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Sports Medicine

Depo-Medrol Injection for Bicep Tendonitis

05/24/2011

Question:

I have had two steroid injections, one in my thumb and one in my shoulder. Both times they used an anesthetic. They are both injected at the same time in the same needle. I get a feeling that the anesthetic is causing it to feel tight and sore. Why is anesthetic injected with the steroid? Can it be done without the anesthetic? I would like to try it without it and see if I feel any better during the shots.

Answer:

Injections for neuromusculoskeletal problems often consist of a combination of steroid ("cortisone") and local anesthetic (Lidocaine or Bupivicaine) mixed together in the same syringe.

The anesthetic will usually provide immediate improvement in pain (especially if Lidocaine is used, since its onset of action is quickest), and also serves to increase the total volume of fluid injected which may be beneficial if exposing a larger surface area of tissue to this mixture is desirable.

Injection of steroid without local anesthetic can certainly be performed. Although this would not have the above advantages, sometimes this is done:

Feel free to ask your physician, if it is determined you would benefit from another injection in the future, to inject just steroid without the local anesthetic.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University