Steroid Injections

Introduction

You have been advised to have a steroid injection to help reduce the inflammation, swelling and pain:

• in one of the joints in your foot

• where you have pain from a bursa (a fluid filled sac) or neuroma (a thickened and inflamed nerve) in the soft tissues of your foot.

You can have up to 3 steroid injections in the same joint or area of your foot in a 12-month period.

This leaflet tells you about the medication and what to expect during and after your injection.

What is a steroid injection?

A long-acting steroid with or without a local anaesthetic (a drug to numb the area so you do not feel any pain) is injected into:

• a joint in your foot that is causing pain or swelling

• the tissues around your joint or soft tissues in your foot, for example in the area of a bursa or neuroma.

Steroids work by reducing any swelling. If local anaesthetic is mixed with the steroid it will help to relieve any discomfort immediately after your injection but the local anaesthetic will start to wear off within a few hours.

How long will it take to work?

This can vary but most people start to feel an improvement straight away. Sometimes in the first 24 hours after the injection you may feel your pain gets worse but it should improve over the next 2 to 3 days.

How long will it relieve my pain?

This can also vary but it usually lasts from a few weeks to several months.

Are there any risks or possible complications?

Risks or possible complications include:

Infection

Infection could be passed into your joint during the injection. The risk of infection is very rare but can happen to less than 1 person in every 78,000.¹

Steps are taken to prevent this at the time of your injection, for example, cleaning the area of skin over the injection site and using a sterile syringe and needle. Your injection site will also be covered with a dressing which should be left in place for 24 hours after your injection.

If you have diabetes, rheumatoid arthritis or have had a recent infection, you must tell your healthcare professional before you have the injection, as you may be at a higher risk of developing an infection.

Thinning or loss of colour to your skin

This is very rare but can happen if the steroid leaks into the skin around your injection site or you have a number of these injections.¹

Temporary flushing of the face or body (redness and heat)

This can happen to 12 to 15 people in every 100.¹ It can happen within a few minutes of having the injection or may not happen until a few hours after. This usually settles very quickly, without any treatment.

Temporary change to the menstrual cycle (periods)

Some women may start their next period earlier than expected, or it may be delayed. Some women may find their next period is lighter or heavier than usual.²

Weakening of the tendons within the foot which can lead to tendon rupture (tear)³

This is rare and may lead to a hammer toe deformity (where one of the small toes of your foot becomes bent and prominent).

Problems with local anaesthetic or the steroid

A reaction to the local anaesthetic or steroid is rare and can happen to less than 1 patient in every 10,000.⁴

Will the injection hurt?

You will have some discomfort during the injection. If local anaesthetic is mixed with the steroid it will help to ease any pain for up to 2 hours.

How will I feel when I get home?

For 2 to 3 days after your injection you may feel increased pain or discomfort so you should rest your foot as much as possible. You should take painkillers at regular intervals, for as long as you need them, rather than waiting until you are in pain. Always follow the instructions provided in the leaflet supplied with your tablets. You should also avoid sports and gradually increase activity after 2 weeks.

Can I drive home after my injection?

You should arrange for someone to bring you to your appointment and take you home. You must not drive home after your injection. You may drive again as soon as you can safely perform an emergency stop. Your healthcare professional will also give you advice.

Will I need further injections?

You will have a review appointment 6 to 8 weeks after your injection. If the injection has helped your pain your healthcare professional may suggest you have further injections. They will discuss this with you.

Contact numbers

If you need further advice or have any problems, please contact the Podiatric Surgery Team.

Podiatric Surgery Team

One Life Hartlepool

Park Road

Hartlepool

TS24 7PW

Telephone: 01429 522471

Opening hours: 9:00am to 5:00pm (Monday to Friday)

If you have any worries or concerns, you should contact your GP during normal surgery hours. Outside surgery hours you should contact your GP’s surgery for the Out of Hours Service number.

Further information is available from:

NHS Choices

Telephone: 111 (when it is less urgent than 999).

Calls to this number are free from landlines and mobile phones or via the website.

The Society of Chiropodists and Podiatrists

1 Fellmongers Path

Tower Bridge Road

London

SE1 3LY

Telephone: 020 7234 8620

Arthritis Research UK

Copeman House, St Marys Gate

Chesterfield

Derbyshire

S41 7TD

Telephone: 0300 790 0400

References

1. Courtney P, Doherty M (2005) Joint Aspiration and Injection and synovial fluid. Best Practice and Research Clinical Rheumatology, Volume 27, pages 137 to 169.
2. Arthritis Research UK Leaflet: Local Steroid Injections.
3. Brinks A, Koes B, Volkers A, Verhaar J and Bierma-Zeinstra S (2010) Adverse effects of extra-articular corticosteroid injections: a systematic review. BioMed Central Musculoskeletal Disorders, Volume 11, pages 1 to 11.
4. Kilmartin TC (2006). Critical Review: The Surgical Management of Hallux Valgus. British Journal of Podiatry, Vol 9, no. 1, pages 4 to 24.

Comments, concerns, compliments or complaints

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