Joint injection request and consent portal

Re-introduction of Joint Injections during COVID-19

Steroid (cortisone) injections were stopped nationally at the start of the Covid-19 pandemic because as well as having anti-inflammatory effects on the body, steroid is also an immunosuppressant. As such there is the potential that undertaking a steroid injection will increase a patient's chances of catching COVID-19 and also potentially making a mild COVID illness a severe or even lethal one. The increased risk would last for up to 8 weeks after the injection was undertaken. The evidence for this, like in many areas of COVID-19, is still being examined.

The prevalance of COVID-19 within our local community is constantly being monitored, and it has been determined that when prevalance rates are low the risks are much reduced and we are able to start undertaking injections in certain patients. Cardiff & Vale University Health Board has performed a detailed literature and evidence review and issued strict guidance for risk assessing patients to identify those who can be offered steroid injections. This guidance also comes with an expanded patient information and consent form that has to be completed in all patients. The prevelance and guidelines are regularly being reviewed and the risk assessment is shown below.

If you are in the Low Risk or Medium Risk groups you can now request a steroid injection at the surgery by completing the following forms at the bottem of this page:

  1. The joint injection request form
  2. The joint injection consent form

Once these forms have been completed we will contact you to book you in with one of the doctors to undertake the injection.

If you fall into the High Risk group we would urge you to seek alternatives to steroid injections. If, however, you feel that an injection is your only alternative and you are prepared to accept the risks, please contact the surgery to arrange an telephone consultation to discuss the situation with one of the doctors undertaking injections.

If you fall into the Very High Risk group we are unable to undertake an injection in surgery and alternative options will need to be explored.

Steroid injections and the COVID vaccination

When you have the COVID vaccination your immune system responds producing antibodies to the COVID-19 virus. Due to the immunosuppressive effects of a steroid injection having a injection prior to or shortly after your COVID vaccination will reduce your immune systems response to the vaccination making the vaccine much less effective and increasing your risks of catching COVID-19. To prevent this effect on your immune system we will not be able to undertake a steroid injection either 2 weeks before or 4 weeks after your COVID vaccinations.

Joint Injection risk table

Risk Factors

  • Asthma - Moderate to severe only
  • Chronic Lung Disease – COPD. Pulmonary Fibrosis, Cystic Fibrosis
  • Diabetes
  • Serious Heart Conditions – Heart Failure, coronary artery disease, congenital heart disease, cardiomyopathy,
  • Chronic kidney Disease – Dialysis
  • Severe obesity – BMI > 40
  • Age - > 65 years
  • Immunocompromised – Cancer treatment, transplant including bone marrow, immune deficiency, HIV with low CD4, medication causing immunosuppression including long-term steroids.
  • Liver disease – Cirrhosis