Cortisone (Steroid) Injection

Cortisone is an anti-inflammatory medication that can be injected into joints and soft tissues under X-ray or ultrasound guidance to decrease inflammation and reduce pain.

This procedure allows a small dose of medication to be injected into a localized and specific area of concern while keeping potential side effects to a minimum. It can also confirm the origin of your pain – considered a “diagnostic” injection. This procedure can be used to treat joint pain or arthritis, or inflammation of a bursa or around a tendon (tenosynovitis).

Relief may last 3-6 months and, if successful, repeat injections can be performed up to four times per year.

HOW DO I PREPARE FOR MY PROCEDURE?

• If you are on anticoagulation drugs (Plavix, Coumadin, Warfarin etc.) you may need to have an international normalized ratio (INR) test and stop your medication prior to the procedure. Please inform our booking coordinators of any blood thinners you may be taking, so that they can discuss further instructions with you.
• If you take insulin to manage your diabetes, please let your booking coordinator know. You may have some juice and a small snack after taking your insulin.
• IMPORTANT: Please schedule your injection either two weeks before or one week after any vaccination appointment.
• For thoracic facet injections, if you are currently taking antibiotics, you will need to wait two weeks after your last dose before having your injection.
• For all other injections, if you are currently taking antibiotics, you will need to wait two days after your last dose before having your injection.
• Take all prescribed medications as directed.
• In case you have any discomfort, please have someone accompany you on the day of your test. It may be more convenient to have someone else drive you home.
• Please arrive 15 minutes before your appointment to allow enough time to fill out a consent form.
• Bring photo identification and your provincial health card.
• Wear comfortable clothes.
• Please do not bring children who require supervision.

WHAT HAPPENS DURING MY PROCEDURE?

• We may provide you with a comfortable clinic gown to change into (depending on the area being treated).
• A team member will review the consent form, explain procedure details, and answer any questions.
• We will then escort you to our treatment suite where you will meet the radiologist who will clean the skin and inject a local anesthetic, similar to the freezing you get at the dentist.
• After the location is confirmed with X-ray or ultrasound guidance, the anti-inflammatory and long-lasting freezing will be injected using a thin, sterile needle.
• You will be assessed post-injection by our team and, if there are no concerns, you will be free to leave.

POST-PROCEDURE INSTRUCTIONS

• First 24 hours: Keep the treatment area clean. Leave the Band-Aid on. Do not shower.
• First 48 hours: Avoid bathtubs, hot tubs, and pools. Avoid strenuous activity and lifting.
• After one week: You may resume physiotherapy. Be mindful of your pain and stop if it hurts too much. Notify your physiotherapist that you have had this injection so they can modify your exercises if necessary.
• Watch for infection: If you develop worsening pain, skin redness at the site of injection, or a temperature greater than 38.5°C, please proceed to an urgent care or emergency centre.
• If you have pain or other symptoms beyond 48 hours after your injection, this is a normal reaction, . You may apply heat and ice to the treatment area. If you have any questions, please call our office at 403-568-3890 or please email us at paintherapy@radiology.ca during business hours.
• Diabetics: Note that cortisone can cause a temporary increase in blood sugar. Please monitor your blood sugar closely and, if you have any concerns, consult with your doctor.
• For HA injections: This product may take time to distribute in the joint. We encourage you to move the joint and massage the area. Rarely, patients may experience a temporary “flare”
  of the joint – pain and stiffness – after these injections. This typically occurs between 12-48 hours after the injection and can be managed by Tylenol or aspirin.

WHEN WILL I SEE RESULTS?

• After your injection, the freezing may last for a few hours. Your symptoms may return until the steroid takes effect in 3-7 days. Please track your symptom response to share with your physician.
• A steroid injection typically provides three months of symptom relief. If an injection does not help relieve your symptoms, then you may need further evaluation by your referring doctor for another cause of your symptoms.
• Results can vary from weeks to months depending on the body part involved, severity of the disease and your symptoms. Most patients get complete relief that is permanent while, rarely, others have limited response.
• Please consult with your doctor regarding your results and any follow up exams or questions.

HOW MUCH WILL IT COST?

This exam is covered under your Alberta Health Care Plan. It is not currently offered at our Saskatchewan clinics.