Mr. Chennagiri consults at The Saxon hospital in Milton Keynes and at The Chiltern Hospital in Great Missenden. Please click here for further information or contact the appointments office at the relevant hospital for to book an appointment.
He sees NHS patients at Stoke Mandeville Hospital, Wycombe Hospital and at The Saxon Clinic.
Steroid injections in the hand and wrist
Cortisone (steroid) injections offer two benefits. They provide useful diagnostic information and can also provide long term relief. Steroid injections are often used along with other non-operative measures such as splints and hand therapy.
Steroids may be injected into soft tissues (eg. tendon sheaths, carpal tunnel) or into joints. Joint injections may be done with or without guidance from an imaging modality like a fluoroscope (similar to x-ray) or an ultra-sound scan. Most of the joints in the hand and wrist are superficial and easily accessed. However, sometimes it is beneficial to perform a ‘guided’ injection. This will be discussed in the clinic. The injection is usually performed with a local anaesthetic drug to minimize pain during the injection and immediately after. It might take a few days to notice the benefits, depending on the condition being treated.
There is no strict limit for the number of injections. If the relief of symptoms is very short-lived or if successive injections are less beneficial (diminishing returns), other options of treatment should be considered. You may wish to discuss this in the clinic.
Risks and adverse effects:
No change in symptoms: The injection may be not work!
Infection: The risk of infection is very small.
Steroid flare: Symptoms often worsen for a day or two after the injection. It is advisable to take painkillers for a day or two to control pain and allow function If it persists for a longer period, immediate medical attention should be sought.
Local changes: Skin depigmentation may occur at the site of injection and is often permanent. It is more common in individuals with darker skin. Thinning of the fat layer under the skin may cause a ‘dimple’ at the site of injection. It however does not result in any functional impairment.
Effect on blood sugar levels in diabetics: Diabetics should monitor their blood sugar levels carefully and may need to adjust their insulin dose for 5-7 days after a steroid injection.