Steroid injections are commonly used to treat various inflammatory diseases of the upper extremities. These include: snap finger (stenosing ligamentitis), de Quervain syndrome, carpal tunnel syndrome, joint inflammation (arthritis), tennis elbow (lateral epicondylitis), tendonitis (inflammation of the rotator cuff tendons).

What are steroid injections?

Steroid injections usually contain a mixture of synthetic cortisone and a local anesthetic such as lidocaine or bupivacaine. Cortisone is a steroid produced by the adrenal glands with a strong anti-inflammatory effect.

 There are several synthetic drugs available, such as triamcinolone, betamethasone and dexamethasone, which appear in pharmacies under various brand names. They all have similar mechanisms of action, although they differ in strength and duration (short and long action). 

There are no advantages of one over the other, so the choice of the drug belongs to the doctor performing the procedure. Anti-inflammatory steroids are very different from anabolic steroids, which are abused by some athletes in bodybuilding or to enhance performance in other sports. A local anesthetic drug dissolves the steroid and numbes the injection site, which reduces discomfort during the procedure.

How does steroid injections work?

Steroid injections work by reducing inflammation. When the inflammation stops, the pain associated with it usually goes away as well.

How is the procedure going?

The injection site is first treated with an antiseptic liquid, such as a solution of iodine, alcohol, or other skin disinfectant. A small needle is then inserted and injected. (See Figure 2) Usually small amounts of steroid and local anesthetic are injected. Then the injection site is covered with a gauze bandage.