Why Choose The Ultimate Arthritis Package?

It's natural to feel anxious about a course of treatment, especially when you're struggling with joint pain and stiffness. We welcome any questions you may have and we're here to explain exactly what happens during the procedure, from the moment you walk into our clinic to how you can best manage your condition in the long term.

Nottingham Sports Injury Clinic is part of the PhysioNeeds group of clinics that has been providing therapies and treatments for over 25 years. James Tomlinson is fully trained in manipulation therapy, shockwave therapy and injection therapy. This allows him to treat a wide range of acute and chronic conditions, including Osteoarthritis.

James has developed the 3 step injection approach in order to combine fantastic value for money with the prospect of significant pain reduction over a 12-15 month period.

If you have questions or require further information please do get in touch...

What is a corticosteroid injection?

A corticosteroid (or ‘cortisone’) is an anti-inflammatory medicine, which can be injected directly into the tissues or structures that are causing your symptoms. It is a safer alternative to taking anti-inflammatory medication by mouth. It acts directly in the area injected and is not the same as the steroids taken by bodybuilders or athletes.

What are the benefits of a corticosteroid injection?

The injection can help to relieve swelling, pain and stiffness caused by inflammation. This may in turn help you to start your rehabilitation and return to normal activities sooner by ‘breaking the cycle’ of pain and inflammation. It can also be helpful to aid in the diagnosis of your condition if it is not clear which structures are responsible for your pain. You may also have a local anaesthetic injected at the same time, which allows for temporary pain relief.

Generally, corticosteroids are used to relieve acute conditions whereas chronic conditions such as osteoarthritis is normally treated with hyaluronic acid injections. For the better results they are often used in conjunction.

Which conditions can corticosteroid injections treat?

Corticosteroid injections can be used to treat a variety of conditions, including the following.

Arthritis

Steroid injections can effectively treat the joint inflammation that is seen in people with rheumatoid arthritis. They can also be used to relieve the pain of osteoarthritis (the most common form of arthritis) and gout.

Bursitis

Bursas are small, fluid-filled pads that allow tendons and muscles to slide easily over bones. The pain associated with inflammation of a bursa (bursitis) — a condition which usually affects the shoulders, elbows, hips and knees — can be treated with steroid injections.

Tendinitis

Tendons are the thick bands of tissue that connect muscles to bones. Repeated motion and stress to a tendon can cause it to become inflamed — this is known as tendinitis. Rotator cuff injury of the shoulder is a common example of tendinitis that can be treated with corticosteroid injections.

Carpal tunnel syndrome

Carpal tunnel syndrome is when the median nerve (which supplies sensation to your thumb and most of the first 3 fingers) is compressed within the narrow passageway in your wrist known as the carpal tunnel. This causes pain, numbness and tingling in the wrist and hand. By reducing inflammation in the carpal tunnel and relieving pressure on the median nerve, corticosteroid injections can ease the pain of carpal tunnel syndrome.

Frozen Shoulder

Multiple studies show that corticosteroids significantly help with the early stages of frozen shoulder by reducing the pain for up to 4 weeks. It is a highly effective when coupled with physiotherapy.

How much does a corticosteroid injection cost?

The injection costs £250 per injection (includes private prescription fee) and most injections are ultrasound guided for increased accuracy and efficacy.

When are corticosteroid injections used?

Although steroid injections can often effectively relieve the pain associated with musculoskeletal conditions, they are usually not used as the initial treatment option. Less invasive treatments, such as rest, oral pain reliever medicines, hot and cold compresses and physiotherapy, are usually tried first.

Make sure you tell your physician about any other conditions you have and any medicines (including complementary medicines and dietary supplements) you are taking before having a steroid injection.

Do I need to restrict my activities after the injection?

After you have had a corticosteroid injection, you need to rest the affected area for 24 hours and avoid strenuous activity for several days.

Is the injection painful?

Cortisone injections will be performed in clinic. Often, it is done ‘landmark guided’ based on knowledge of anatomy. It can also be done under ultrasound guidance, to improve accuracy. The injection itself can be uncomfortable, so your physician may give you a local anaesthetic to numb the skin before the injection.

A local anaesthetic medicine such as lignocaine is also usually added to the corticosteroid injection. This anaesthetic can relieve your pain immediately, confirming the injection has hit the right spot. After a few hours, the anaesthetic will wear off, and you may feel some pain or discomfort until the anti-inflammatory effect of the steroid kicks in, which is usually after a couple of days.

Putting ice on the area and taking a pain medicine (such as paracetamol) may help relieve any discomfort in the meantime.

Advantages of steroid injections

The main advantages of corticosteroid injections is that they relieve pain and inflammation. This can in turn can reduce swelling and improve mobility. The beneficial effects can last for several months.

In some cases, getting a steroid injection allows you to take part in physiotherapy or rehabilitation exercises to help longer-term improvement or recovery.

Risks and side effects

The most common side effects are pain and inflammation of the tissues surrounding the injection site. This temporary worsening of symptoms is known as post-injection flare, or steroid flare, and may last for a couple of days.

People occasionally report skin discolouration around the injection site. The skin may become lighter around where the injection was given. There is also a risk of nerve damage associated with steroid injections.

There is a small risk of infection associated with the injections. Joint infections (septic arthritis) are especially serious, and can result in permanent damage to the joint. See your doctor as soon as possible if:

• you experience pain for more than 48 hours after the injection;
• pain develops more than 2 days after the injection;
• the area becomes red, hot or swollen; or
• you develop a fever following the injection.

Corticosteroid injections should never be given if you have an infection, including an infection of the skin at the injection site.

Corticosteroid injections may weaken tendons, sometimes possibly causing tendons to rupture. Repeated injections of steroids may also damage joint cartilage and contribute to thinning of nearby bone (local osteoporosis). For these reasons, as well as the risk of general side effects, there are limits to how many times and how frequently corticosteroid injections can be used in the same area.

General side effects may include:

• a rise in blood sugar levels that lasts for up to 48 hours after the injection (usually only noticed if you have diabetes);
• a temporary rise in blood pressure lasting a few days;
• sleep problems; and flushing of the skin on the face and chest – this usually lasts no more than a few hours.

Long-term problems associated with corticosteroid medicines

People who take steroid medicines orally (by mouth) for prolonged periods are at risk of several side effects, including weight gain, high blood pressure and osteoporosis. There is only a very small risk of these problems developing following injections of corticosteroid, because, unlike when a person takes corticosteroid tablets, only very small amounts of the medicine enter the bloodstream.

What is DUROLANE?

DUROLANE is a single-injection treatment of hyaluronic acid designed to provide powerful and lasting pain relief when you are suffering from pain due to osteoarthritis. DUROLANE is the only high weighted hyaluronic acid injection on the market and it even improves the consistency of the existing fluid in your joint.

How does DUROLANE work?

DUROLANE is a hyaluronic acid which acts like a lubricant and shock absorber in the synovial fluid. A DUROLANE injection may cushion your joint and manage your symptoms.

What are the benefits of DUROLANE?

As early as two weeks after an injection, DUROLANE can reduce osteoarthritis joint pain and improve the physical activity and quality of life of osteoarthritis patients. Some patients have pain relief lasting between 12 -15 months.

Is DUROLANE right for me?

If you are an osteoarthritis patient who is not getting enough pain relief from oral medications, physical therapy or steroids, DUROLANE might be right for you. Speak with your clinician about hyaluronic acid treatment with DUROLANE.

How much does a DUROLANE injection cost?

A DUROLANE injection costs £350 per injection and most injections are ultrasound guided for increased accuracy and efficacy.

Is there any reason why I couldn't have a DUROLANE injection?

You should not use DUROLANE if you have infections or skin disease at the injection site. DUROLANE has not been tested in pregnant or lactating women, or children. Full indications and contraindications information can be found in product labelling, at DUROLANE.com