Melbourne Hand Surgery 

Coronavirus update: We will be closed on Wednesday 8 April, but will reopen at 8:30am on Thursday 9 April. 

Melbourne Hand Surgery has mechanisms to protect our patients and staff while we continue to provide healthcare services. All consultations are now conducted via telehealth (phone or videoconference), except where we have previously confirmed the requirement for an in-person physical examination or wound care management.  Only emergency surgery is being conducted in hospitals for the foreseeable future, in keeping with Government directives. 

Due to the change in circumstances we will be closed on Fridays until further notice. If our practice is unable to physically open for business at any point in the coming weeks or months we will communicate this to existing scheduled patients via email and SMS (please do not attempt to reply other than with Y or N to an SMS, as the automated system does not facilitate this). Incoming telephone calls and receipt of voicemail messages may be temporarily affected by such a change. We will use this website banner to update you on changes to our practice and the availability of non-urgent procedures and surgery in the weeks and months ahead. Thank you for your understanding as our entire community works through these unprecedented and rapidly evolving times together (last updated: 4 April 2020).

Corticosteroid injections

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Corticosteroid injections are administered to reduce inflammation in conditions such as trigger finger, de Quervain’s tenosynovitis, basal thumb joint arthritis and carpal tunnel syndrome. In many instances they are an effective treatment that allows surgery to be avoided. Corticosteroids are a synthetic version of hormones produced naturally by the adrenal glands.

For information about how corticosteroid injections are used in the treatment of abnormal scars please visit this page.

How are corticosteroid injections given?

The injections are commonly performed as an office procedure. In some instances you will be referred to have the procedure performed under ultrasound or x-ray guidance by a radiologist. You do not have to fast for the procedure and you will be awake for the procedure.

Are corticosteroid injections painful?

As with all injections there is some discomfort from the procedure; the amount of discomfort or pain varies. For this reason local anaesthetic is commonly used, either mixed with the injection or as a separate injection to numb the area prior to the corticosteroid injection. After the local anaesthetic wears off you may notice pain or discomfort until the corticosteroid starts to take effect.

What should I do after a corticosteroid injection?

clasped hands man sitting in jeansTake it easy. Applying cold packs to the area and/or taking paracetamol or ibuprofen will reduce any discomfort. You should rest the area for 24 hours and avoid strenuous activities for one week. If you experience numbness from the local anaesthetic you should avoid activities that could put you at risk of injury until later in the day when the numbness has worn off.

What are the possible complications of corticosteroid injections?

Possible complications from corticosteroid injections include atrophy of the skin and subcutaneous fat over the injection site, altered pigmentation of the skin over the injection site, temporary irritation of the tissues around the injection site, weakening of tendons (including tendon ruptures) and joint infection. Sometimes the injection can result in temporarily increased pain, due to inflammation ("post injection flare"). Corticosteroid injections can temporarily elevate blood sugars in people with diabetes. Injections are contraindicated when there is, or has recently been, a local infection.

How often can I have a corticosteroid injection?

three fingersThere are limits on how many times and how frequently corticosteroid injections can be used in the same area. Usually no more than three injections are given. Speak with your specialist about what limits and contraindications may apply in your individual circumstances.

General Principles

If you are interested in learning more about corticosteroid injections you may wish to view this educational video created for general practitioners by NSW Hand Surgeon Dr Stuart Myers. Please note that this video is created for doctors, not patients. For more information about injections for specific areas please visit the relevant page on the Melbourne Hand Surgery website.

FRACS

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