A joint injection is a procedure your foot and ankle orthopaedic surgeon uses to introduce medication into a joint. The injection is done under sterile conditions using a syringe and needle.
The goals of a joint injection are to relieve pain and improve joint function. Your doctor also may confirm your diagnosis when giving a joint injection.
An injection may be needed if you have redness, pain, swelling, loss of smooth motion, and trouble with walking normal distances.
Joint injection should be avoided in certain situations. Some of these include the presence of skin or blood infections and a history of allergic response to the injectable medication or its components. In addition, your surgeon may rule out a joint injection if there was little improvement after a previous injection, you have a bleeding disorder or are on blood thinning medication, you have poorly controlled diabetes, or your body has problems fighting infections.
Your surgeon will position your foot for the injection procedure. The skin over the joint will be cleaned and sterilized with topical iodine, chlorhexidine or alcohol. The medication will be injected using a syringe and needle. The injection site may need to be covered with a bandage or have pressure applied for a few minutes.
Specific Techniques
The ankle, subtalar, and metatarsophalangeal joints are the common joints for injections. An ultrasound or X-ray may be used to help guide the injection. In addition, fluid can be drawn from the joint before an injection and sent for testing. The symptoms of infection, gout, and autoimmune disease can be similar, and lab testing can help determine a diagnosis.
You may be asked to remain in the office for 30 minutes or so to be observed for side effects of the injection. You may be instructed to avoid or limit activity for a day or so after the injection. Your foot and ankle orthopaedic surgeon may prescribe other medication, splinting, or physical therapy as part of your treatment plan. Your specialist will tell you when to schedule your next appointment.
Potential complications include infection at the injection site, infection of the joint, tenderness, swelling, and warmth. There can sometimes be nerve or blood vessel injury, or damage to the joint surfaces.
When corticosteroids are used, they may cause loss of skin pigment or thinning of the skin. Corticosteroids also can cause weakening of a nearby ligament or tendon with the possibility of complete tears. This medication also may temporarily increase blood sugar and disrupt the body’s own steroid hormone balance, particularly in patients with hormone disorders.
Local anesthetic may cause flushing, hives, chest or abdominal discomfort, and nausea. Viscosupplements, substances that act like naturally occurring joint fluid, may cause joint pain, swelling, and inflammation. Contrast agent may cause allergic reaction.
Should I apply ice or heat after a joint injection?
It is generally recommended that you apply ice once or twice per hour for 10-15 minutes for the first few hours after a joint injection. You should avoid applying heat to the affected joint.
How should I clean the injection site at home?
No specific cleaning of the injection site is typically needed. You generally are able to resume normal showering or bathing after joint injections.
Will a joint injection interfere with my other medications?
You doctor will be able to answer this question for you. Be sure to bring a current list of your medications to your appointment.
Will a steroid injection raise my blood sugar?
If you are diabetic, a joint injection with a corticosteroid may cause your blood sugar to increase for a short time. It is a good idea to talk to the doctor who manages your diabetes medication and your surgeon before you receive a joint injection.
Original article by Christopher Reb, DO
Last reviewed by David Garras, MD, 2018
The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. The content of FootCareMD, including text, images, and graphics, is for informational purposes only. The content is not intended to substitute for professional medical advice, diagnoses or treatments. If you need medical advice, use the "Find a Surgeon" search to locate a foot and ankle orthopaedic surgeon in your area.
