Sore joints?

The most common joint injection that I do is to treat wear and tear (osteoarthritis) of the knee. This can result in 4-6 months of improvement in pain and stiffness, and the injection can be repeated as often as 3 monthly. It is good option for patients wishing to delay or avoid knee surgery, and those who experience side effects with painkillers.

The first thing to do is assess the knee by discussing the symptoms and performing an examination. If it is suitable for injection we will go through the consent process. There is a risk that the injection won’t help with symptoms, a small risk of infection (approximately 1 in 10,000), a risk of temporary worsening of pain (approximately 2-5%) and small risks of bleeding and dimpling of the fatty tissue of the knee.

If the patient is keen to proceed I will identify and mark the easiest access point to the knee joint and clean the skin. A mixture of steroid and local anaesthetic is injected, this is no more painful than a simple blood test. A sterile dressing is applied and should remain in place for 24 hours. The patient should rest the knee for a day, and avoid any strenuous activity for 5 days, and then they can carry on as usual.
Shoulder problems such as arthritis, tendonitis and frozen shoulder are also frequently treated with injections. There is less evidence of benefit for shoulder problems, but anecdotally many patients do find them helpful. I inject shoulders in carefully selected patients, usually alongside ongoing physiotherapy.

Other conditions that I treat include carpal tunnel syndrome and trigger finger, both of which may resolve with a steroid injection, thereby avoiding a surgical procedure.