At Complete we have been carrying out steroid injections for over ten years. Steroid injections are extremely effective for reducing pain, improving function, and returning people back to their desired sport as soon as possible.
One of the most common questions we get regarding steroid injections is ‘how many steroid injections can I have? There is no simple answer to this as it depends on the individual presentation of the case.
A majority of injections we carry out at Complete are a one off and do not require repeat injections. However, if you have an arthritic joint for example osteoarthritis in the knee or base of the thumb then repeat injections may be required. The NHS suggests that you have no more than three injections per year and they should be at least 6 weeks between injections https://www.nhs.uk/conditions/steroid-injections/.
If you have arthritis and we feel you may require multiple injections then we often use a substance called hyaluronic acid. Most commonly we use it for knee joint arthritis as this is the joint where a majority of the research has been carried out. Hyaluronic acid is a lubricant and is not classified as a ‘drug’ and so has very few side effects.
“The NHS suggests that you have no more than three injections per year and they should be at least 6 weeks between injections”
Other conditions that occasionally require more than one injection are frozen shoulder (known medically as Adhesive Capsulitis), carpal tunnel syndrome, acromioclavicular joint pain and trigger finger.
At Complete we are very judicious with when and where we carry out steroid injections. We always spend a significant amount of time in your appointment discussing your specific case with you outlining the pros and cons of a steroid injection.
What harm can multiple injections do?
Steroid injections are very safe procedures with very few side effects. However, carrying out multiple injections to exactly the same site has the potential to cause thinning of the cartilage and weaken tendons. It can also cause thinning of the skin and depigmentation (discolouration) of the skin. Also, the more injections you have in one location the less effective each injection becomes.
We also get requests for steroid injections when people are on a waiting list for an operation, such as a total knee or hip replacement or carpal tunnel surgery. We work very closely with surgeons and receive many referrals from surgeons to carry out a steroid injection to help people whilst they wait for their operation. However, this varies from one surgeon to the next and some surgeons we work with do not want a steroid injection being carried out within a three-month time frame of the operation date. So, the decision is made on a case by case basis and we always recommend the client speaks to their surgeon to ask for their opinion.
If you would like to discuss whether or not an injection is an appropriate intervention for your condition, then please feel free to email us at info@complete-physio.co.uk