Injection therapy and physiotherapy

Information for patients about joint or soft tissue injections


At Water Lane Clinic we administer therapeutic injections of corticosteroid and hyalgan.


What is a corticosteroid?

A medicine which can relieve swelling, stiffness and pain by reducing inflammation

Is this the same drug that athletes and bodybuilders take?

No.  The steroids we inject are completely different and are extremely safe

Why do I need a steroid injection?

Because it will help reduce your pain.  You can then start rehabilitation sooner, have fewer treatment sessions and return to your normal activities more quickly. 

What is an hyalgan?

This medication is used to pain in patients with joint inflammation (osteoarthritis). It is usually used in patients who have not responded to other treatments such as exercise, or physical therapy. Hyaluronate (also known as hyaluronan) is similar to a substance that occurs naturally in the joints. It may work by acting as a lubricant and shock absorber in the joint, helping the knee to move smoothly, thereby lessening pain.

Why don’t I just take anti-inflammatory pills?

You can, but the side effects of these are much more common and can cause stomach upsets and bleeding.  These injections bypass the stomach

Are there any times I should not have an injection?

Yes, if you:


 Have any infection on your skin or anywhere else
 Are allergic to local anaesthetic or steroid
 Feel unwell
 Are due to have surgery at the area soon
 Are pregnant
 Are under 18
 Do not want the injection

What are the possible side-effects?
These are very rare but if you are worried you should contact your physiotherapist:

 Flushing of the face for a few hours
 Small area of fat loss or a change in colour of the skin around the injection site
 Slight vaginal bleeding
 Diabetic patients may notice a temporary increase in blood sugar levels
 If you are taking blood thinning drugs there may be some temporary bruising   
 Infection: if the area becomes hot, swollen and painful for more than 24 hours you should contact the physiotherapist or doctor immediately
 Allergic reaction to the drugs is extremely rare. You will be asked to wait for 30 minutes after the injection to ensure there is no reaction.

How is the injection done?
The skin is cleaned with antiseptic.  A needle is gently put into the affected part and the solution is injected through the needle.  Shortly after, you will be examined again.


Is the injection painful?
Not particularly, as your physiotherapist has had intensive training in the technique.  Sometimes it can be sore for a few hours, but you will be told what to do about this

How fast does the injection work?
If local anaesthetic is also used the pain should be less within a few minutes, though it may return after about an hour, just as when you visit the dentist.  The steroid usually starts to work within 24-48 hours but may take longer

How long does the effect last?
This varies from person to person and the condition being treated, but the steroid usually continues working for 3 to 6 weeks


How many injections can I have?
This depends on the part of the body involved and will be decided by your therapist and yourself.  Usually one injection is sufficient, but if the pain is severe or has been there for a long time, you may need more

What should I do after the injection?
If the problem was caused by overuse, you will probably be told to rest the area for about a week; if it is a joint pain, you may start early gentle movement. 

When will I have to be seen again?
Usually your therapist will want to see you again about ten days to two weeks after the injection.  You will then be given appropriate physiotherapy treatment and probably some exercises for you to do at home.

Water Lane Clinic Physio Team