What are joint injections?
The term joint injection describes a number of injections used in pain management treatments, the most common being a cortisone injection or a local anaesthetic.
Cortisone refers to a group of medications known as corticosteroids. These medications have strong anti-inflammatory agents and can be used to treat parts of the body where inflammation is the primary cause of pain. They are often used to treat pain in knee, elbow, hip and shoulder joints.
Joint injections provide short to medium term pain relief, generally three to six months. They do not provide long term pain relief and will not cure underlying conditions causing pain, such as arthritis.
There is no specific preparation required for a joint injection. At the time of booking our friendly customer service team may ask you a few questions, and will provide you with all relevant information about the procedure and aftercare.
Please wear loose clothing to your appointment, preferably a shirt and pants/skirt, so we may access the treatment site easily. In some instances, you may be given a gown to wear. You may also be asked to remove objects like watches or jewellery for your scan, so consider leaving any valuables at home.
Please arrive 15 minutes before your appointment with your Medicare card and/or concession card, your referral, and any relevant previous scans. If you have a child aged 6 or under, they must be supervised by an adult other than the patient.
Depending on the procedure, your background risk and the type of blood thinner you are taking, you may be contacted by us and asked to temporarily withhold your blood thinners. If you are not sure if you are able to safely withhold your blood thinners, then you can ask your referring doctor whether you are able to stop them temporarily. If you have been advised by your doctor not to stop your blood thinners, then please advise us so we can take this into account when planning for your procedure.
At the start of your joint injection appointment, a team member will ask you some questions and talk to you about the procedure. After you arrive, the procedure will be discussed with you by one of the team members, and you will have the chance to ask any questions of the radiologist or any of the team members before proceeding. You will then be asked to sign a consent form indicating that you wish to proceed with the procedure.
Your injection will be performed by a radiologist under imaging guidance - normally ultrasound or CT – with the assistance of either a radiographer, sonographer, nurse or clinical assistant.
Your skin around the area being injected will be cleaned with an antiseptic solution. In some cases a local anaesthetic will be initially administered, which may cause a stinging sensation which will quickly subside. A needle will then be guided into place in the joint under imaging guidance. When the needle is in the correct position, the mixture of corticosteroid and local anaesthetic will then be injected. You may feel some discomfort or cramping during this injection which usually settles very quickly.
The length of your appointment may vary, but generally a joint injection will take 15 – 30 minutes. You may be asked to stay at the clinic for a short period following the injection to ensure that you do not have any problems.
It is common for people to feel numbness or weakness in the joint following the injection. This is caused by the local anaesthetic and usually wears off over a period of a few hours. The extent to which people experience effect this can be variable between different people, and may also vary between procedures on the same person. You may also feel as though your leg is ‘giving way’ for injections in your lower limb (e.g. hip and knee), or that you are ‘dropping things’ for injections in your upper limb (e.g. shoulder, hand).
Depending on the type of injection, you may be asked not to drive for a period of at least 6 hours following the procedure while the local anaesthetic is having effect, although this may be longer in some cases.
Most people do not report any problems following the procedure, or at most report only minor side effects from the procedure. However, there are some risks that you need to be aware of:
- Pain or discomfort during the procedure – It is common to feel some discomfort during any procedure involving needles, although we will try to minimize your discomfort with local anaesthetic. However, you should let us know if you are feeling pain during the procedure.
- General malaise –A feeling of general malaise is also sometimes reported and may also be caused by the steroid. People may also report difficulty sleeping or anxiety for a couple of days after the procedure.
- Steroid flush - People may report a flushing of the skin over their face and chest a day or two after the injection. This is related to the steroid and usually settles by itself. It does not usually require any treatment.
- Flare of pain – some patients may feel an increase in their symptoms after the injections. This may be caused by the corticosteroid (steroid flare) or sometimes the local anaesthetic. This will usually settle down by itself over the course of a few days, although sometimes may take longer. You may take analgesia if you experience a flare, as it will not affect the outcome of the injection. Most people who experience a flare also report that their usual baseline symptoms improve once the flare has also settled.
- Hyperglycaemia – The corticosteroid may temporarily elevate your blood glucose levels. This is usually only relevant to diabetic patients who are monitoring their BGL and taking insulin, and may require a temporary change to your usual insulin dosing regimen.
- Allergic reactions – serious allergic reactions are rare for this type of procedure, although may be caused due to a reaction to the skin cleaner, corticosteroid or local anaesthetic. If you suffer from an allergic reaction it will usually occur at the time of the procedure, and will be treated accordingly by the radiologist.
- Failure of the procedure – in some cases the procedure may not alleviate your pain, or may only partially relieve your symptoms. The reason for this may be for a variety of reasons, but is usually related to the cause of your pain rather than anything related to the procedure itself. The fact that the procedure has not alleviated your pain is still important information for your referring doctor to know, as it will help to further guide the diagnosis and management of your pain in the future.
- Bleeding – Bleeding and bruising is usually very minimal. It may be more common in people who have an underlying bleeding disorder or who are taking blood thinners. Rarely it may cause a ‘haemarthrosis” or bleeding into the joint requiring further medical or surgical treatment.
- Infection – this is uncommon and usually minor, although uncommonly may require hospital admission and treatment with antibiotics or surgery.
You may require a driver to take you home and you should not drive for at least 6 hours following the injection. We ask that you avoid any strenuous physical activity, including standing for more than one hour at a time, for 48 hours post injection.
If you experience pain following the procedure, you may treat with a local application of a cold pack and analgesia (e.g. paracetamol or NSAIDs).
If you develop fever with joint pain, swelling, redness and warmth in the days or week following an injection, call Qscan on 1300 177 226 or contact your GP. If you are still concerned and it is after hours, please contact your nearest Emergency Department.
Our friendly customer service team will provide you with any specific aftercare instructions at the time of your appointment.
Our friendly customer service team can advise you of all costs involved with your joint injection including any out-of-pocket costs, if relevant. Please contact us for a quote or to book your appointment.