As more and more of the UK population receive their Covid-19 vaccinations and routine healthcare treatments resume, many people are wondering whether it is advisable to delay certain procedures or delay having the vaccine to ensure the best possible outcomes for their health.
The British Orthopaedic Association has put together some helpful guidance for patients and clinicians who are due to have corticosteroid injections and other types of orthopaedic treatment to help them steer through the next few weeks and months.
What are corticosteroid treatments used for?
You may be offered an injection of corticosteroids if you are experiencing pain and inflammation in your joints due to conditions such as osteoarthritis, bursitis or frozen shoulder.
Steroids occur naturally in the human body and by injecting artificial steroids into painful, inflamed areas the aim is to reduce inflammation and relieve pain. These injections do not treat the underlying cause of the condition but they can provide short-term relief from symptoms. Some types of steroid injections provide pain-relief within hours while others take up to a week to take effect.
What are ultrasound guided injections?
Injections of steroids may be made directly into the inflamed joint (intra-articular injections), into the soft tissue close to the joint (peri-articular injections) or into a muscle (intra-muscular injections). We use ultrasound to pinpoint exactly where the inflammation is so that the steroid can be injected into the right location to deliver maximum pain-relief. Improving accuracy means improving the effectiveness of corticosteroid injections.
Guidelines for the timing of corticosteroid injections and the Covid-19 vaccine
With many types of orthopaedic surgery having been postponed due to the pandemic, more and more people are experiencing pain and inflammation and, consequently, there is a growing demand for pain-relieving injections. We understand the eagerness of patients and we are now routinely offering ultrasound guided injections once again. However, if you are due to have your Covid-19 vaccination, it’s important to take the guidance from the BOA into account. It states:
- It is safe to have steroids alongside the Covid vaccine, however your body might not produce such a good immune response to the vaccination as it would do without it.
- We do not recommend delaying vaccination if you are taking steroids or have recently had steroids or will be receiving steroid treatment soon. This applies whether the treatment is in the form of an injection, tablet or IV.
- If you need additional steroids to control inflammatory disease, that may take priority over vaccination, as a flare can also worsen the risks from Covid-19.
- It is important for as many people as possible to receive the Covid-19 vaccination as quickly as possible and to receive maximum benefits from it. For this reason, it may be appropriate to delay a non-essential steroid injection, as part of a shared decision agreed with your consultant. The rationale for this is so that the response to the vaccine can be most effective. The BOA guidelines state, for example: “For a patient who is on an elective waiting list for a steroid injection of up to 80mg methylprednisolone or 80mg triamcinolone, the administration of the Covid-19 vaccine is the priority if the vaccine has been offered to the patient and the prevalence of Covid-19 is high. In this scenario, the steroid injection should be deferred by 2 weeks after the vaccine, to enable the patient to mount the best response to the Covid-19 vaccine.”
The BOA also makes recommendations about other types of orthopaedic treatment, such as waiting seven days after having the Covid-19 vaccine before undergoing elective surgery. This is because the vaccine can produce symptoms such as fever and it is important that these are not wrongly attributed as post-surgical complications, which may indicate an infection.
If you are due to have an ultrasound guided injection of corticosteroids and are concerned about the timing of your Covid-19 vaccine, talk to us.
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