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Trigger Finger

Carpal Tunnel Syndrome

Shoulder Injuries

Knee Injuries

  • From £120 per area

 An inital consultation charge for £60 will be applicable for the above treatment. Once the Doctor has assessed the joint then an accurate cost for the procedure can be determined. Further imaging such as an Ultrasound or an X-Ray maybe required before proceeding with the injection.

 

How do steroid injections work?

Steroid injections can be used to treat a large variety of conditions. Steroid injections work in a variety of different ways, but all are based around reducing inflammation.

 

What are steroid injections used for?

Trigger Finger - this is a condition in which the tendons in the hand that allow bending of the fingers and thumb do not glide normally. One or more tendons in one or both hands may be affected. The tendons become thickened, often with no cause found, and this results in difficulties in the tendons gliding, particularly as they pass through a tight tunnel within each finger known as the flexor sheath. This results in pain when bending the finger, clicking and can result in an inability to straighten the finger out from the palm once bent, often needing to use the other hand to straighten the finger again. This condition can be successfully treated with precise steroid injection into the area of constriction within the palm. Sometimes it may take more than one injection to completely resolve the symptoms.

Carpal Tunnel Syndrome - This is a condition caused by compression of the median nerve at the wrist. The median nerve is responsible for sensation to the thumb, index and middle fingers and also for some of the muscle movements of the hand, particularly those over the palm, at the base of the thumb. Compression may lead to pain, pins and needles and sometimes numbness of typically the thumb, index and middle fingers. It may also cause weakness of grip and muscle wasting in the hand in some cases. Steroid injection aims to improve these symptoms, but at the very least prevent worsening.

Shoulder Problems: Rotator Cuff problems

Knee Problems: Mild / Moderate Arthritis

 

How will the steroid injection be performed?

All steroid injections are performed in sterile conditions

Trigger finger - the steroid is often combined with a local anaesthetic in a single injection to the affected site. We encourage movement of the affected finger after the injection

Carpal Tunnel Syndrome - the steroid is often combined with a local anaesthetic in a single injection to the affected site. We encourage movement of the affected hand after the injection

 

What are the risks?

All procedures carry risks, but the risks for this form of procedure are very low. Should you have any post-operative problems at all, we would advise you to contact us immediately so that we may provide support.

Infection - the risk of an infection after your surgery is very low. If the injection site were to become infected you may notice increasing pain, spreading redness or a thick, yellow smelly discharge. This can often just mean a course of tablet antibiotics are needed

Bleeding - the risk of bleeding is also very low, but you experience some slight oozing from the injection sites for the first 10-15 minutes after injection.

Scarring - injections by their nature will only leave small puncture wounds where they have entered, these are normally not visible long term. When treating keloid scars, there can be a risk the injection puncture sites could cause further keloid formation, but as these are the point of entry of the steroid, this is very rare.

Fat atrophy - where steroids are injected, they may cause some loss of volume of the surrounding tissues, called fat atrophy. You may notice this as thinning of the skin and surrounding tissues. This is quite rare, but may occur with recurrent, frequent steroid injections.

Hypo/hyperpigmentation - steroid injections may cause either darkening, or more commonly a lightening or loss of pigment of the skin. This, again, is quite rare, but may occur with recurrent, frequent steroid injections. It can be temporary or in some cases permanent.

No improvement - there is always a risk that steroid injection does not give the improvement desired, but this is not common and should this be the case, we would be more than happy to discuss how best to manage things further.

Nerve/Tendon injury - when injecting steroid for trigger finger or carpal tunnel, extremely rarely, nerves giving feeling to the fingers may be injured, leading to either temporary or permanent numbness. There is also a risk of rupture of the tendons that bend the fingers, leading to loss of the ability to bend the finger. These risks are extremely rare and precise surgical techniques are used to ensures that the steroid is injected only the required site.

Recurrence - your symptoms may recur in the future either with further keloid scar formation or return of your trigger finger or carpal tunnel symptoms. This risk will be discussed with you at your consultation

Other risks will be specific to the area in question and will be discussed with you in your consultation

The use of steroid or hyaluronic acid as part of a wider management plan for pain relief and increased movement

 

What are steroids

Some steroids occur naturally within the body.  Man made steroids act like those naturally occurring steroids to reduce inflammation. They can be given in the form of an injection or in tablet form.  A steroid mixture can be injected into or around an inflamed joint to ease symptoms of pain and/or movement restriction.  The term ‘local injection’ refers to the way the steroid acts in a particular area.  There are a number of different steroids are available each with pros and cons, some work quite quickly but for a relatively short time, while others are effective for longer but also take longer to start working.

 

What are steroid injections used for?

They’re used for any inflammatory arthritis and sometimes for severe osteoarthritis,gout and also and for conditions affecting certain muscles, tendons and other soft tissues.

 

Why are local steroid injections prescribed?

A local steroid injection is given to reduce inflammation and pain within a joint.  They’re frequently given to those suffering from rheumatoid arthritis and other types of arthritis particularly during a flare up of symptoms that prevent normal function.  An injection into a joint is called an intra-articular injection.

If the pain or inflammation is near an affected joint but not within the joint itself, you may be given an injection into the tender area rather than the joint.  This is called a peri- articular injection or soft tissue injection.

 

When and how do I have local steroid injections?

The most appropriate steroid mixture and dose for your condition and symptoms will be discussed and decided with a recommended consultant.  Most injections are quick and easy to perform.

If you have an injection into a joint, you should rest it, or at least avoid strenuous exercise, for the first 1–2 days.  However, at Resolve Physiotherapy injections are given as part of a complete treatment package as injections often settle pain but do not cure the underlying problem responsible for the pain.  Its important to recognise this and therefore schedule your follow up treatments efficiently to make use of the pain free period anticipated that allows physiotherapy rehabilitation to advance.  Our physiotherapists will be keen to give more intensive treatment after the injection, while your joint is less painful.

If the injection is very helpful, and other treatments are either unsuitable or less effective for you, it may be repeated
if necessary.

 

Side effects

Side-effects can include a temporary flare-up of joint pain, infection, changes in mood and thinning of the skin. These will be discussed with you fully before the injection is consented to.

Injection therapy is used as part of a programme to help treat:

  • Inflammatory pain from a range of orthopaedic conditions
  • Reduced range of movement/stiffness within a joint
  • Carpel Tunnel Syndrome
  • Bursitis of peripheral joints i.e. knee/shoulder/elbow