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🏥 Gotokuji Orthopedic Clinic / Patient Guide

Steroid Injection Guide

Quick relief for inflammation — how the injection works and what to know

A steroid injection is a shot that quickly and powerfully reduces inflammation in a joint or tendon.
Unlike oral medication, it works directly at the problem area, making it ideal when pain and swelling are severe.
It is used for a wide range of conditions including frozen shoulder, trigger finger, tennis elbow, gout flares, and osteoarthritis.
However, too many injections can affect cartilage and tendons, so careful control of frequency and spacing is important.

1
Pinpoint the source of inflammation

Using examination and ultrasound, we identify the exact joint or tendon causing pain

2
Inject steroid directly into the affected area

The steroid is mixed with a local anesthetic and injected to strongly reduce inflammation

3
Block inflammatory substances

The steroid stops the body from producing substances that cause pain and swelling

4
Effects last days to months

Depending on the type, effects can be fast-acting or long-lasting

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Frozen shoulder (adhesive capsulitis) with night pain
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Trigger finger, tendinitis, de Quervain's disease
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Acute flare-up of knee osteoarthritis
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Tennis elbow (lateral epicondylitis)
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Calcific tendinitis, gout attacks, and other intense inflammation
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Triamcinolone (Kenacort)
Long-lasting type. Effects continue for weeks to months. Commonly used for joint injections
Betamethasone (Rinderon)
Fast-acting. Effects last about 2 to 3 weeks
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Methylprednisolone (Depo-Medrol)
Long-acting type. Often used for shoulder and knee injections
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Dexamethasone (Decadron)
Very fast-acting but lasts only a few days. Used for acute flares
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Hyaluronic Acid (separate category)
Not a steroid. Improves joint lubrication. Relatively fewer side effects than steroids, though post-injection pain, swelling, and rarely infection can occur
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Ultrasound-Guided Injection
Injecting while watching on ultrasound lets us place the medication accurately while avoiding tendons and nerves
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We choose a medication appropriate for your symptoms

The speed and duration of relief varies by medication type, from fast-acting dexamethasone to long-lasting triamcinolone. At our clinic, we select an appropriate medication based on your symptoms and the affected area, and mix it with a local anesthetic before injecting. We always use the smallest effective dose and number of injections, and we administer them carefully. Note that the relief is usually temporary and does not treat the underlying cause.

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Side Effects and Precautions
1) Effects on cartilage: Injections are spaced at least 2 weeks apart, and injections to the same area are limited to about 3-4 times per year. 2) Steroid flare: Pain may temporarily worsen after injection. 3) Infection risk: Rarely, septic arthritis can occur, so we use sterile technique, and we do not inject when there is an infection at or around the injection site. 4) Skin thinning and loss of skin color: The skin at the injection site may become dented or lose pigment, so extra care is taken in areas with thin skin such as the fingers. 5) Weakening of tendons: Repeated injections into a tendon sheath can lead to tendon rupture, and as a rule we do not inject the Achilles tendon. 6) Blood sugar rise: If you have diabetes, blood sugar may increase after the injection — please tell your doctor.

💡 Important Things to Remember

  • Steroid injections treat inflammation — they do not fix the underlying cause
  • Pain may temporarily increase after injection, but usually settles within 1-2 days
  • Injections to the same area should be limited to about 3-4 times per year
  • It is important to combine injections with rehabilitation and treatment of the root cause