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How and where are steroid injections given?

Medically reviewed by Carmen Pope, BPharm. Last updated on Dec 3, 2021.

Official answer


Steroid injections can be given by several different routes depending on the condition being treated, for example:

  • Directly into joints (intraarticular) to treat conditions such as rheumatoid arthritis or gout
  • Directly into muscles (intramuscular) for conditions such as systemic lupus erythematosus or Behçet's disease
  • Directly into inflamed bursae (bursae are small fluid-filled sacs that reduce friction between moving parts in your body's joints) to treat conditions such as shoulder bursitis
  • Directly around inflamed tendons or into the soft tissue around joints to treat tendonitis (inflamed connective tissue between muscle and bone) near the shoulder, elbow, hip, knee, hand, or wrist
  • Intravenously (into a vein) for when severe inflammation needs to be controlled quickly, for example, with severe multiple sclerosis (MS) flares
  • Epidurally (into your spinal cord) for lower back pain and leg pain.

How are steroid injections given?

Steroid injections are given by a trained healthcare professional. The steroid is in a sterile, liquid form that is suitable for administration with a needle.

You may need an ultrasound scan to find where the inflammation is, so the steroid can be injected into the exact spot for maximum benefit.

Your healthcare professional will use a needle to put it into the targeted area. When injecting into the spinal cord or a joint, bursae, or around tendons, generally some form of local anesthetic is given beforehand, to reduce the discomfort. Loose-fitting clothes may be more comfortable if you’re going for a steroid injection.

Most injections are quick and easy to perform and will be done in a hospital, clinic, or doctors’ surgery but you may want to arrange transport home after the injection, especially if you’re going to have a local anesthetic because numbness from the anesthetic can make it difficult to drive.

Are steroid injections painful?

You may feel slight pain or discomfort while you are having a steroid injection, but only for a short period.

Local anesthetics are often given for steroid injections into the spinal cord or a joint, bursae, or around tendons. These minimize the pain, and some people feel no pain at all, but their effects wear off within half an hour unless you’ve been given one that is long-acting. You may find you have some residual numbness after the anesthetic wears off that could last up to 24 hours.

Where is the most painful place to get a cortisone shot?

The most painful place to get a steroid (cortisone) shot is into the palm, sole, or into any small space (such as an ankle joint). The size (length) and gauge (width) of the needle can also factor into the amount of pain you experience.

How long does it take steroid injections to work?

Short-acting soluble steroids start to relieve pain within hours and the effects should last about a week.

Longer-acting steroids take around a week to become effective but can ease symptoms for two months or longer.

Learn more:

  • What are steroid injections and how are they used? Versus arthritis.,called%20an%20intra%2Dmuscular%20injection.
  • Steroid Injections. Cleveland Clinic. 2021.,needle%20into%20the%20targeted%20area.

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