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Ultrasound is a very high frequency sound wave that is passed into your body through an ultrasound probe. As it passes through the tissues, a proportion of the wave is reflected from each of the layers of tissue. The scanner picks up the returning sound waves and processes them into an image. As such, ultrasound has many applications, including being able to precisely administer a steroid injection in affected joint and area. Ultrasound-guided steroid injections have revolutionized pain management by offering a precise and effective method for delivering anti-inflammatory medication to affected areas. These injections are commonly used to treat conditions such as arthritis, tendonitis, and bursitis.

What are ultrasound-guided steroid injections?

Ultrasound-guided steroid injections involve using ultrasound imaging to guide the precise placement of corticosteroids into inflamed or painful areas. The corticosteroids help reduce inflammation and alleviate pain, providing relief for conditions affecting joints, tendons, and soft tissues.

Steroid injections are effective in alleviating specific pain present in affected joints and muscles. After an injection, patients often feel immediate relief from the pain, effects can last for several months. Depending on the area being treated, steroid injections can be administered in the same place up to four times in a year.

Steroids (specifically Glucocorticoids) are very powerful anti-inflammatory substances. They can settle down a painful joint or other soft tissue and give patients the opportunity to get on with their everyday activities. The injection also administers local anaesthetic to provide some immediate relief until the steroid has time to take effect. The steroids used at Fusion Healthcare are not the same as those used to build muscle. Medications are administered very cautiously and Fusion Healthcare we will not recommend patients to have large numbers of repeated injections.

In rare cases, pain may feel worse immediately following the injection, however, these effects subside after a few days.

What can ultrasound-guided steroid injections treat?

These injections can tackle a whole range of issues, including:

• Painful and swollen joints, ligaments, or tendons
• Joint inflammation,
• Tendonitis
• Bursitis
• Nerve impingements
• Inflammatory arthritis
• Osteoarthritis
• Other soft tissue conditions
• Carpal tunnel syndrome
• Plantar fasciitis

What is involved in the process?

An ultrasound transducer, otherwise known as an ultrasound probe, is used to acquire the images of the affected area or areas. The probe is applied to the area that is being scanned and a water-based gel is used to allow for good contact and less friction between the prob and the skin. The probe is used to identify the where the pain is coming from and pinpoint the best place for the insertion of the needle and administration of the local anaesthetic and steroid. to be administered. As such, a thorough ultrasound investigation of the area is important before proceeding as well as discussing with the patient where they feel the most pain when doing their everyday tasks.

The procedure is carried out by a highly qualified NHS clinician in the Fusion Healthcare clinic, who will thoroughly discuss with the patient the ins and outs of the procedure and follow up care. As this is a procedure involving the administration of medication, a referral is required from a healthcare provider before having the procedure done privately. Often, physios may refer their patients for this form of treatment if physiotherapy alone is providing little relief from the pain. Additionally, chronic pain that may not be alleviated by painkillers can also warrant this form of treatment.

The procedure

The clinician who performs the injection will choose the most appropriate steroid and dose to use based upon clinical condition and symptoms present. They will first perform a clinical examination and ultrasound scan. This allows for a more formal diagnosis and also a precise delivery of the injection treatment. Provided there is no reason not to proceed they will then usually inject the steroid directly into the area that is inflamed, such into the joint or around the soft tissue identified in the diagnosis. Most injections are comfortable and well tolerated by the patient.

• Preparation: The patient is positioned comfortably, and the area is cleaned to prevent infection.
• Ultrasound Imaging: A gel is applied, and an ultrasound probe is used to locate the target area.
• Needle Insertion: Under real-time ultrasound guidance, a fine needle is inserted into the precise location.
• Steroid Injection: A corticosteroid, often combined with a local anaesthetic, is injected into the inflamed tissue.
• Post-Procedure Care: The patient may be advised to rest and avoid strenuous activity for a short period.

What are the benefits of Ultrasound-guided steroid injections?

• Pain relief: Steroid injections can reduce inflammation and provide significant pain relief. 
• Accuracy: Ultrasound guidance helps ensure the needle is placed precisely in the target area. 
• Minimally invasive: The procedure is quick and doesn’t require surgical incisions. 
• Improved mobility: Steroid injections can help improve joint mobility. 
• Reduced risk of injury: Ultrasound guidance can help reduce the risk of injury and other potential side effects. 
• Immediate Feedback: The physician can assess the affected area in real-time and make necessary adjustments.

Repeat injections

If you find the injection is helpful with alleviating pain from the target area, and other treatments have been unhelpful or are unsuitable, steroid injections can usually be safely repeated. Some injections are used in order to provide a ‘window of opportunity’ to engage in exercise and rehabilitation. Generally, the pain is better controlled and the focus will return to exercise and conservative management, therefore often the need for further injections can be reduced. The possibility of repeat injections can be discussed with the clinician on the day of the treatment.

Steroid injections for chronic pain, painful joints, or other reasons for discomfort are a great option, and sometimes the only option left, in targeting chronic and server pain and symptoms. The use of anaesthetic and steroid means patients can have immediate relief from their symptoms while the steroid has time to work providing longer term relief of several months. For long term relief, it is recommended to repeat injections in the affected area for when symptoms may start to come back. Steroid injections are valuable and can help with movement, pain relief, and in getting back to doing everyday activities pain-free.

Ultrasound-guided steroid injections offer a safe and effective way to manage chronic pain and inflammation. With real-time imaging, this procedure enhances accuracy, minimizes risks, and improves patient comfort. For patients struggling with persistent pain, Ultrasound-guided injections can be a valuable option going forward in management and relief.