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Joint Injections

Joint Injections: Shoulder, Knee, Hip, Carpal Tunnel

What is a joint injection?

Any time two bones meet in the body, it is called a joint. Joints are surrounded by a joint capsule. When a joint is inflamed, irritated and in pain, a joint injection of local anesthetic, steroid or other medication can often help.

What is the purpose of a joint injection?

Steroid injections are designed to decrease inflammation, irritation and pain in a specific joint and its surrounding tissues.

How long does the joint injection take?

Joint injections typically take only a few minutes to complete.

What is actually injected?

The injection typically consists of a local anesthetic and a steroid medication. Other medications can sometimes be injected as well.

Will the joint injection hurt?

Prior to the joint injection, we use numbing medicine at the skin using a very thin needle. This often feels like a “pinch and a burn” to numb the skin before entering the deeper tissues and joint capsule.

Will I be “put out” for the joint injection?

Typically not. This procedure can often be completed under local anesthesia.

How is the joint injection performed?

The position you are in for joint injections depends on the joint being injected. Shoulders, elbows, wrists, fingers and knees are often injected with the patient sitting up whereas hips, knees, ankles and toes are often injected with the patient lying down either on the back or the side. Before the injection, the patient’s skin is cleaned with antiseptic solution and then the injection is carried out. A band-aid is usually applied afterward to cover the injection site.

What should I expect after the joint injection?

In terms of pain relief, the joint injections may provide immediate pain relief, at least for a few hours. This is due to the local anesthetic medicine that is injected into the joint. When the local anesthetic wears off, you may have some soreness for a day or two after the procedure. This is due to the irritation of the needle insertion itself. If steroid is also injected, longer term pain relief may be expected starting around 2-7 days after the injection. Thus, there may be lag time between the time the local anesthetic wears off and the steroid takes effect.

What should I do after the joint injection?

We recommend you have a ride home and take it easy for the rest of the day (and possibly also the next day) after the procedure. Take it easy and slowly increase your activity level as tolerated.

Can I go to work to work the next day?

Unless there are any complications or side effects, you should be able to return to work the next day. You may still have soreness in your joint the day after, so we recommend you increase activity level slowly.

How long does the effect of the medication last?

The immediate pain relief is usually from the effects of the local anesthetic that was injected. Although this wears effect wears off in a few hours, the steroid begins working in about 2 to 7 days after the injection and its effect can last for several days to a few months.

How many joint injections do I need to have?

Depending on your response to the first injection, you may be recommended to have an additional injection. This typically depends on your response to the injection and the severity of the condition of the joint itself.

Can I have more than three joint injections?

For a few reasons, generally, we do not recommend more than three injections in any six to twelve month period of time. The steroid medication being injected is meant to last from several weeks to months and it is unlikely that you will get further benefit by increasing the number of injections. There are also side effects that are associated with steroids and the likelihood of these side effects increases with each injection. If the injections are not working, consideration to stronger therapies, including surgery may need to be discussed.

Will the joint injections help me?

It is difficult to predict with 100% accuracy how a patient will respond to a joint injection. However, patients who typically have pain that is milder and has been present for a shorter amount of time generally respond better than those with more severe, longstanding pain.

What are the risks and side effects of joint injections?

Joint injections are generally very safe procedures. The most common side effect of the procedure is pain and soreness, which typically subsides with time. Other, more rare, risks include infection, bleeding and worsening of symptoms. There are risks also associated with the medications that are injected as well. For instance, steroids could cause weight gain, increase in blood sugar and the suppression of the body’s own ability to produce cortisone. Serious side effects are uncommon.

Who should not have a joint injection?

Patients who have an allergy to any of the medications that are injected, are on blood thinners as a part of their medication regimen, have an active infection or have poorly controlled diagnoses such as diabetes or heart disease may not be good candidates for a joint injection. Your physician will determine whether you are a safe candidate.

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