Home

1) Cortisone injection therapy
2) Ostenil joint injections

Cortisone Advice

WHAT IS IT? Cortisone is a powerful anti-inflammatory which will reduce pain.

AIMS OF CORTISONE INJECTION To reduce pain and inflammation associated with soft tissue injury or early arthritis of a joint. It is also helpful in breaking down or preventing scar tissue.

HOW LONG DOES IT LAST The effect of cortisone is unpredictable. In some conditions it can cure the problem in others the effect is short term only i.e. just days or weeks.

OVERVIEW

Injection time Most injections will take 30-60 seconds, although nerve injections may take a few minutes.

Injection placement The injection is most effective if placed in the area of most pain.

Is the injection site numbed first The cortisone is combined with local anaesthetic to relieve any discomfort during the injection. Sometimes the area is anaesthetised prior to injection.

Time off work It is advisable to rest on the day of the injection but you can return to normal the following day.

Pain associated with the injection Obviously pain is very subjective but most people would rate the pain as 2 or 3 on a scale of 1 to 10, 10 being the worst agony imaginable. Onset The effect should be noticeable within the first 3-7 days.

Indications for cortisone in foot pain: Heel pain, pain in the knuckle joint of the ball of the foot, Morton's neuroma pain, tendonitis, joint pain (e.g. arthritis) and nerve compression pain.

Maximum number of injections: Usually if the problem is going to respond to cortisone it will do so within 3 injections, if there is no improvement after this it is unlikely that further injections will help.

RISKS OF CORTISONE INJECTIONS

• Flare up of pain so the condition gets worse in the first 1-3 days.
• Thinning of the skin
• Loss of pigment in the skin
• Damage to the joint cartilage
• Allergic reaction usually no more than facial flushing.
• Weakening of the tendon and rupture of the tendon
• Failure to improve pain

ALTERNATIVE TREATMENTS

• Anti-inflammatory gels e.g. Voltarol (available over-the-counter)
• Padding, strapping and splints
• Compressive bandaging
• Joint fluid replacement injections (e.g. Ostenil)
• Ice and rest
• Foot supports (orthoses)
• Glucosamine-chondroitin-MSM tablets
• Appropriate surgical intervention

Ostenil Injection Therapy

In wear and tear joint (osteo) arthritis, the body's natural joint fluid which lubricates synovial joints (e.g. big toe joint) is reduced. Much like losing oil from your car engine, this can increase friction and wear in a joint where cartilage damage has already occurred due to the arthritis. As much as 50% of the natural (hyaluronic acid) joint fluid can be lost. Ostenil is an injection of hyaluronic acid which replaces the lost fluid in the joint. Firstly, we commence with a cortisone injection to reduce inflammation in the (synovial) lining of the joint; then a course of 3 injections are spaced one week apart. This won't cure the arthritis as such but can relieve joint pain and defer surgery where surgery may be indicated.