What steroids are commonly injected?

Many patients ask the question: How long does a steroid injection take to work? To answer that question we need to first look at the kind of type of steroid injected. This is one of the reasons that these are now commonly not used very much for joint and soft tissue conditions.

Highly soluble steroid injections such as hydrocortisone, were commonly injected for joint and soft tissue conditions years ago. they are very fast acting but unfortunately not very long lasting. This is why these type of steroids are now no longer commonly used to treat joint and soft tissue conditions.

The steroid injections administered for joint or soft tissues are usually longer-acting steroids such as: Triamcinolone Acetonide (Kenalog) and Methylprednisolone (Depo-Medrone). These steroids are highly insoluble in water. That means that they tend to form a depot in the injected structure and the active steroid is released more gradually. This means that they are seen as longer-acting steroids. One of the downsides of longer acting steroids is that they do not work immediately.

How long does it take before steroids to start working?

It Is generally accepted that Depomedrone and Kenalog steroids take at least several days to start working, in some cases people report that they notice the benefit after only one day or so. In many cases it can take as long as 5 to 10 days after injection for the benefits to show. In a minority of cases, it could take as long as two weeks before these steroids start working.

How long will the steroid injection last for?

There is no quick answer to this question. This will largely depend on your condition and the severity of your condition. For example, it is likely that in a degenerative condition such as osteoarthritis eventually when the steroid has stopped working the symptoms return. The evidence for how long steroid injection can last as long as 10 weeks or so. Although most studies do not look at longer term outcomes. Anecdotally it is not uncommon for people to report pain relief for many more months following steroid injection.

However, in non-degenerative conditions the success can be longer lasting. For example in steroid injection for De Quervains tenosynovitis (a very common and often debilitating tendon condition at the wrist) at four year follow up 90 % of patients completely recovered following steroid injection (Anderson, Manthey and Brouns, 1991).

Conclusion:

So hopefully this summary goes some way to answer the question we posed at the beginnning of this blog: How long does a steroid injection take to work?

  • Steroid injections generally take up to a week to start working. A small number of people  report benefit as soon as one day after the injection. A minority of people might not see any benefit for up to two weeks following a steroid injection.
  • Most injections if succesfull will last for at least a few months. But In degenerative conditions such as  (osteoarthritis)  the benefits are generally temporary. In non degenerative conditions such as a number of soft tissue conditions the benefits can be much longer lasting and for certain conditions (de quervains tenosynovitis) for example the recovery can be permanent.

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