Steroid Injections for Hand and Wrist Conditions
What is steroid injection used for?
Steroids are potent anti-inflammatory medications commonly used to treat various hand and wrist conditions, such as arthritis, trigger finger, carpal tunnel syndrome, and tendonitis.
What should I expect after the injection?
Steroids are often injected with a local anaesthetic. The anaesthetic will wear off within a few hours, but you may experience increased pain for several days following the injection. This is due to the injection of fluid into a confined space, which raises pressure and can cause discomfort. Pain can generally be managed with over-the-counter pain-killers like paracetamol or ibuprofen. In some cases, pain may become more intense and this is known as a “steroid flare.” Although a flare can be very uncomfortable, it typically resolves within a few days and does not cause long-term harm.
What are the potential complications of a steroid injection?
While steroid injections are generally safe, there are some rare but serious complications to be aware of:
- Skin or Fat Necrosis: In some cases, the skin or underlying fat at the injection site may thin or break down, leading to discoloration or a hollow appearance. This is a rare occurrence and may resolve over time.
- Infection: Although infection is uncommon, it is a serious complication that requires prompt medical attention. Symptoms of infection include redness, increasing pain, fever, and loss of function. If you experience any of these symptoms, contact your healthcare provider or visit your GP or the nearest A&E department immediately. Infection can result in significant loss of function if left untreated.
- Tendon Rupture: Tendon rupture is an extremely rare complication, but it can occur, especially when the injection is given for trigger finger rather than arthritis. In such cases, surgery may be required to restore function, and permanent loss of function is possible.
- Artery or Nerve Damage: Injecting steroid directly into an artery can cause blood clots, potentially leading to gangrene of the affected finger or thumb. If the injection is administered near a nerve, it can cause nerve damage, leading to loss of sensation and chronic pain.
- Altered Blood Sugars: Steroid injections can elevate blood sugar levels, particularly in individuals with diabetes. If you have diabetes, it is important to monitor your blood sugar levels closely after the injection and adjust your insulin dosage as needed.
- Complex Regional Pain Syndrome (CRPS): CRPS is a rare but serious complication that can develop after hand or arm surgery, occurring in about 1 in 10,000 patients. It causes severe pain, swelling, stiffness, and increased sensitivity in the affected hand. CRPS can be treated with physiotherapy and medication, but recovery may take up to two years, and long-term disability can occur in some cases.
