Cortisone Joint injections as we recover from the Coronavirus pandemic

9th June 2020

The use of steroid injections in musculoskeletal medicine is a standard treatment, but recent events with COVID-19 has asked questions of these.

Although there is no clear evidence that steroid injections can increase the likelihood of acquiring COVID-19 or increasing the severity, possible concerns have been raised regarding reduced survival benefit and possible harms. We do know that steroids will reduce your immunity for short period of time.   Furthermore complications and mortality related to COVID-19 are higher in some groups of people, particularly older people and those with comorbidities.

It is your decision if you would like to go ahead with this injection but only after careful consideration and full conversation about risk and we would strongly advise other treatment choices if possible. We will only consider steroids if you have high levels of pain and disability, have failed first-line measures such as rest, anti-inflammatories and physical therapy, and continuation of those symptoms will have a significant negative effect on you health and wellbeing. They must be supported with guidance about activity modification and exercise therapy.

The Faculty of Pain Medicine released a comprehensive statement which is posted here for your information.  The NHS summarised their guidance here. However it should be born in mind that these were both written in March at the height of the UK pandemic. Prevalence of COVID-19 in Dorset is currently extremely low and as of the end of May of the 150 reporting local authorities, the two in Dorset were 143rd and 145th in the list.

 

Dr Alder and the team at Dorset Private GP have always considered steroid injections on an individual basis, mindful of risk and the effects on the immune system and are practising in line with the current guidance.  We definitely will not be administering injections if you have COVID-19 infection, or if there is a possibility, that you may have COVID-19, even if there are no symptoms at the time.