Corticosteroid Shots for Reducing Inflammation

Steroid injections are a common and effective treatment for a wide range of musculoskeletal and nerve-related conditions.

They can help relieve pain and inflammation associated with:

• Osteoarthritis (joint wear and tear)
• Inflammatory arthritis (such as rheumatoid arthritis, gout, and pseudogout)
• Bursitis and tenosynovitis (e.g., rotator cuff issues, trochanteric bursitis/gluteal tendinopathy, tennis elbow and more)
• Nerve pain (e.g., carpal tunnel syndrome, occipital nerve blocks for headaches)
  
  

Most of these injections can be safely and effectively performed in a primary care setting, apart from certain areas like the spine, which requires specialist care.

Ultrasound guided steroid injections

At Lakeview Clinic not only do we provide services for steroid injections, but we also have an option for ultrasound-guided steroid injections too.  Using real-time ultrasound imaging allows us to deliver medication precisely where it’s needed, increasing both safety and effectiveness.

Ultrasound guidance is especially useful when:

• The target area is difficult or risky to access (e.g., due to bone spurs, severe arthritis, higher BMI, or there are nearby critical structures that need to be avoided).
• A previous non-guided injection didn’t provide relief.
• The pain source is unclear (e.g., differentiating between pain from the hip, SI joint, or lower back). In these cases, a guided injection can provide both pain relief and diagnostic insight.

Note: While ultrasound guidance improves accuracy, insurance may not always cover it unless these specific conditions are met. Please speak with your provider about this beforehand.

Frequently Asked Questions

What’s in a steroid injection?

Most injections include:

• A short-acting anesthetic (e.g., lidocaine) for immediate, temporary relief. This wears off after a few hours.
• A long-acting corticosteroid (e.g., Kenalog, Depo-Medrol) to reduce inflammation. Steroid benefits typically begin within a few days to 2 weeks and may last for several months.

When should I consider a steroid injection?

• To delay or avoid surgery.
• To improve pain and mobility to better participate in physical therapy.
• To reduce reliance or side effects of NSAIDs, Tylenol or other pain medications.
• To prevent other injuries due to compensating for the current pain.

If pain is disrupting sleep or interfering with certain activities.

What are the potential risks?

While generally safe, possible side effects include:

Systemic effects (e.g. transient elevated blood sugar, elevated blood pressure, facial flushing): typically temporary and rare, but can be more likely in individuals with certain predispositions like diabetes

Bleeding: <1%

Infection: <1%

Temporary discomfort during the injection

“Steroid flare” (increased discomfort/swelling in the first 48 hours post-injection): ~5%

Allergic reaction: rare

Skin thinning or discoloration at the injection site: <1%

Tendon rupture: <0.1%

Ineffectiveness of the injection

When can’t we do the injection?

We generally avoid steroid injections in the following situations:

• Acute fracture in the target area
• Active systemic infection or infection at or near the injection site
• Uncontrolled diabetes (typically fasting glucoses >200 or A1C >8.5%)
• High bleeding risk (e.g., INR >3.5 or certain blood disorders)
• Known allergy to the anesthetic or steroid (though alternatives may be available)
  
  

Note: We do not inject prosthetic joints. Additionally, if there is desire for a spinal injection this must be done with X-ray or CT guidance by a specialist.

Is there a limit to how many injections I can receive?

There’s no strict lifetime limit, but to minimize systemic effects, we typically do not recommend more than one injection every three months per joint, or 3–4 injections per year.

Which steroid injections are offered at Lakeview Clinic?

• Head: occipital blocks
• Shoulder: rotator cuff, shoulder joint, biceps tendon, AC joint
• Elbow: elbow joint, lateral or medial epicondylitis (i.e. tennis elbow, golfer’s elbow)
• Wrist: carpal tunnel, De Quervain tenosynovitis, small joints of wrist
• Fingers: CMC joint, trigger finger(s), other small joints
• Hips: greater trochanter (bursitis/gluteal tendinopathy), hip joint (must be ultrasound guided)
• Sacroiliac (SI) joint
• Knees: knee joint, pes anserine bursa
• Ankle: ankle joint
• Foot/heel: Achille’s, Plantar fasciitis, Morton’s neuroma, MTP joint, small joints of feet 
• Trigger point injections

Note:

Foot/heel injections are done primarily by Dr. Arens (Podiatry)

Ultrasound guided injections are done by Dr. Clark (Family Medicine)

If you’re considering getting a steroid injection or have additional questions, speak with your Lakeview provider. We’re here to help you make an informed decision based on your unique needs and health goals!