Steroid injections can be added to a treatment program that may already include analgesics(pain medications), anti-inflammatory medications, physical therapy, occupational therapy, and/or supportive devices such as canes and braces. Whether one or more of these treatment methods are used depends on the nature of the problem. For example, in an otherwise healthy individual, tendinitis may be adequately treated with only a local steroid injection. However, in a patient with rheumatoid arthritis, injections are generally a small part of a multi-faceted treatment approach.
As with any medication, there are possible side effects or risks involved. Common risks from steroid injections include pain at the injection site, bruising due to broken blood vessels, skin discolouration and aggravation of inflammation. Rarer risks include allergic reactions, infection, tendon rupture and serious injury to bones called necrosis. Long term side effects (depending on frequency and dose) include thinning of skin, easy bruising, weight gain, puffiness in the face, higher blood pressure, cataract formation, and osteoporosis (reduced bone density). Steroid injections may be given every 3-4 months but frequent injections may lead to tissue weakening at the injection site and is not recommended. Side effects do not happen in everyone and vary from person to person.
This is a rare complication that may occur if a small hole is made in the fibrous sac and does not close up after the needle puncture. These small holes are only made in less than 1% of epidural injections and usually heal on their own. The spinal fluid inside can leak out, and when severe, the brain loses the cushioning effect of the fluid, which causes a severe headache when you sit or stand. These types of headaches occur typically about 2-3 days after the procedure and are positional - they come on when you sit or stand and go away when you lie down. If you do develop a spinal headache, it is OK to treat yourself. As long as you do not feel ill and have no fever and the headache goes away when you lay down, you may treat yourself with 24 hours of bed rest with bathroom privileges while drinking plenty of fluids. This almost always works. If it does not, contact the radiologist who performed the procedure or your referring physician. A procedure (called an epidural blood patch) can be performed in the hospital that has a very high success rate in treating spinal headaches.