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How effective are steroid injections?

Q) I'm in my 30s and have had lupus for 19 years. I've developed ossification and bursitis in my left hip which is very inflamed and painful, making walking very limited. I've been offered a steroid injection and wonder if they have good results? How long can the effects last, and are there any long-term side-effects?
Helen Belcher, Barnstaple, Devon (Autumn 2005)

A) I'm not entirely sure what the problem is in your hip. I can give you advice about steroid injections. Steroids are often given by injection where a particular joint or bursa is inflamed. They're usually extremely effective and this benefit may continue for some time – usually three months with the newer, longer-acting steroids. In general they're a very safe treatment but there's a risk of infection, probably in the order of one in 40,000 injections. I've never seen this complication in my practice. The injections may cause a brief increase in pain at the site of injection and may cause flushing in the face. If the injection is given just under the skin then some skin changes may occur – loss of pigment and sometimes a little dimple (due to loss of fat). These local side-effects usually recover with time.

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