Private Joint Injection clinic Belfast
We offer cortisone joint injections both with ultrasound guidance for accuracy and without ultrasound guidance.
If you have seen your own GP or physiotherapist about your joint problem and have a referral letter for a joint injection you can now book directly to have the joint injection with one of our doctors. We have two options joint injection under Ultrasound or joint injection with palpation of the area (without ultrasound imaging)
Price £250*
Price £350*
*If a second joint requires injection during the same appointment there is an additional fee of £120.
If you do not have a referral letter for your joint injection and have not been assessed already by either a doctor or physiotherapist then Dr Graham, Dr Russell, or Dr McKeown must see you first for an initial examination and consultation.
Book a 30-minute initial consultation with the doctor to assess your joint or tendon problem including carpel tunnel. We will decide if an injection is suitable and advise you on other therapies and on what exercises to do. You may need an Xray of the joint or another type of scan before a steroid injection can be performed. We can refer you into the NHS for your scans or investigations.
Price £130
Types of joint, tendon and nerve injections explained
Injection Option 1
Joint injection without Ultrasound guidance
Knee joint
Trochanteric bursa (side of hip)
Tennis elbow
Golfers elbow
Plantar fasciitis
Carpal Tunnel injection
Price £250*
*If a second joint requires injection during the same appointment there is an additional fee of £120.
Injection Option 2
Joint injection under ultrasound guidance with Dr GRaham
Shoulder- subacromial injection for bursitis.
Shoulder- both frozen shoulder and rotator cuff bursitis
Knee joint
Elbow joint
Trochanteric bursa (side of hip)
Tennis elbow
Golfers elbow
Wrist joint
Trigger finger
Finger joints
Plantar fasciitis
De Quervain’s Tenosynovitis
Carpal Tunnel injection- around the median nerve.
Price £350*
*If a second joint requires injection during the same appointment there is an additional fee of £120.
What you need to know about Joint Injections
This appointment is made up of an initial 30 minute consultation, where the GP will assess your painful joint or joints and decide if a steroid injection will benefit you.
Due to the current pandemic with COVID-19 the guidance states clearly that a steroid joint injection should only be considered when the benefit outweighs the slight increased risk of infection.
The most common reason to have a cortisone or steroid joint injections is severe debilitating pain that does not respond to medication or rubs, interferes with sleep and is getting worse despite other treatments.
The British Society of Rheumatology have recently updated their guidance which you can read here. Guidelines vary between countries, but as with any cortisone injection either into a joint, tendon area or muscle, the potential risks and benefits should always be carefully considered.
Who can do joint injections?
Joint injections are also known as ‘Cortisone-injections’, or ‘Steroid-injections’.
They are performed by rheumatology doctors, orthopaedic surgeons, GP’s (general practitioners) who have been trained in this procedure and also by some physiotherapists.
When do I need a steroid joint injection
One of the most common reasons to have a steroid joint injection is because of pain from arthritis of the joint, either Rheumatoid arthritis, osteoarthritis, or another type of inflammatory arthritis such as psoriatic arthritis.
Other reasons for a steroid injection are swelling or inflammation of a tendon that is not settling with physio and exercises, and pain where the muscle inserts into the bone such as Tennis or golfers Elbow.
Types of conditions that benefit from a cortisone injection
The steroid is used to reduce swelling and pain, and improve movement of the joint. If you have an inflammatory arthritis like rheumatoid then you will probably also take a medication to reduce inflammation, where a steroid injection is used only when there is s bad flare-up of your joint pains.
In the case of osteoarthritis, there is no licensed medication to reduce the disease progressing, although diet and exercise can help, so often a steroid injection is used to alleviate pain.
Tendon pain can be sudden (acute) or longstanding (chronic). Both these types respond very differently to steroid injections, but always need some amount of strengthening exercises to ensure the abnormal tendon changes into a healthier tendon with the correct stimulation.
Tennis and golfers elbow are not true tendon injuries, though they do respond similarly to both exercise and steroid injection.
De Quervains tenosynovitis is a common problem for woman who are either pregnant or have just given birth and it does respond well to a steroid injection.
Our GPs will assess you joint or tendon and decide on the best treatment plan. Sometime a steroid injection will do more harm than good and it is important to consider other options.
How long does the joint injection procedure take?
Most injections of the knee, elbow or shoulder take approximately 45 minutes to perform.
The first ten minutes are for asking you questions about your joints/tendons and your general health, then ten minutes to assess the joint to ensure an injection is suitable. After that if the procedure is necessary and you will benefit a consent form will be filled-out.
The area to be injected will be prepared so that it is clean and sterile. Iodine is used to clean the skin and allowed to dry for 5 minutes. The joint or tendon injection itself, takes ten minutes which allows for the local anaesthetic to work; however, if there is fluid in the joint this will be removed which can take an additional ten minutes.
Are joint injections painful?
Usually joint injections cause a little discomfort initially as the local anaesthetic is being injected, then after that you may feel some pressure only.
It is important to let your doctor know if you think the anaesthetic is not enough.
There can be some pain one hour after the injection when the local anaesthetic wears -off, but this is often minimal and sometimes there is no pain at all.
As infection is a rare but possible side-effect of a cortisone injection. you will be advised if you you have bad pain to let the doctor know.
who will perform my joint or tendon injection?
We have 4 GPs who can perform joint injections in the clinic.
Dr. Graham has been performing joint injections since 2004 when she first worked in rheumatology, and has now performed over 1000 injections. She has maintained her skills in joint injections while woking as a GP, alongside good relations with her rheumatology colleagues and can recommend prompt onward care.
Dr Tim Russell and Dr Rory McKeown are also highly skilled in performing joint injections.
If a joint injection is not needed either because it may not help, or in some cases could cause other problems, our GPs will explain this to you and offer an alternative treatment. A consultation fee of £130 will be charged.
For injections of the hip or the back, we will refer you to have this done under X-ray or Ultra-sound guidance.
Side-effects of a steroid joint injection
Steroid injections can thin-out the joint lining and in some cases result in an infection of the joint, or more rarely collapse of the joint structure if there is severe arthritis underlying.
Other side effects are pain after the procedure once the local anaesthetic wears off, and very rarely you can paradoxically develop a flare-up of your arthritis due to the steroid crystallising in the joint.
Steroid or cortisone injected into the joint is absorbed by the rest of your body and can theoretically increase your risk of other infections if high doses are used.
Each person responds differently to steroid. Rarely, steroid can cause the adrenal glands where your natural steroid is produced to stop doing their job which can increase your risk of infection if this is not picked-up by your doctor.
Side-effects of a tendon-injection
Not all tendons benefit from a steroid injection and in some cases if the tendon is weak and stiff from chronic inflammation the steroid injection can result in the tendon breaking or tearing.
It is important to be properly assessed by your doctor to decide if an injection is likely to benefit you and to weigh up the possible side-effects.
In some cases an X-ray of the joint is required first and our GPs will refer you for this if needed. ( You can usually have the X-ray performed that day in Belfast).
Dr. Graham’s experience in Rheumatology
Dr.Graham first worked in the specialty of Rheumatology in 2004 as a Staff grade in Antrim Area Hospital, then again in 2007 as a Rheumatology Registrar in the Leicester Royal Infirmary and again in Antrim Area as a staff grade in 2008.
Finally while still working as a GP, she returned to rheumatology In 2015 to work in Musgrave Park Hospital, Belfast. During this time she set the foundations for her research in Sport and exercise medicine and the following year she was granted approval to carry out research into the effects of exercise on women with rheumatoid arthritis.
Her research was conducted through Musgrave park hospital rheumatology department, and in 2016 she obtained her Masters degree in Sport & Exercise Medicine, graduating from the university of Bath.
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