Injection Clinic
Here at Physiotherapy Room Holmfirth, we offer joint injections including Cortisone & Hyaluronic Acid. We can also provide aspirations of a swollen joint most typically the knee join post-injury or due to an arthritic flare up to provide relief and remove fluid build up.
Conditions which can generally be helped with injections include Osteoarthritis (wear and tear joint degeneration), Rheumatoid Arthritis, Bursitis, Frozen Shoulder, Trigger finger, Carpal Tunnel, Tendinitis and Gout.
Our injections are carried out by our specialist Injection Therapist Kristian Thackray.
Procedure
The procedure for our injections are as follows:
- Depending on the area to be injected the patient will adopt a specific position to make the injection as comfortable as possible
- The area to be injected is marked
- The area to be injected is then cleaned with a sterile anti septic solution to reduce the risk of infection following the injection
- Sometimes but not regularly a Local Anaesthetic is administered to the area to numb the area and make the injection relatively comfortable and as pain free as possible
- The injection is carried out on the area you will feel a sharp scratch and a pressure sensation as the fluid is injected
- A plaster is applied
- You will spend 15 minutes in the clinic before leaving to be monitored for any adverse effects
Frequently Asked Questions
What is a steroid injection?
Cortisone injections, commonly referred to as steroids in the UK, are powerful anti-inflammatory medications used to relieve pain by targeting inflamed joints or body tissues. These injections can provide significant relief for various conditions and are administered directly into the affected area.
In the UK, cortisone injections are available under several brand names. We currently use Kenalog which Contains the active ingredient Triamcinolone Acetonide.
Cortisone injections can offer quick relief from pain and inflammation, helping patients regain mobility and improve their quality of life.
In the UK, cortisone injections are available under several brand names. We currently use Kenalog which Contains the active ingredient Triamcinolone Acetonide.
Cortisone injections can offer quick relief from pain and inflammation, helping patients regain mobility and improve their quality of life.
What is a hyaluronic acid injection?
Hyaluronic Acid injections are a key treatment option for osteoarthritis, especially when other pain management methods have proven ineffective. Hyaluronic Acid is a vital part of both joint and cartilage structure, It lubricates the joints and is essential for maintaining healthy joint function. As we age, our body’s production of hyaluronic acid decreases, leading to joint degeneration and conditions like arthritis. The process of injecting hyaluronic acid into osteoarthritic joints is known as Viscosupplementation. This treatment helps replenish the lost Synovial fluid, alleviating pain and improving mobility. The brand we use is Ostenil Plus which Contains a preservative called Mannitol and is delivered as a single injection that can be ‘topped up’ when needed.
What is a joint Aspiration?
Specialist soft tissue and joint injection physiotherapists can perform joint aspiration procedures to relieve excess fluid buildup in a swollen joint or bursa. The knee is probably the most commonly swollen joint in the body, and many patients come to see us with significant knee inflammation. Aspirating a swollen joint can make a huge impact to a patients comfort and significantly reduce pain from the pressure build up of the excessive joint fluid called an Effusion. In most cases, we draw out excess Synovial fluid, which is a thick liquid located between your joints. Knee joints normally have around 6ml synovial fluid. This fluid cushions the ends of bones and reduces friction when you move your joints. Inflammation of the knee can result in a significantly larger volume of fluid in the joint causing pain and reduced function. Sometimes we aspirate blood mixed with synovial fluid. This happens after trauma to the knee. Very rarely, the fluid aspirated may appear infected. In this case, we will advise you to seek medical attention for further investigations. Straight away patients typically report a feeling of relief. This is usually because the excess fluid puts a lot of hydrostatic pressure on the joint. Excess fluid also reduces movement.
How do I know which to choose between hyaluronic acid and steroid?
When it comes to managing joint pain, many patients at our clinic find themselves uncertain about whether to opt for hyaluronic acid or corticosteroid injections. Both options are effective for relieving pain in various peripheral joints, but their applications differ based on specific conditions and patient needs.
Hyaluronic acid is particularly beneficial for patients with osteoarthritis who experience little to no inflammation (swelling). Ideal candidates typically include:
– **Active Individuals**: Those aged 40-50 who participate in regular sports or exercise and wish to maintain their activity levels (e.g., running or long-distance walking).
– **Minimal Swelling**: Patients with joint pain but no significant effusion may benefit most from this treatment.
– **Steroid Alternatives**: Hyaluronic acid serves as a suitable option for individuals allergic to steroids or those advised against steroid use for medical reasons.
Hyaluronic acid is particularly beneficial for patients with osteoarthritis who experience little to no inflammation (swelling). Ideal candidates typically include:
– **Active Individuals**: Those aged 40-50 who participate in regular sports or exercise and wish to maintain their activity levels (e.g., running or long-distance walking).
– **Minimal Swelling**: Patients with joint pain but no significant effusion may benefit most from this treatment.
– **Steroid Alternatives**: Hyaluronic acid serves as a suitable option for individuals allergic to steroids or those advised against steroid use for medical reasons.
Do injections Work Straight Away
Research has shown it takes 4-8 weeks to really start showing the efficacy of Hyaluronic Acid. Cortisone is more effective for pain in the first 4 weeks but by 8 weeks Hyaluronic injection provides longer-lasting pain relief in addition to being better for the joint overall.
How long do the effects Last
The response to steroid injection can be variable and depends on a number of factors. Typically, steroid injections will give pain relief from between six weeks to six months. With Hyaluronic Acid, because there is no steroid injected, a patient can have a top-up whenever they feel it is necessary, providing they have seen beneficial results. Steroid injections are only advised every 4 months at the most frequent.
Will I cause any harm to my body by having a steroid injection before my holiday?
No you should be fine to have a steroid injection prior to travelling. Steroid injections are very safe and provided you do not have more than 3 injections each year into the same body part (e.g. knee joint) they are very unlikely to cause any significant harm to the tissues. Hyaluronic acid injections are not known to have any harmful effects. Most steroid injections take between 3-5 days to start fully working. We usually recommend for the patient to have the steroid injection around 10 days prior to a holiday as this is when it should be giving its maximum pain-relieving affects. At the minimum, you should give 2-3 days before flying to allow time for any post-injection discomfort to settle or signs of infection to arise before you go off on your holiday.
Are there any side effects or risks?
Injection therapy is very safe. Single use, sterile disposable needles are used in the clinic. Serious side effects are very rare – less than 1 per 20,000 treatments. Clinicians do their very best to make sure this does not happen by using “best practice” methods.
Common side effects:
- Soreness for a few hours or days.
- Temporary flare-up of symptoms.
- Facial flushing (1 in 20 people).
- Bruising/bleeding, especially if you take blood thinners.
Rare side effects:
- Infection (seek urgent medical attention if the area becomes red, hot, swollen, and painful).
- Allergic reaction (very rare, but a medical emergency).
- Joint damage (usually only with frequent, high-dose injections).
- Skin dimpling or color change at the injection site.
- Tendon injury (rare, reduced by resting after the injection).
- Nerve injury (rare).
Other things to keep in mind:
- Steroid injections can raise blood sugar levels in people with diabetes.
- Large doses of steroids may cause menstrual changes in some women.
- The injection might not work, or its effects might wear off.
- If the injection doesn’t work, you can’t have surgery on that joint for several months.
Do I need to do anything after my injection ?
- Relative rest after the injection
- Check where you had the injection from time to time – if there are signs of significant infection you need to go to A&E straight away. The place of injection would look hot, red, swollen and you may feel unwell or have severe pain at the injection site. If you are unsure about minor signs and you are well, then contact us.
- You can continue to take normal painkillers if you think you require these (what you know you can normally take)
- You will be asked to remain in the clinic for 15 minutes following the injection to allow observation of possible adverse reactions.
Can I Drive Afterwards?
Yes, but we ask for you to remain in the department for 15 minutes following your injection to make sure you have no immediate side-effects before you leave.
Further Information
For further information visit https://www.nhs.uk/conditions/steroid-injections/