Landmark-guided means the injection is placed using palpable anatomical landmarks, bony points, tendons and joint lines that your physiotherapist identifies through careful examination, to guide precise needle placement. This is a well-established technique used across musculoskeletal medicine and does not require ultrasound equipment. Your physiotherapist will always assess whether landmark-guided injection is appropriate for your specific joint or condition.

A steroid (corticosteroid) injection is a fast-acting anti-inflammatory that reduces pain and swelling in an irritated joint or soft tissue, commonly used for conditions like bursitis, tendinopathy, frozen shoulder and acute arthritic flare-ups. A hyaluronic acid injection works differently: it supplements the joint's natural lubricating fluid, helping to ease pain and improve movement in joints affected by wear-and-tear (osteoarthritis), with effects that tend to build gradually and last longer. Your physiotherapist will recommend the most suitable option after your assessment.

Suitability is confirmed at your Initial MSK Assessment, where your physiotherapist reviews your symptoms, medical history and any relevant scans. Injection therapy is not usually recommended if you have an active infection near the injection site, are pregnant, have a known allergy to the medication, or have certain bleeding disorders. Your physiotherapist will discuss any risks specific to you before proceeding.

Steroid injections typically provide relief from a single injection, though this varies by condition. Hyaluronic acid may be given as a single injection or a short course, depending on the product used and how your joint responds. Your physiotherapist will explain the recommended approach for your condition at your assessment, and review your progress at the Follow-Up appointment.

Most patients describe the sensation as a brief pinch or pressure rather than significant pain. A fine needle is used, and the procedure itself takes only a few minutes. Some mild discomfort or aching at the injection site for a day or two afterwards is normal and usually settles quickly.

Injection therapy is generally very safe when carried out by a qualified practitioner, but as with any injection there are some possible side effects, including temporary soreness, mild swelling, or a short-term flare in symptoms (sometimes called a "steroid flare"). Rarer risks include infection or skin changes at the injection site. Your physiotherapist will talk through the specific risks and aftercare advice relevant to your treatment before you go ahead.

After your injection, rest the treated area for up to 48 hours and avoid anything that makes your pain worse. You can then gradually return to your normal activities. Please avoid high-impact exercise for around two weeks to help reduce the small risk of tendon irritation and allow the injection to work properly. If you notice increasing pain, redness, warmth, swelling, or any other signs of infection, seek medical advice promptly. If you have any concerns, please contact our clinic or your GP surgery.

Yes - injection therapy works best as part of a wider treatment plan. Many patients combine injections with physiotherapy and a tailored exercise programme, which helps address the underlying cause of pain and supports longer-lasting results. Your physiotherapist can advise on the best combination for your condition.

No referral is required, you can self-refer directly for an Initial MSK Assessment. If your physiotherapist identifies anything requiring further investigation, such as imaging or a specialist opinion, they will guide you on the appropriate next steps.

The steroid injection fee covers the assessment, procedure and clinical time. The steroid medication itself is prescribed and dispensed separately by a pharmacy, so this cost is paid directly by you at the point of collection. The hyaluronic acid injection fee is fully inclusive, with no separate prescription cost.