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Corticosteroids are anti-inflammatory drugs which can be either injected locally or taken orally. Injected corticosteroids are more commonly used in musculoskeletal conditions, due to the maximal concentration at the site of injury and the reduced risk of side-effects.
Corticosteroid injections (also known as cortisone or hydrocortisone) have the reputation of being extremely painful, however this can be limited with the use of a local anaesthetic.
The aim of injecting corticosteroids is to reduce pain and inflammation sufficiently to enable a strengthening program to be commenced and should be used in conjunction with physical therapy and correction of predisposing factors. The use of these injections should be limited to following the failure of conservative treatment and the number of injections to one site should be restricted.
What are corticosteroids used for?
Corticosteroid injections are commonly used to treat the following musculoskeletal conditions:
- Tendon injuries
- Joint synovitis
- Runners knee (iliotibial band syndrome)
- Plantar fasciitis
Short courses (5-7 days) of oral corticosteroids (such as prednisolone) are occaisionally used to treat:
- Osteitis Pubis
- Adhesive capsulitis (frozen shoulder)
- Chronic tendinopathies
- Acute cervical or lumbar radiculopathy/diskogenic pain
What are the side-effects / negatives?
- Inhibition of collagen synthesis and tissue repair.
- Infection (rare but can occur following injection).
- Avascular necrosis of the femoral head .
- Injections do not always work.
- Only 1-2 injections can be used on the same area.
- More injections leads to an increased risk of tendon rupture.