It is a great pleasure to introduce Dr Stephen Miller to you. Stephen is an experienced GP with a specialist interest in Musculoskeletal Medicine and Sports and Exercise Medicine. As well as being part of the team here at Edinburgh GP, Stephen works in an NHS Rheumatology Clinic. He has also been Club Doctor for Hibs Football Team and has supported professional athletes.
In this article, Edinburgh GP’s Dr Stephen Miller discusses the use of steroid injections for musculoskeletal problems.
There has always been debate around the use of steroid injections for musculoskeletal (MSK) problems. Specialist opinions range from using them from the outset of symptoms to steroid injections not having a place in MSK therapy at all. My view lies somewhere in the middle. They are not a simple “cure” for every MSK issue and there are small risks which need to be considered. In the right patient at the right time, they are invaluable as part of a holistic treatment plan. They can alleviate your pain significantly in the short-to-medium term allowing you to progress with functional rehabilitation with your physiotherapist to achieve a long-term improvement in your condition.
How do steroid injections work?
The idea behind steroid injections is that they provide a strong anti-inflammatory treatment directly to the affected joint, tendon sheath or bursa (pocket of fluid which overlies a bone or joint). Consequently, they tend to work better in conditions with underlying inflammation.
Is it safe?
Yes
Steroids can have potential side effects and need to be used with caution. In this case, the steroid is delivered directly to the area where it is needed so systemic side effects are not an issue.
Infection or other complications such as bleeding are very rare.
Prior to the treatment we will go through a safety checklist to make sure there are no contraindications.
We will go over any risks and balance these against benefits.
On the whole the procedure is very safe.
What conditions do they work best for?
- Trochanteric pain (pain on the outside of the hip)
- Frozen shoulder
- Rotator cuff problems of the shoulder
- Tendon problems around the hands or feet.
- Osteoarthritis of almost any joint particularly Knees.
What does it involve?
Most people do not find steroid injections too painful and it is a quick procedure we can do in a normal appointment.
The steroid is slowly injected into the affected area under sterile conditions. Some injections also contain local anaesthetic to give you instant relief.
Get in touch
If you’re wondering whether a steroid injection might be right for you, please do get in touch. Within one consultation we can discuss your symptoms and the impact they are having on your life, carry out a thorough musculoskeletal examination, arrange any investigations that might be necessary and, if appropriate, give the steroid injection there and then.