You have been referred for a joint injection to help reduce the joint pain you are experiencing in your hand.
This injection may help you carry out daily tasks more easily, and where indicated, make hand therapy exercises more comfortable.
Pain relief from the injection may last from a few weeks to several months, everyone responds differently.
What is an x-ray joint injection?
Placing steroid medicine directly into the joint will help to reduce any inflammation that may exist within the joint, and can help provide pain relief.
A small amount of steroid may also help protect joint cartilage. With the addition of local anaesthetic (a fast acting, temporary pain reliever) the joint can immediately feel more comfortable, helping to identify which joint is the most problematic.
During the procedure you will either be sat or laid down with an x-ray plate under the area to be treated.
Your skin will be thoroughly cleaned and your hand placed down onto a sterile surface to ensure a sterile procedure is undertaken.
The clinician will then use X-ray guidance to help direct a small needle into the joint where a small mixture of anti-inflammatory (corticosteroid) and anaesthetic is injected.
One or several joints may be injected depending on the location of pain. This procedure is usually undertaken as an out-patient procedure in theatre, and you will be allowed to go home after a short period of time.
Please note, that it is advisable not to drive within the first hour after the joint injection, and where possible avoid driving yourself to your appointment.
What are the potential risks and side effects?
When local anaesthetic is injected into joints it may affect some of the nerves and blood vessels which run close by.
This may result in immediate numbness or even weakness of the area but this effect is temporary and usually disappears within 30 minutes.
A bruise may develop around the injection site, which normally resolves itself. Significant bleeding is a serious but rare event.
About 1 in every 5 patients experience worsening of their symptoms for about 2 or 3 days after the injection, this is referred to as post injection flare pain.
Rest and simple pain killers that are safe for you to take usually help.
If your symptoms continue to worsen for longer than a few days or you have signs of redness, progressive warmth and swelling around the injection site, you should contact your doctor or attend the emergency department.
You should inform them you have had this procedure so they can then rule out, or treat any infection. Infection of the joint is a serious but rare complication.
Another rare but serious side effect is an allergic reaction to the steroid or local anaesthetic medicine. Any medicine can produce this response even in someone who has previously had the same medication without a problem.
Any allergic reaction is most likely to occur within 20 minutes of the injection, and for this reason, you will be asked to remain in the department for a minimum of 20 minutes.
Steroid injections can increase blood sugar levels in diabetic patients for a few days after the injection. The effects are usually small, but additional monitoring might be advised.
Other more minor side effects can include facial flushing (resolves within 24 to 72 hours) and skin changes, such as thinning and/or paling of the skin around the injection site.
What should I do before I come into hospital?
You do not have to do anything different to prepare for this procedure. However, active infection for example a cold or sore throat, may be associated with an increased risk of joint infection.
If you are on a course of antibiotics on the day of your procedure, you should inform us to change the date as it will not be possible to carry out the injection until 2 weeks after you have completed the course.
Any active skin infection, rash or broken skin in the area of the intended joint injection must be fully healed before an injection can be considered, and if you are experiencing any of these problems, please contact us.
If you have had any allergic reaction to local anaesthetic or steroids in the past, please contact us before your appointment.
If you have had any major surgery within 3 months of your planned injection, please contact us prior to your appointment.
If you have had a COVID vaccination within 2 weeks of your injection date, you must inform us before your appointment. It will not be possible to perform an injection for up to 2 weeks before or after a COVID vaccination.
You will also need to inform us on the day if you are on any blood thinners or if you are diabetic; this will not prevent the procedure from taking place, but will help us advise you appropriately after the injection. You may find it helpful to bring in a list of your medications on the day.
If you have any questions regarding this, please contact the department using the contact details indicated on your appointment letter.
What should I expect after the injection?
You will be asked to remain in the department for 20 minutes after your injection.
This will be increased to at least an hour if you have had to drive yourself to your appointment, and it is strongly advised that you try to avoid driving yourself to and from your appointment.
It is advisable to rest the area for at least 24 to 48 hours and avoid activities that make pain worse.
You can gradually return to full function after this initial rest period, and be guided by the pain you feel. If you experience post injection flare pain, suitable painkillers are safe for you to take to help with this.
It often takes a steroid injection around 1 to 2 weeks to provide pain relief. Returning to work after a steroid injection depends on your occupation, but most patients are able to return after 1 to 3 days.
You should expect a follow-up appointment with your consultant team, and this generally is a telephone appointment 6 to 8 weeks after your injection.
Contact number
Hand therapy
- Telephone: 01642 855595
- Monday to Friday only
- 8am to 4pm
Information for patients
This leaflet can be made available in other formats including LARGE PRINTS, CD, braille and in languages other than English, upon request.
Patient experience team (PET)
South Tees Hospital Foundation Trust would like your feedback. If you would like to share your experience about your care and treatment or on behalf of a patient, please contact The patient experience team who will help you to do this.
This service is based at The James Cook University Hospital but also The Friarage Hospital in Northallerton, our community hospitals and community health services.
South Tees Hospital Foundation Trust
- Telephone: 01642 854807
- Freephone: 0800 0282451
- Email: [email protected]
- Monday to Friday, 9am to 4pm
Out of hours if you wish to speak to a senior member of trust staff, please contact the hospital switchboard (numbers below).
The James Cook University Hospital
Marton Road
Middlesbrough
TS4 3BW
Telephone: 01642 850850
The Friarage Hospital
Northallerton
North Yorkshire
DL6 1JG
Telephone: 01609 779911
Leaflet Reference: PI001 – Version 01
Review Date: 23/04/2029