergy to any of the drugs used: risk of anaphylaxis
  • Have sepsis – local or systemic infection
  • Are reluctant to have the injection
  • If you are under 18
  • Had a recent fracture
  • Have a prosthetic joint
  • Are pregnant

Q: What are the possible side-effects?
A: These are very rare and your clinician will discuss them with you:

  • Post injection flare
  • Skin atrophy/depigmentation/bleeding
  • Tendon atrophy/rupture
  • Infection –  if the area becomes hot, swollen and painful for more than 24 hours you should contact your clinician or doctor immediately
  • Facial flushing
  • Menstrual irregularity
  • Impaired diabetic control
  • Temporary bruising if you are taking blood thinning medication

You will be asked to wait for 30 minutes after the injection to ensure there is no allergic reaction to the drug.
Q: Is the injection painful?
A: Not particularly, as your therapist has had intensive training in the technique. Sometimes it can be sore for a few hours, but you will be told what to do about this.

Q: How fast does the injection work?
A: If local anaesthetic is also used the pain should be less within a few minutes, though it may return after about an hour. The steroid usually starts to work within 24-48 hours but may take longer.

Q: How long does the effect last?
A: This varies from person to person and the condition being treated, but the steroid usually continues working for 3 to 6 weeks.

Q: How many injections can I have?
A: This depends on the part of the body involved and will be decided by your therapist and yourself. Usually one injection is sufficient, but if the pain is severe or has been there for a long time, you may need more.

Q: What should I do after the injection?
A: If the problem was caused by overuse, you will probably be told to rest the area for about a week; if it is a joint pain, you may start early gentle movement.

Q: When will I have to be seen again?
A: Usually your therapist will want to see you again about a week or ten days after the injection. You will then be given appropriate physiotherapy treatment and probably some exercises for you to do at home. You will also usually be reviewed a month after the injection to monitor the long term effect of the treatment.