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Introduction
Injections for chronic pain are generally done into a joint space, around specific nerves and sometimes into trigger points. The injection mixture usually contains a long acting local anaesthetic and a long acting steroid. These help by reducing some of the pain signals travelling to the brain. Even though it may not be a cure, the benefits can last for several weeks or months. Sometimes injections are used to help in getting a diagnosis and planning an appropriate surgery.
The pain relief from an injection procedure should be taken as a window of opportunity to engage with physiotherapy and undertake regular exercise to improve the long term outcome.

Treatment Options
The decision on whether to go ahead for an injection procedure is an optional one. The likelihood of the injection being a successful treatment for you is best discussed in the clinic.
     (a) You could decide not to have an injection at all and look at other conservative strategies to develop your pain coping skills.
     (b) You could have an injection to help break your pain->activity->increased pain cycling. Thereafter, use a conservative strategy to manage your pain.
     (c) You could decide to keep having these injections at safe periodic intervals, so long as you find them beneficial. You would be exposed to the possible long term risks of repeated steroid injections.

Risks
Early
  1. A risk of bruising from procedure due to injury to blood vessels from a sharp needle. You may have to temporarily stop "blood thinning " medication such as warfarin, heparin, dabigatran and clopidogrel.
  2. Introduction of infection through the skin puncture wound.
  3. Erratic blood sugar levels in diabetics due to steroid interfering with sugar metabolism.
  4. The injection procedure may require use of X-rays, which may carry risks of birth malformations in an unborn child if you are pregnant.
  5. It is not advisable to fly within 2 weeks after the injections due to an increased risk of blood clots.
​Long term
  • Increased risk of osteoporosis
  • weakening of your immune system
  • change in your metabolism leading to weight gain



Follow up plan
As your pain decreases, you should try to gently increase your exercise. Simple activities like a daily walk, using an exercise bike or swimming on your back will help to improve your muscle tone. It is best to increase your activities slowly. Try not to overdo things on a good day so that you end up paying for it with more pain the following day.
​A follow up appointment will generally be arranged and you may be requested to fill a form that we use as part of assessments to continuously improve our service.
Information Leaflets about medications commonly used in chronic pain management
- click to download -

Amitriptyline
File Size: 751 kb
File Type: pdf
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Nortriptyline
File Size: 753 kb
File Type: pdf
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Duloxetine
File Size: 751 kb
File Type: pdf
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Gabapentin
File Size: 751 kb
File Type: pdf
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Pregabalin
File Size: 838 kb
File Type: pdf
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Opioids
File Size: 84 kb
File Type: pdf
Download File



DVLA Guidance for driving if on pain medication
File Size: 134 kb
File Type: pdf
Download File

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