HOW LONG DOES THE INJECTION TAKE?
The injection appointments take 30 minutes. This allows time for registration, discussion with your consultant about the injection, completion of a consent form and then the procedure itself. The procedure normally takes less than five minutes. Afterwards you will be given post-injection advice.
WILL MY INSURANCE COVER THE COSTS OF THE INJECTION?
At present the Joint Injection Clinic is a self-pay service only however we expect that in the near future we will be able to offer treatment under authorisation from all major private medical insurers.
DO I NEED A REFERRAL FOR AN INJECTION?
A referral is required for all injections and procedures. The referral must be made by a medical doctor i.e. General Practitioner, orthopaedic surgeon or specialist musculoskeletal physiotherapist/osteopath and should be received by the clinic prior to the appointment.
WHAT SHOULD I LOOK OUT FOR FOLLOWING THE INJECTION?
The main complication to look out for after an injection is infection. If the injection site becomes red, hot, tender or swollen or if you develop a fever then you should contact the clinic or seek medical advice immediately, i.e. GP, walk-in-centre, Accident & Emergency. This issue would normally be managed with antibiotics as required.
After an injection it is not uncommon to develop a painful flare in your symptoms. This may start after the local anaesthetic has worn off and may last 24-48 hours. If this is the case then you can use simple painkillers such as paracetamol and ibuprofen (as long as they are well tolerated), as well as applying ice (wrapped in paper towel) to the area for 10 minutes every hour as required.
Insulin-Dependent Diabetes Mellitus (IDDM)
A steroid injection can temporarily increase blood sugar levels by making insulin less effective.
If you have IDDM then it is advisable to cautiously monitor blood sugar levels for 5-7 days after the injection. This may mean testing two or three times a day to ensure that the levels are not increasing. If blood sugar levels become high then medical advice should be sought from the person who normally manages your diabetes (usually your GP).
WHAT ARE THE RISKS ASSOCIATED WITH THE INJECTION?
The main risks associated with a musculoskeletal injection include: local infection (1 in 10,000 risk). This means that for every 10,000 injections performed one would expect to see 1 infection.
Other risks include:
Local bleeding/Nerve damage at injection site - 1 in 10,000
Post-injection flare - 1 in 50
Local skin pallor (depigmentation) and thinning of the skin (fat atrophy)
Injection should be avoided if you have a fever or are unwell.
Caution should be taken if you have insulin-dependent diabetes, as steroid injections can raise the blood sugar, requiring frequent self-monitoring in the days following the procedure.
If you are breast feeding then this should be discussed with the clinician undertaking the procedure. In general the clinician will advise either expressing breast milk to provide baby with enough for 48 hrs, or using formula milk to cover the same time period.
If you are taking warfarin or blood-thinning medication then you should tell the clinician prior to the injection.
WHAT HAPPENS AFTER THE INJECTION?
If you have any concerns following the injection then please contact our friendly admin team who will help with any queries.
If you have concerns about a possible infection and are unable to reach the admin team (out of hours) then please contact the NHS emergency helpline on 112 or seek further medical advice via a Walk-In-Centre or Accident and Emergency.
DO I NEED TO TAKE EXTRA PRECAUTIONS DURING THE COVID 19 PANDEMIC?
At present, during the current Coronavirus pandemic, clinicians are being asked to be more cautious than normal when using steroid injections. There is a presumed risk that a soft tissue or joint injection (using steroid) could lead to mild immunocompromise (weakening of the immune system), therefore if exposed to Coronavirus following an injection you may be slightly more at risk of developing an infection than if you had not had a steroid injection. There is little evidence to convincingly prove this theory but we still need to exercise caution particularly in elderly individuals (over 70 years), and in immunocompromised individuals with chronic heart, lung, liver, kidney issues and in individuals who have cancer or HIV, or in those who have had their spleen removed. If you have any specific questions please ask the referring clinician and/or the doctor performing the injection.