Steroid injections can be a highly effective treatment, offering a valuable opportunity to relieve pain, engage in rehabilitation, and address factors contributing to your condition. However, there are times when pain may worsen after the injection. Understanding the potential reasons for this can help you manage and address any concerns.
5 Reasons Why Your Pain May Be Worse After a Steroid Injection:
Can Infection Cause Pain After a Steroid Injection?
Infection: While extremely rare, with approximately 1 in 50,000 cases, infection is the most serious cause of increased pain after a steroid injection. It’s important to distinguish between a typical post-injection pain flare and an infection. Infections can develop at any time after the injection, though symptoms typically appear within the first few days and may take up to a week or two to manifest. Signs of infection include a significant increase in pain, difficulty moving the affected area (such as trouble walking if the injection was in your hip, knee, or ankle, or difficulty moving your arm if it was in your shoulder), redness, heat, and swelling at the injection site, as well as fever, feeling generally unwell, or nausea. If you experience these symptoms, contact your healthcare provider immediately, and you may need to visit A&E.
What Is Post-Injection Pain Flare and How Long Does It Last?
Post-Injection Pain Flare: Several factors can contribute to a pain flare after an injection. Around a quarter (1 in 4) of people may notice an increase in pain within the first 24 hours after the injection. This type of pain usually resolves on its own within a few days. In rare cases, it may persist for a week or two but typically responds well to rest, ice, and over-the-counter pain medications like paracetamol or ibuprofen. Unlike an infection, a pain flare is limited to the injection site and does not cause systemic symptoms like fever or nausea. On very rare occasions, the pain can be severe (a condition known as pseudosepsis), and medical attention is necessary.
Can Needle Contact with Sensitive Structures Cause Increased Pain?
Accidental Needle Contact with Sensitive Structures: Although rare, the needle may accidentally touch delicate structures such as nerves or blood vessels during the injection. Using ultrasound guidance during the procedure significantly reduces the risk of this complication by ensuring precise needle placement.
Do Steroid Injections Weaken Tendons and Fascia?
Tendon or Fascia Tears: Steroid injections can temporarily weaken tendons and fascia. It’s documented that introducing steroids into or near these structures can have a short-term weakening effect. To avoid further damage, it’s important to rest the affected area after the injection. Your clinician will provide tailored instructions on how long you should rest after the injection, based on your individual situation. Before returning to more dynamic activities or sports, it’s crucial to have a follow-up physiotherapy assessment. Your physiotherapist will guide you through a series of exercises to gradually strengthen the area before you resume full activity.
Can a Nickel Allergy Cause Pain After a Steroid Injection?
Nickel Allergy: Most hypodermic needles in the UK contain traces of nickel. If you have a nickel allergy (which is very rare), you might experience a localised allergic reaction after the injection. This can present as a red, itchy, and painful patch around the injection site. This reaction usually settles with a course of antihistamines and the application of an ice pack.
If you would like to book an appointment or discuss whether a steroid injection can help you, please contact us at 020 7482 3875 or email info@complete-physio.co.uk. One of our clinicians will be happy to call you back.