Why are injections used for pain management?

24th January 2022

Written by: Dr. Vicann During

In this blog we want to discuss how Dr. Vicann During uses injections as part of his treatment of patients. The usual medication that is injected is corticosteroids, often also known as cortisone or just steroids. For ease, these will be referred to as cortisone injections.

What are corticosteroids?

Corticosteroids are one of different types of steroids that your body naturally produces. Unlike anabolic steroids, which for many is linked with bodybuilding and muscle growth, corticosteroids are mainly used to reduce inflammation and dampen down your body’s immune response. In other fields of medicine, corticosteroids are most used for the treatment of conditions such as asthma, hayfever or Rheumatoid Arthritis for its anti-inflammatory properties.

How can a cortisone injection help me?

Most issues do not require any injection. However, there may be times where your pain is so severe that you struggle to sleep or they may affect the things you do despite resting, painkiller tablets or creams or with input from a professional practitioner. This is where cortisone has a huge role to play in managing your pain and allowing you to function. Improving your pain means that your practitioner may be better placed to help support your recovery longer term whilst the cortisone is having an effect. In addition, all injections done by Dr. During at the clinic are ultrasound guided, meaning you can be certain the injection has gone into the correct place.

Which parts of the body can your inject?

Cortisone can be injected into joints in your arms (including your shoulder) and legs (including the hip). In addition, tendons around these joints can respond well to cortisone.

Are there any risks to having an injection?

Cortisone injections have been done for many years safely and continue to be the most common medication injected into joints and tendons. Despite this, there are some potential risks, a good guide to which can be found here. In addition, some studies have shown that frequent injections can accelerate cartilage damage in joints and increases the risk of tendons tearing. The risk of tendon damage is higher in load bearing joints (those in your legs) compared to your arms. As such, it is vitally important that you do not rely on regular injections to manage your problems long term. As part of an appointment with Dr. During before an injection is given, you will be fully assessed to ensure that it is safe and appropriate to inject.

What happens after the injection?

All injections performed by Dr. During are with local anaesthetic, meaning that afterwards you may notice some immediate improvement in your pain. Once this wears off after a few hours a few people may experience an increase in their pain as the steroid can at times take up to a couple of weeks to really start to notice the effects. It is recommended to rest the injected area for a minimum of 2 days and if your pain is better you can resume exercises and start seeing your practitioner again. Ice, Paracetamol and anti-inflammatory gels, creams or tablets can be used to manage any worsening of your pain. Dr. During will always call to review how you are after the injection at no extra cost at a mutually convenient time.

Can you inject anything other than cortisone?

In short yes, although the longer answer is much more complicated. The main alternative offered by Dr. During is Hyaluronic Acid injections in the form of Ostenil Plus. Hyaluronic Acid is a naturally occurring substance within the body and plays a vital role in supporting the growth and development of the joint’s bone and cartilage as well as acting as a “joint lubricant”. Hyaluronic Acid also has some anti-inflammatory effects, although this is not as strong as cortisone. Their evidence for its effectiveness compared to cortisone is mixed and even when effective, it takes longer than cortisone to start to notice the benefits, although when it is effective it seems to last longer than cortisone. The decision to inject Hyaluronic Acid as opposed to cortisone can only be made after a full assessment. Other substances such as dextrose (prolotherapy) and PRP are not currently offered.

If you have any questions about injections for your pain, please do get in touch and Dr. During will be happy to advise. For a more detailed account of what to expect when visiting Vicaan and if he is the right physician for you, read this helpful blog. 

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