We offer joint injections using both steroid (cortisone) and hyaluronic acid (Durolane).
Therapeutic joint and soft tissue injections can be used to relieve pain from conditions such as osteoarthritis, bursitis, and tendonitis.
We can usually offer an injection on the same day as your initial consultation, although sometimes it may be necessary to arrange scans or xrays first.
Knee
Shoulder (Glenohumeral Joint for arthritis)
Shoulder (Subacromial space for bursitis)
Hip Bursa / Greater Trochanter
Carpal Tunnel
Trigger Finger
Base of Thumb (Carpometacarpal Joint)
De Quervain's Tenosinovitis
Tennis Elbow
Base of Big Toe (Metatarsophalangeal Joint)
Wrist (Radiocarpal joint)
Ankle (Tibiotalar joint)
To arrange your joint injection, either contact our office, or use the online booking link. It will usually be possible to have your injection at the first appointment. On some occasions, it may be recommended to have some investigations before an injection. If this is the case, you will need to come back following your scans. We are able to arrange the full range of imaging at the Nuffield Hospital, including X-Ray, MRI, CT, and ultrasound scans.
Please note that you will be charged two fees: one for your medical consultation, and a second for any procedure(s) performed. Consultation fees are payable in advance, procedure fees may be paid by card, on the day.
If you wish to consider a hyaluronic acid injection, please notify us in advance of your appointment so that we can ensure we have the appropriate version in stock for your procedure.
You will have a consultation with our doctor, who will ask about your symptoms, and examine you. If you have any x-ray or scan results, or letters from an NHS clinic, it can be helpful to bring these in with you, or upload them to your patient portal in advance of your appointment.
If we agree that it will be beneficial to administer an injection, then this will be done in our operating theatre during the same appointment. We will carefully make some marks on your skin with a pen, to guide the injection, before injecting some local anaesthetic into the skin and underlying tissues to numb them completely. The medication is then injected into the joint space or around the tendon in question, where it can have maximum effect.
We use local anaesthetic administered via a very fine needle, before all joint injections. There may be mild discomfort as this goes in, but you should not have any pain during the joint injection itself.
The steroid works as a powerful anti-inflammatory, similar to anti-inflammatory medication, but is delivered directly to the joint or tendon in question.
A short-term benefit is often felt immediately, because we usually inject local anaesthetic into the joint, mixed with the steroid. However, this will wear off in a couple of hours. The steroid usually takes effect after a few days.
This varies significantly. For inflammatory conditions such as tendinitis or bursitis, the problem may never recur after it has settled down. For arthritic joints, a good result would be 6 months, but it can be more or less than this.
For any given joint, the minimum interval between injections must be at least 3 months, with no more than 3 injections given in a year.
The best evidence for Durolane is for patients with mild to moderate arthritis in the knees. However it can also be used in other joints. This can be a useful injection for patients who no longer respond to steroid injections, or for patients who prefer to avoid steroids.
Hyaluronic acid is a synthetic form of the synovial fluid which naturally cushions our joints. Injecting HA into a joint is known as ‘viscosupplementation’ and can provide additional cushioning and lubrication in the joint, and relief from arthritis pain.
Early effects may be felt within a few days, it normally takes a week or two for maximum benefit to be felt.
Results for this also vary, but Durolane is thought to be the longest lasting of the hyaluronic acid injections. 6 to 9 months would be normal, but there are also reports of it lasting over a year.
The usual minimum interval for this is 6 months.
This will be discussed at your consultation in depth. The usual risks which we will discuss are: failure to improve symptoms, recurrence of symptoms, bleeding or infection in the joint (very rare), side effects to the steroid (flushing, menstrual changes, elevated blood sugars), skin changes around the injection site.
No problem. Please contact us with your query.
