How Do You Know When Its Time for Another Knee Cortisone Shot
one. About hydrocortisone injections
Hydrocortisone injections are used to treat swollen or painful joints, such as afterward an injury or if you have arthritis.
The hydrocortisone is injected directly into the painful articulation. This is called an intra-articular injection. The joints almost oft injected are the shoulder, elbow, knee joint, hand, wrist or hip.
Hydrocortisone injections are also used to care for painful tendons and bursitis (when a small purse of fluid which cushions a joint gets inflamed). They're sometimes used to treat musculus pain when it's in a particular expanse.
The injections commonly help save pain and swelling, and make move easier. The benefits can last for several months.
Hydrocortisone is a type of medicine known equally a steroid (or corticosteroid). Corticosteroids are not the same as anabolic steroids.
Hydrocortisone injections are only bachelor on prescription. They're usually given past a peculiarly trained doctor in a GP's surgery or hospital dispensary.
In an emergency, medical staff may give college dose hydrocortisone injections to care for severe asthma, allergic reactions, severe shock due to injury or infection, or failure of the adrenal glands.
NHS coronavirus advice
As long as you take no symptoms of coronavirus infection, carry on taking your prescribed steroid medicine as usual.
If you develop any coronavirus symptoms, do not stop taking your steroid medicine all of a sudden. Ask your doctor about whether you need to stop taking it or not.
Updated: 20 March 2020
Other types of hydrocortisone
There are dissimilar types of hydrocortisone, including skin creams, suppositories and tablets.
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2. Key facts
- Hydrocortisone injections for joint pain work by releasing the medicine slowly into the articulation. This reduces pain and swelling.
- After an injection, your joint may feel better for several months –sometimes as long as a year.
- Some people get increased hurting and swelling in their joint immediately after having the injection. This pain tends to get away later on a few days.
- Depending on which joint is being treated, you may be able to have injections in the same place upwards to 4 times a year.
- Hydrocortisone injections can affect your immune system, so you lot're more likely to get infections. Tell your doc if you come into contact with chickenpox, shingles or measles as these infections could make you very sick.
- If you take been having long-term hydrocortisone injections for a long time, yous may demand to deport a steroid emergency card. Ask your pharmacist or doctor if you exercise non take one.
3. Who can and cannot have hydrocortisone injections
Almost adults and children, including babies, tin can take hydrocortisone injections.
Hydrocortisone injections are not suitable for some people. Tell your doctor before starting the medicine if you lot:
- take ever had an allergic reaction to hydrocortisone or whatever other medicine
- have ever had low or manic low (bipolar disorder) or if whatsoever of your close family has had these illnesses
- take an infection (including an eye infection)
- are trying to become pregnant, are already significant or you are breastfeeding
- have recently been in contact with someone with chickenpox, shingles or measles (unless you're sure you lot are immune to these infections)
- accept recently had, or you're due to have, any vaccinations
Hydrocortisone injections tin can make some health problems worse so information technology'southward of import that your doctor monitors y'all.
Make sure your physician knows if yous have:
- any unhealed wounds
- high blood pressure level
- an middle problem called glaucoma
- weak or delicate bones (osteoporosis)
- blazon 1 or type 2 diabetes
If yous have diabetes and monitor your own blood saccharide, you will need to practise this more often. Hydrocortisone injections tin affect your blood sugar command.
4. How and when to have hydrocortisone injections
A specialist doctor will usually give you lot your injection. This may be at your GP surgery.
If the injection is for pain, information technology may contain a local anaesthetic. Yous might also have a local anaesthetic by spray or injection to numb the skin earlier the hydrocortisone injection.
You can go domicile after the injection, simply you may need to rest the area that was treated for a few days.
You may exist able to have a hydrocortisone injection into the same joint upwards to iv times in a year. The number of injections you need depends on the expanse being treated and how stiff the dose is.
If you have arthritis, this type of treatment is merely used when simply a few joints are affected. Normally, no more than 3 joints are injected at a time.
The dose of hydrocortisone depends on the size of the articulation. It can vary between 5mg and 50mg of hydrocortisone.
Will the dose I have go up or down?
If you need a follow-up injection, the amount of hydrocortisone could go up or down. It depends on how well the previous injection worked, how long the benefits lasted and whether you had whatever side effects.
5. Side effects
Most people practice not have whatever side effects after a hydrocortisone injection. Side effects are less probable if simply one office of the trunk is injected.
If you lot're having high doses of hydrocortisone injections, or y'all're as well taking other steroid medicines or tablets for fungal infections or HIV, you may get underactive adrenal glands as a side effect. Ask your doctor if you need to carry a steroid emergency carte.
Common side effects
The most mutual side outcome is intense hurting and swelling in the joint where the injection was given. This usually gets improve afterwards a solar day or two.
You may also get some bruising where the injection was given. This should go away afterwards a few days.
It helps to rest the joint for 24 hours after the injection and avoid heavy exercise. It'due south condom to accept everyday painkillers such equally paracetamol or ibuprofen.
Serious side furnishings
With hydrocortisone injections, the medicine is placed direct into the painful or swollen articulation. It does not travel through the residue of your body. That means, it's less likely to crusade side furnishings.
Sometimes, though, hydrocortisone from a joint injection can become into your blood. This is more likely to happen if you've had several injections.
If hydrocortisone gets into your blood, it can travel effectually your body and there's a very small adventure that you may accept a serious side effect.
Call a doctor straight away if you lot:
- are depressed (including having suicidal thoughts), feeling high, mood swings, feeling anxious, seeing or hearing things that are not there or having strange or frightening thoughts – these tin be signs of mental wellness bug
- have a high temperature, chills, a very sore pharynx, ear or sinus pain, a coughing, pain when you pee, mouth sores or a wound that will not heal – these can be signs of an infection
- are sleepy or confused, feeling very thirsty or hungry, peeing more than oft than usual, flushing, breathing quickly or having jiff that smells similar fruit – these can be signs of diabetes or complications of diabetes
- have a "moon face" (a puffy, rounded face), weight gain in the upper dorsum or belly – this happens gradually and can be a sign of Cushing's syndrome
- have swelling or throbbing in your arms or legs, or if you feel breathless or accept breast pain – these tin exist signs of a deep vein thrombosis (DVT) or a blood clot
- have whatever changes to your eyesight
Some of these side effects, such as mood changes, can happen after a few days. Others, such as getting a rounder face, tin happen weeks or months after treatment.
Children and teenagers
In rare cases, if your child or teenager has hydrocortisone injections over many months or years, it can boring down their normal growth.
Your kid'south doctor volition monitor their top and weight carefully for as long every bit they're having treatment with hydrocortisone. This volition help them spot any slowing down of your child's growth and change their handling if needed.
Even if your child's growth slows down, it does not seem to have much consequence on their overall developed height.
Talk to your doctor if you're worried. They will be able to explicate the benefits and risks of giving your child hydrocortisone injections.
Serious allergic reaction
It'due south extremely rare to take an allergic reaction (anaphylaxis) to a hydrocortisone injection.
These are not all the side furnishings of hydrocortisone injections.
Information:
You can study any suspected side result using the Xanthous Menu rubber scheme.
Visit Yellow Card for further information.
6. Pregnancy and breastfeeding
Hydrocortisone and pregnancy
Hydrocortisone injections tin can be used in pregnancy and breastfeeding.
Your doctor will only prescribe hydrocortisone injections for you while you're pregnant or breastfeeding if the benefits of the medicine outweigh the chances of information technology beingness harmful.
Tell your medico if you're trying to become pregnant or if you're already significant before having a hydrocortisone injection.
Hydrocortisone and breastfeeding
It'due south safe to take hydrocortisone injections while you're breastfeeding.
Only very small amounts of hydrocortisone become into breast milk, so it'southward unlikely to exist harmful.
Non-urgent communication: Tell your doctor if you lot're:
- trying to become significant
- meaning
- breastfeeding
For more than information nearly how hydrocortisone can bear on yous and your baby during pregnancy, read this leaflet on the All-time Use of Medicines in Pregnancy (BUMPs) website.
7. Cautions with other medicines
There are many medicines that can bear on the way hydrocortisone injections work.
It'south very important to check with your doctor or pharmacist that a medicine is prophylactic to mix with hydrocortisone injections earlier you beginning having them.
This includes prescription medicines and ones that you lot purchase similar paracetamol, ibuprofen and aspirin. It also includes herbal remedies and supplements.
Of import: Medicine safety
Tell your physician or chemist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
8. Common questions about hydrocortisone
How exercise hydrocortisone injections work?
Hydrocortisone injections contain the active ingredient hydrocortisone. This is a steroid (or corticosteroid).
The injection releases the hydrocortisone slowly into the role of your body that is painful or swollen. Like other steroids, it works past calming downwardly your immune system. This reduces inflammation and helps to salve the pain and swelling.
When will I feel better?
A hydrocortisone injection usually takes a few days to start working – although sometimes they work in just a few hours.
How many hydrocortisone injections volition I need?
If your pain and swelling gets better later on a single hydrocortisone injection, y'all may not need some other one.
If you lot have a long-term problem and hydrocortisone injections work well, yous may deport on having them.
Doctors usually recommend waiting at least 3 months before having another hydrocortisone injection in the same articulation.
Will the injections injure?
The injection can be a little uncomfortable, but many people say they're not as bad as they idea they would be.
How well do hydrocortisone injections work?
Hydrocortisone injections usually assistance with hurting and swelling for effectually 2 months. They tin also make movement easier.
If y'all take a short-term joint injury, an injection will often help y'all commencement to move once more so that your trunk tin heal itself.
For long-term joint pain, an injection should assistance for a few months, only you lot may need farther injections.
Why practice I need to be careful of infections?
Hydrocortisone injections can sometimes affect your allowed system, so you lot're more likely to take hold of infections such every bit flu, the common cold and chest infections.
Continue away from people with infectious diseases, especially chickenpox, shingles or measles. If yous've never had these illnesses they could make you very sick.
Tell your doctor straight away if yous come up into contact with someone who has chickenpox, shingles or measles. Your doctor may be able to prescribe a medicine to protect you.
Do I need to carry a steroid menu?
Steroid emergency bill of fare (red card)
If you lot are prescribed steroid medicines such as hydrocortisone injections your adrenal glands may not make equally much of some of the hormones your body needs such equally cortisol (known as the stress hormone). This is known as adrenal insufficiency.
It's more than likely to happen if you take high doses for a long time (especially tablets and injections) or if you regularly employ different kinds of steroids at the same fourth dimension (such as a steroid nasal spray and a steroid inhaler).
Your md or pharmacist will assess your risk of adrenal insufficiency based on the type and dose of steroids y'all're taking, and may recommend that yous carry a steroid emergency card. This carte is the size of a credit card and fits in your wallet or handbag.
The Addison'southward Disease Cocky-Help Group (ADSHG) website has more information about the NHS steroid emergency carte du jour.
Of import
If you need whatsoever medical or dental treatment, or are having surgery or an invasive procedure, show your steroid emergency carte du jour to your doctor or dentist. This is important so they know you lot are having steroid treatment and can give you extra steroids equally needed.
Blue steroid carte du jour
If you lot have been having hydrocortisone injections for longer than 3 weeks, or yous have been prescribed a high dose, your doctor or pharmacist volition give you a blue steroid treatment card.
It tells you how you can reduce the risks of side furnishings. It likewise gives details of your doctor, how much prednisolone you take and how long the treatment volition last for.
If y'all need whatever medical or dental treatment, prove your blue steroid bill of fare to the medico or dentist.
Can I drink booze with it?
Yep, yous can potable alcohol before and after a hydrocortisone injection.
Are there any food or drinks I need to avert?
You can eat and drink normally before and after a hydrocortisone injection.
Will it touch my fertility?
Hydrocortisone injections do not touch the fertility of men or women.
Are other treatments bachelor?
There are other types of medicine for treating swollen or painful joints.
You lot could try an everyday painkiller like paracetamol or an NSAID like ibuprofen.
NSAIDs (not-steroidal anti-inflammatory drugs) are medicines that are used to relieve pain and reduce inflammation.
Some can be bought over the counter from pharmacies, while others need a prescription. They're bachelor as tablets and capsules, suppositories, injections, creams and gels.
NSAID creams and gels can assist if you have muscle or joint hurting in a particular part of your trunk, equally they tend to accept fewer side effects than tablets or capsules. They include painkilling creams such every bit ibuprofen or diclofenac. You massage these into the skin over the painful area.
If these treatments do not work, your md can prescribe stronger painkillers such as naproxen and codeine.
Tin can lifestyle changes assistance painful joints?
There are other options that can help sore or swollen joints.
It might assistance to:
- improve your full general fitness through regular exercise
- do an exercise programme to increase musculus strength around your joint
- use hot and cold treatments to the articulation
- use a walking stick or frame to support yourself (if your walking is affected)
- have electrotherapy (for example using a TENS machine)
Information technology'south best to ask for good communication from a physiotherapist or occupational therapist.
Source: https://www.nhs.uk/medicines/hydrocortisone-injections/
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