Risk Factors

Risk Factors

Most of the risks associated with injections that are usually not serious (please read the specific injectable information tabs and documents). Please note that specific risk factors associated with your individual medical history are considered in isolation, therefore it is vital that you include this within the online form or make one of our practitioners aware if there is an omission. Specific medical conditions are considered on an individual basis and will be discussed with you prior to the delivery of a treatment. The content within this section, discusses infection and allergies as well as aftercare to reduce the risk of complications associated with these issues.

As a general point, all our injections are delivered with ultrasound guidance to target the area of the body that is causing pain or inflammation. This also means compared to non-guided (blind) injections we can greatly limit the potential of damaging non-targeted structures such as major blood vessels or nerves. 

Infection

Whilst rare, as the skin is breached one of the most serious complications that can occur after injections is infection, if you experience any of the signs or symptoms of infection then you must not ignore them as they can lead to joint or soft tissue damage. If treatment is delayed the infection can spread to other areas of the body. Joint infection requires urgent medical attention. If you experience any of the symptoms below, please seek medical attention by your clinician/GP on the same day or attend A&E to be screened for infection:

• Significantly increasing pain
• Local redness, heat and swelling
• Suddenly feeling unwell
• Fever/high temperature

Micro bacteria are invisible, organisms live on surfaces, in the air and in the human body. Techniques are in place to reduce the number of bacteria on the skin, but bacteria cannot be removed completely, in most cases the bacteria are harmless but in rare cases they can be very harmful to the joint (e.g. septic arthritis). Infection risk with injections is small, as the medical device, medicine and equipment that are used are sterile (untouched and packaged). 

When preparing the injection, we make sure that all sterile products that contact the injectable remain untouched (i.e. needle, drug vial), should advanced procedure like aspirations or when multiple syringes are used (i.e. combination treatments, hydrodistension, Arthrosamid), sterile gloves are also worn when removing syringes from the needle that is inserted into the targeted anatomy (i.e. joint).

Aseptic technique

An aseptic technique ensures that only uncontaminated equipment and fluids come into contact with susceptible body sites. It should be used during any clinical procedure that bypasses the body’s natural defences. Using the principles of asepsis minimises the spread of organisms from one person to another.

Healthcare-associated infections are caused by a wide range of microorganisms. These are often carried by the patients themselves, and have taken advantage of a route into the body provided by an invasive device or procedure. Healthcare-associated infections can exacerbate existing or underlying conditions, delay recovery and adversely affect quality of life (NICE, 2012).

Using the principles of asepsis minimises the spread of organisms from one person to another.

Aseptic solutions & allergies

Chlorhexidine is an antibacterial present in a wide range of topical and oromucosal antiseptic products, including over-the-counter mouthwashes. At Cheshire Joint Injections Chlorhexidine is our preferred choice of aseptic solution however as with other solutions, in rare cases some people may be allergic.

Healthcare professionals are reminded that chlorhexidine is known to induce hypersensitivity, including generalised allergic reactions and anaphylactic shock. The prevalence of chlorhexidine hypersensitivity is unknown, but available literature suggests this is likely to be very rare. Products or medical devices containing chlorhexidine should not be administered to anyone with a possible history of an allergic reaction to chlorhexidine (NICE, 2012).

If you have a known allergy to chlorhexidine, please let us know ahead of your appointment.

Aftercare

After your injection you will be given specific advice about what to do in the days following. Some key points are listed below:

• Keep the area dry for 6 hours
• Do not massage, rub creams, anti-inflammatory products or shower gels into the area
• Do not return to strenuous exercise for 72 hours (this is a timeframe average that varies per patient and condition and therefore may be longer)
• Maintain general hygiene 
• If you develop a rash, tight chest or other potential signs of allergy please attend A&E and do not drive 

This is general advice that applies to all injections, please also read specific injectable documents for information on your specific treatment