Ultrasound Guided Cortisone Injections in South London
Cortisone Injections at our clinic
We are a leading musculoskeletal clinic offering diagnostic ultrasound and ultrasound guided procedures such as cortisone injections or hyaluronic acid injections for musculoskeletal pathologies. We perform all procedures as part of a comprehensive and global management of your condition.
​
We offer our services at our South London clinic and also offer home visits in the South London area. A free telephone consultation is available to understand whether an ultrasound scan will be helpful and appropriate in your particular case.
​
Booking is quick and easy, please see our book appointment page for more details.
What are Cortisone Injections?
Although “cortisone" is often used as a general term, it refers to a class of hormones called corticosteroids which are natural anti-inflammatory substances produced by the adrenal glands (above the kidneys). We do not actually inject cortisone as per say as it is short acting and less potent, but we use medications of the same family such as Triamcinolone Acetonide, Methylprednisolone or Dexamethasone which last longer and are more effective to manage inflammation, decrease pain, swelling and stiffness. We usually combine these injections with local anaesthetic drugs such as lidocaine, to reduce the discomfort of the injection and limit pain afterward.
The main effects of corticosteroids injections are:
​
-
Anti-Inflammatory Effects where corticosteroids act by inhibiting the production and release of pro-inflammatory substances, such as cytokines and prostaglandins. This helps to reduce the inflammatory response at the site of injection.
-
Suppression of the Immune Response meaning that corticosteroids can dampen an overactive immune response present in some pathologies, which contributes to inflammation and tissue damage.
-
Reduction of Swelling (oedema) and accumulation of fluid in the affected tissues often caused by inflammation. Corticosteroids can help reduce this swelling by stabilizing cell membranes and decreasing the permeability of blood vessels, thereby limiting the leakage of fluids into the tissues.
-
Pain reduction as a secondary effect by reducing inflammation, swelling, and immune response.
​
What our patients say
What can be treated with ultrasound guided cortisone injections?
Cortisone injections have be used for decades as they are easily available and effective to manage a wide range of musculoskeletal conditions. Extensive medical research suggests that ultrasound guidance is more effective and decrease the risk of complications. Some of the common conditions that we treat include:
​
-
Arthritis such as osteoarthritis.
-
Tendon injuries like tendonitis or tendon tears.
-
Nerve conditions and entrapment such as carpal tunnel syndrome, cubital tunnel syndrome or tarsal tunnel syndrome.​
-
Bursitis commonly seen in shoulder, elbow, hip and knee pain.​
​
How often do I need to have cortisone injections done?
The frequency of corticosteroid injections will depends on various factors, including the specific medical condition being treated, previous response to the injections, and individual features. Prior to repeat an injection, we will also consider the severity and chronicity of the condition, the location of the injection, and any potential side effects associated with repeated use.
​
There is no risk of becoming addicted to corticosteroids if you have repeated procedures but there is some evidence that repeated injections may cause further joint degeneration (especially on the knee) or cause tendon damage. In some other conditions like trigger fingers, repeated injection are known to be safe. These side effects are more likely to occur if there are other risks factors (obesity, smoking...) and the need for repeated injection will be assessed on a case by case basis. If further injections are not recommended, we will discuss other alternatives such as hyaluronic acid or Arthrosamid® injections.
Are cortisone injections a long-term solution for my condition?
Corticosteroids have a short term effect (around 3 months) but a common belief is that cortisone injections do not address the underlying causes of your pain and will only stop the symptoms.
​
First of all, your pain has a massive impact on your daily life and any relief, even temporary, can help significantly with your sleep, work or family activities, and as a result, improve your general well being and mental health. Fortunately, simple pathologies, even when causing severe pain, tend to improve overtime and by the time the steroid has stopped working, we expect that your body has healed by itself and the pain won't return.
​
Secondly, the pain free period allowed by steroid injections (up to 3-6 months on average and sometime over 1 year) is a window that will be used to begin further treatment such as a prescribed exercise program or sessions of physiotherapy, in order to address other causative factors for your problems.
​
In some cases steroid injections can also be a permanent solution by stopping chronic inflammation or disrupting your pain signal. More information about pain can be found on our blog.
At your virtual consultation and first appointment, your clinician will ask questions and assess you to diagnose your problem and explain to you the options available. This will help you to understand how you can use the respite from pain which a corticosteroid injection provides, to work directly on your problem and provide you with a personalized exercise plan to avoid reliance on injections in the future.
Why should I book my ultrasound guided cortisone injection at Insight MSK?
All our procedures and diagnostics are part of a comprehensive management of your condition in line with recent scientific evidence. All injections are ultrasound guided, which have been proven to be more effective and are all preceded by a thorough clinical examination. We do not only diagnose or "fix" problems but we strive to understand the context and causative factors which have led to your condition in order to prevent re-occurrence. These require several skills and the ability to deal with complex and multiple information which often need the expertise from different specialists and therefore multiple appointments, travel, fees... We offer all these services together to give you a prompt single point of contact to assess, diagnose and manage your condition thanks to our unique and vast experience in musculoskeletal medicine.
Your clinician
All our injection treatments are carried out by our experienced physiotherapist and injection clinician, Maxence Legout. Max has over 15 years experience and holds a senior position in the NHS, where he carries out over 2000 ultrasound-guided injection & procedures every year.
​
For more information please see our clinician page, or book a free telephone consultation to speak to Max directly.
What are possible side effects of cortisone injections?
Fortunately, serious side effects to corticosteroid injections are rare and reactions are generally mild and short-lived. but like any drug or medical intervention there are risks such as anaphylaxis (life-threatening allergic reaction, which is extremely rare in response to injected steroid or local anaesthetics), infection (1 out of 50 000 patients), but more likely to occur if you suffer from diabetes, rheumatoid arthritis, Chronic Kidney Disease, HIV or if you take intra venous drugs.
​
Less serious reaction can occur such as a temporary increased pain (20% of the cases), cosmetic changes to the skin including depigmentation or localized fat atrophy around the injection site, bruising around the injection site (more likely, if you are on blood thinning medications), tendon rupture, increased cartilage degeneration, numbness or tingling, abnormal vaginal bleeding, temporary facial flushing, mood disturbances or depression (if you or your family have a history of psychosis or bipolar disorders) and of course failure to work.
​
Your clinician is trained to recognise and deal with severe immediate reaction and we are equipped with the appropriate first aid equipment. To minimise risks of side effects we advise rest for 48h (including driving for lower limb procedures) and you will be asked to wait up to 20 minutes in the waiting area.
We encourage you to communicate any concerns with us to ensure a comfortable and informative experience.
Can I have a cortisone injection while I am pregnant or breastfeeding?
Cortisone injections during breastfeeding is safe. No side effects on breastfed infant has never been reported for any corticosteroids. The amount of drug passing through the breast milk is very small and will no cause any harm to your baby. However, reduced maternal milk production has been reported. More information can be accessed on the Breastfeeding Network or the Drugs & Lactation database (LactMed®). Of course we will always weigh benefits against potential risks, considering factors like the specific condition being treated, and the overall health of the mother and baby. As with any treatment, the lowest effective dose for the shortest duration is preferred.
​
Pregnant women are often subject to various musculoskeletal conditions which are commonly well managed with cortisone injections such as Carpal Tunnel Syndrome, De Quervain Tenosynovitis or sacroiliitis. Corticosteroids are known to cross the placenta with systemic administration such as oral or intravascular drugs. However there is little support that it increases any developmental defect on the baby. Despite non-systemic corticosteroids, which means drugs not reaching the entire body circulation such as cortisone injections inside a joint, are not considered absolute contraindication by recent medical research, we do not offer injections during pregnancy.
If you are suffering from a MSK condition during your pregnancy, a diagnosis from a medical professional is an essential first step in understanding your problem and understanding what is the right course of treatment for you since effective alternative management can be offered.
MEDICAL REVIEW - The medical information on this page has been reviewed for accuracy by Maxence Legout, MSc, Physiotherapist.