Ultrasound-guided cortisone injections in Inner West Sydney

A corticosteroid (cortisone) — a synthetic version of cortisol, the hormone your body makes naturally. Common preparations include triamcinolone, methylprednisolone or betamethasone. It is a potent anti-inflammatory.

In most cases a small amount of local anaesthetic is mixed in. This numbs the area quickly and confirms the needle is in the right place. Cortisone reduces pain, swelling and stiffness — but it is important to understand it does not heal damaged tissue; it creates a calmer window for rehabilitation to work.

Discomfort is usually mild. The needle is fine and local anaesthetic is generally mixed in, so most people feel a brief sting or a sensation of pressure that passes quickly.

Once the anaesthetic wears off (about 2–4 hours later) some people notice a temporary “post-injection flare” for 24–48 hours. This settles with rest and ice, and responds well to simple pain relief.

0–4 hours: the area feels numb from the local anaesthetic. 24–48 hours: a possible flare in pain — rest and ice. 3–7 days: the cortisone takes effect and pain settles. Weeks to ~3 months: your window of relief.

Plan to rest the injected area — strictly for the first 24 hours, and ideally for 5–7 days for a weight-bearing or tendon-related site. Depending on the area you may need someone to drive you home, or to wear a sling or boot. Use this calmer window to progress your rehabilitation.

Cortisone injections are very safe when done well, but no procedure is risk-free. Specific points to know:

Infection and bleeding are rare (in the order of 1 in 80,000 injections). Post-injection flare — a temporary increase in pain for 24–48 hours — is the most common effect.

Less commonly: facial flushing, and short-lived mood, sleep or menstrual changes (more likely if you’ve had them before). Shallow injections can cause skin lightening (depigmentation) or a small dimple of fat thinning, especially in darker skin. Tendon rupture can occur if cortisone is injected directly into a tendon — which is why we avoid that. People with diabetes may notice a temporary rise in blood-sugar for a few days.

If pain at the site persists beyond a couple of days, or you develop fever, spreading redness or heat, please contact the clinic for review.

Often a single, well-placed injection is enough to settle a flare and let rehabilitation progress. Some conditions benefit from a second injection after review.

We deliberately avoid repeated injections into the same tendon or weight-bearing joint, because cortisone is a “catabolic” steroid that can weaken tissue over time. As a general guide we limit injections at any one site, and we’ll always discuss the trade-offs with you.

We understand appointments need to fit around family. Because you may need to rest the area afterwards — and sometimes arrange a lift home — it’s worth planning ahead. If you need to bring a child, please let reception know when booking so we can help make the visit smooth.

Tell us if you take aspirin, anti-inflammatories or blood-thinning medication — whether or not an injection is planned. In the 24 hours before, avoid large amounts of alcohol and vigorous exercise, and wear loose, comfortable clothing.

Your doctor will take a history, examine you, and may arrange tests or imaging to confirm the injection is the right step and the safest target.

Let us know early. Corticosteroid injections are generally deferred during pregnancy and used only when clearly necessary, after weighing the benefits and risks with you. Small amounts are considered low-risk in breastfeeding, but we’ll always discuss your individual situation first.

Cortisone injections in children and adolescents are uncommon and are decided case-by-case, with attention to growth plates and developing tendons. They are arranged only where genuinely indicated and after a specialist assessment.