Melbourne Hand Surgery 

Coronavirus update: All consultations at Melbourne Hand Surgery are now conducted via telehealth (phone or video consultation), except where we have previously confirmed the requirement for an in-person physical examination or wound care management.  Mr Babazadeh is accepting referrals; Dr Tomlinson is not accepting urgent referrals and is on sabbatical leave. 

Emergency and urgent surgery is currently being conducted in hospitals. We anticipate a return to full elective surgery services from 31 July, in line with Victorian Government directives on the staged recommencement of elective surgery. Out of an abundance of caution we will apply the same approach to the recommencement of elective rooms procedures. 

Our practice will be closed on Fridays until further notice. We will use this website banner to provide general updates 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 community works through these unprecedented and rapidly evolving times together (last updated: 20 May 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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