Steroid Injections London

Steroid Injections London is an established Central London Clinic providing prompt access to Cortisone injections.

The majority of our clients come to us from a recommendation, that says it all. We’ve grown into
one of the most reputable clinics in the West End of London by putting our clients first.

Our ethos is to provide a cost effective solution, delivered by very experienced clinicians, so you have peace of mind.

You can expect to be assessed, including an ultrasound scan, prior to performing an ultrasound-guided injection, all in one appointment.

What are the advantages of Ultrasound-Guided Steroid Injections?

Steroid injections London

Steroid injections are also known as corticosteroid injections and cortisone injections. The name comes from the powerful anti-inflammatory ingredient in the injection. They are a synthetic version of the body’s own “glucocorticoids” that help regulate the inflammatory process. As they are a strong anti-inflammatory agent, if you inject this into a painful inflamed area, it will usually help reduce pain and swelling giving great symptomatic relief.

Steroid injections are an excellent treatment for inflamed joints, tendon sheaths and for individuals with chronic joint pain conditions eg inflammatory arthritis like Rheumatoid.

If you need pain relief in a joint or other areas and the waiting times are too long in the NHS then we can help you today! Paying privately for these services at a private hospital is very costly. We offer a same-day cost-effective solution for you that includes an ultrasound scan and musculoskeletal assessment.

Using ultrasound guidance allows us to see exactly where the problem is and direct the injection to exactly the right location. Research shows that this significantly improves outcomes with these procedures and also allows us to use the lowest most effective dose. If injecting “blind”, ie without ultrasound guidance there is a chance repeat injections may be required which is undesirable. Using the ultrasound to guide the injection also allows us to ensure we do not damage any other structures during the procedure, avoiding excessive tissue damage and pain.

Steroid Injection Appointment Process

Only One Appointment Needed

Assessment
Assessment

First we examine your area of pain and provide a preliminary diagnosis.

Ultrasound scan
Scan

We then perform an Ultrasound Scan so we can assess the root of pain and see beneath the surface.

Treatment options
Options

We can then discuss the diagnosis and treatment options with you.

Assessment
Procedure

If appropriate, there may be an injection that can reduce the pain and help you recover faster.

Report
Report

We will provide you with a report of any procedures and findings for your GP or specialist. You will also be sent advice on aftercare of the condition.

Cost of Steroid Injections

The price for an Ultrasound-guided injection includes:
  • Ultrasound scan and musculoskeletal assessment
  • Prescription of Medicine (There is no need for a GP referral – we can do all of this in house for you)
  • Ultrasound-guided Injection
  • Report of assessment and scan findings and details of injection
  • All injections are performed by highly experienced advanced physiotherapist with qualifications in diagnostic ultrasound and injection therapy and is an independent prescriber of medicines.

Steroid Injections

Standard steroid injection £230

Advanced procedure £250

Hyaluronic acid Injections

Ostenil Plus £250

Durolane £295

PRP Injections

PRP injection £315

Hyaluronic acid/PRP combo injection £350

David Harris

Introducing David Harris

David is the clinical director at Oxford Circus Physiotherapy and holds a Post Graduate Diploma in Musculoskeletal Diagnostic Ultrasound which includes Ultrasound-guided Injections and is an Independent Prescriber of Medicine. He is highly qualified in manipulative therapy, sports and orthopaedic rehabilitation. He was trained in New Zealand and has experience working with elite athletes assessing them for muscular imbalances. He has worked for professional sports teams and been part of the New Zealand Health team for the Olympics and Commonwealth games. He specialises in Diagnostic musculoskeletal scanning, Ultrasound-guided injections, spinal pain, sporting injuries, muscular imbalance and exercise prescription.

David Harris

Introducing David Burliston

David has spent 10 years as an Advanced Practice Physiotherapist in Guys and St Thomas NHS Accident and Emergency Department. He has experience of running steroid injection clinics in the Harley Street area. He is passionate about providing quality care for people with traumatic and non traumatic injuries and pain. His qualifications include a Masters in Sport and Exercise Medicine, Postgraduate Diplomas and Certificates in Diagnostic Musculoskeletal Ultrasound, Independent Prescribing of Medicines, Orthopaedic Medicine and Injection Therapy. David has worked at multiple sporting events, ranging from BUCS competitions to FA tournaments and trackside at the London 2012 Olympics.

What our patients say

David is a highly skilled clinician with experience in ultrasound guided injections and diagnostic ultrasound. He has worked along side me in clinic and been a valuable source of knowledge for rehabilitation programmes for our clients. We have lectured together on diagnostic ultrasound courses and discussed patients professionally to improve overall patient management. I have no hesitation in recommending his services and have referred clients to him all the way from Jersey!”

Dr Dave Howell – Jersey Sports Medicine and Shockwave clinic.

Working with David Harris and the team at Oxford Circus Physiotherapy has been extremely valuable to both me and my patients. Their skill, experience and desire to get to the bottom of a patient’s/clients problem has lead to us successfully collaborating on several, sometimes difficult, cases over the years. Oxford Circus Physiotherapy will guide you from the point of injury diagnosis back to physical performance and I am happy to recommend them.

Dr Ademola Adejuwon – Consultant in Sports and Exercise Medicine

The Oxford Circus Physio team are incredibly professional. The technology they use and the expert advice available is a cut above the competition. Probably the best value clinic in central London.

Matt Gardner – Client

Frequently asked questions

What is an Ultrasound-Guided-Injection?
We use an ultrasound scanner to identify the cause of your pain and when appropriate, we can then inject at exactly the right place to help alleviate your symptoms. 
What do we inject?

Corticosteroids, Platelet Rich Plasma (PRP) and Hyaluronic Acid. Hyaluronic acid and PRP sounds scary but we actually have it in our bodies already! Our skin is up to 55% Hyaluronic acid so it is an essential part of our make up. PRP is made from our own blood plasma and helps tissue regeneration.

Corticosteroid injections are an excellent treatment for Inflammed joints, tendon sheaths and for individuals with chronic joint pain conditions eg Inflammatory arthritis like Rheumatoid. They are a synthetic version of the body’s own glucocorticoids that help regulate the inflammatory process. They are a strong anti-inflammatory agent which will usually help reduce pain and swelling in the right conditions.

Hyaluronic Acid injections are becoming increasingly popular for individuals with joint pain. Hyaluronic Acid has less harmful effects than cortisone on joints and tendons and the effects can last much longer. For those individuals experiencing pain in a joint that is not responding to conservative treatment, it could offer an alternative option as it is a quick and simple procedure. The other benefit of using Hyaluronic acid is that it can be repeated without long term detrimental effects to a joint or tendon like cortisone can have.

Platelet Rich Plasma (PRP) injections are a type of therapy that involves using the patients own blood constituents to create an injectable product that helps with various soft tissue and joint problems. It can give long lasting reduction in pain associated with tendon, ligament and joint degeneration. As the process involves using no other products apart from the patients own platelets and growth factors to help healing in the tissue, it is popular for those who want to avoid artificial interventions or surgery. It is also a popular option if you have tried a range of other therapies but are still struggling. It is important to stress that it is still paramount that it accompanies a structured rehabilitation strengthening plan to achieve the best results.

So what is it?
Steroid injections are also known as corticosteroid injections and cortisone injections. The name comes from the powerful anti-inflammatory ingredient in the injection. They are a synthetic version of the body’s own “glucocorticoids” that help regulate the inflammatory process. As they are a strong anti-inflammatory agent, if you inject this into a painful inflamed area it will usually help reduce pain and swelling giving great symptomatic relief.  Steroid injections are an excellent treatment for Inflamed joints, tendon sheaths and for individuals with chronic joint pain conditions eg Inflammatory arthritis like Rheumatoid You could consider having an injection of Corticosteroid if:
  • You have severe joint pain eg Frozen shoulder or severe arthritis in a one of your joints 
  • You have a painful tendon sheath not responding to conservative treatments eg De Quervains. 
Hyaluronic Acid (HA) is a Gel like substance that is naturally present throughout the human body. Its role is to retain water and keep tissues moist and well lubricated. It is also a natural part of the fluid that lubricates your joints. Here are 3 key reasons why you should consider a HA injection for your painful joint.
  • Lubrication. Hyaluronic acid binds well to water, producing a viscous, jelly-like consistency. This viscous fluid provides lubrication and also acts as a shock absorber within the joint.
  • Transport medium for nutrients into the joint. This is what can keep the joint surfaces healthier for longer.
  • Reducing inflammation. Hyaluronic acid plays an important role in reducing joint inflammation and pain caused by injury or tissue degeneration. The better quality the lubricating fluid is in the joint the less inflammed your joints will become.
You can read more about Hyaluronic acid injections here. PRP is made up from your own body’s blood constituents so the first step is to draw blood from the patient (usually a vein in the arm). This is exactly like having a blood test. The blood is then spun very quickly using a specialist piece of equipment known as a centrifuge. This process causes the various constituents in the blood to separate into separate layers. One specific layer of the separated blood is plasma which will contain 2-5 times the usual number of platelets for a similar sample of normal blood. This layer is then extracted into a syringe ready to be injected back into the damaged area to stimulate healing. Here are some key reasons why you should consider a PRP injection for your painful joint or tendon.
  • Research shows that a series of PRP injections can give an excellent outcome for pain relief in knee Osteoarthritis.
  • It’s your own platelets and growth factors in high concentrations that are used to treat your injury
  • There are no artificial products or drugs used in this therapy so it’s as close to nature as you can get!
  • We can combine PRP with Hyaluronic acid in one syringe to maximise the benefits of both therapies
Does it hurt?

Not really! Using the ultrasound helps guide us to be as accurate as possible making it a more comfortable procedure than injecting “blind”. This means it will have its best potential for working too. Obviously with any injection there is always a little discomfort at the start. 

You could consider having an injection of Corticosteroid if:

  • You have severe joint pain eg Frozen shoulder or severe arthritis in a one of your joints
  • You have a painful tendon sheath not responding to conservative treatments eg De Quervains.

You could consider having an injection of Hyaluronic acid or PRP if:

  • You have arthritis in a one of your joints and you do not want a steroid injection or to avoid having surgery prematurely.
  • You have a painful stiff tendon not responding to conservative treatments.

To have an assessment and discussion with us about if this treatment is suitable for you please use the button below.

Do I need GP referral?
No. You can self refer directly to us and we will perform an assessment and diagnostic scan to evaluate the best treatment approach for you. 
Can you have too many steroid injections?

Steroid injections, also know as cortisone injections or corticosteroid injections are used mostly to control pain and inflammation in musculoskeletal conditions. They can be very effective but they can also wear off over time and people may require further injections.

One question we are often asked is “How many cortisone injections can I have?”. The answer is not so simple as some people suffering from painful inflammatory rheumatoid arthritis may require several injections in their life time whereas others presenting with a “tendinitis” such as “De Quervain’s tenosynovitis” usually only need one injection.

Occasionally symptoms can return after a steroid injection and this may be because you have pushed the joint or tendon physically again causing another flare or it may return as the steroid wears off and you may not have corrected the underlying biomechanical cause of the symptoms while you were pain free. If you have an arthritic joint, symptoms may return in time as further joint deterioration occurs. All of which may prompt you to look into having another steroid injection.

There is not a definitive number that you can have in your lifetime. It is all about timing, location, age, level of degeneration in a joint and long term management.

So how many steroid injections can I have?

There is evidence that having too many steroid injections into the same area can cause damage to the tissues. The NHS recommends you do not have more than 3 injections in the same area in one year. It is also recommended that you have around 6 weeks between injections if you are repeating a steroid injection. The time between injections is to prevent an accumulation of the steroid in 1 area and therefore potentially increasing the likelihood of side effects. So as long as you follow these guidelines we can repeat a steroid injection if you have had relief in the past.

Are steroid injections bad for you?

A steroid injection or cortisone injection is often given bad press.  They are used mostly to control pain and inflammation in musculoskeletal conditions like arthritis and inflamed soft tissue structures like bursitis and tendon sheath inflammation (tendinitis). They can be very effective but they can also have unwanted side effects.

If you have taken medication like Ibuprofen to control pain and inflammation by mouth then you have released that drug to the entire blood stream and a tiny amount of the drug is distributed all over the body. The use of an ultrasound-guided steroid injection will mean that a higher concentration of anti-inflammatory medication will be deposited only at exactly the right location to control the pain and hopefully limit effects elsewhere in the body. For this reason, steroid injections can have less harmful side effects that taking oral medications.

Are there alternatives to cortisone injections?

Yes. We use Hyaluronic acid injections for joint and tendon pain. This does not have any of the negative effects that cortisone injections can have however is not as good as an anti-inflammatory agent. That means if you are in a lot of pain right now then Hyaluronic acid is not as suitable as it will take longer to give you symptomatic relief but could last longer than a steroid.

For example, it may be a good option around the achilles tendon as it does not weaken the tendon and usually there is little to no inflammation in painful achilles tendon conditions. The hyaluronic acid will help with tendon glide, pain relief and long term healing.

Hyaluronic acid can also be very good in an arthritic knee in younger individuals where we want to prevent further joint deterioration. Whereas in older knees the amount of degradation is much higher so a steroid injection may not adversely effect the joint long term. We often combine cortisone injections and Hyaluronic acid injections at the same time to give you the best of both injections.

Platelet Rich Plasma (PRP) injections are also useful in the management of arthritic joints, ligament injuries and tendinopathy. This is also not a powerful anti-inflammatory agent like cortisone is. It is considered to be a pro inflammatory treatment in that you are encouraging the body to stimulate an inflammatory response to help with the healing of tissue. Therefore this treatment is less suitable for already inflamed tissues.

A good example is in “Tennis Elbow”. There is research to suggest that using a steroid injection to treat this condition will give temporary relief but at 3 months post injection, things are usually worse. PRP may be a more suitable alternative as it is considered a regenerative medicine and more likely to give better long term symptomatic relief than a steroid injection.

What are the potential side effects of cortisone injections?

Post injection flare
Around a quarter (1 in 4) people may notice an increase in their pain within the first 24-hours after a steroid injection. This usually settles itself within a couple of days. Simple painkillers, such as Paracetamol and applying a cold compress will help. This is only a temporary increase in symptoms but can be disheartening when you are looking for symptomatic relief. We try to use the lowest dose of medication possible to reduce the risks of this.

Skin changes
Injections containing steroid can occasionally cause some thinning and changes in the colour of the skin (local depigmentation) at the injection site. In rare cases a steroid injection into muscles or joints can cause an indentation (fat atrophy) in the skin around the injection area.

Infection
As with any injection into the body, there remains a small risk of infection. The risks involved in this are similar to having a blood test.

Weight gain
People are often concerned around the possibility of steroid related side effects, such as weight gain. One of the advantages of injectable steroids, compared with tablets, is that the dose can be kept low. This means you are unlikely to suffer any systemic side effects like weight gain.

Diabetes
People with diabetes may experience a fluctuation in their blood sugars. This should always be discussed with your GP and the therapist providing the injection, before the injection takes place. It is important that you be vigilant of your blood sugars for around a week to two weeks after the injection. If you have well controlled diabetes then it is usually safe to proceed with a steroid injection.

Other possible side effects when having cortisone injections include facial flushing, temporary changes in menstruation and mood.