What are the aftercare instructions for joint injection?

Joint Injection Aftercare Instructions

Patients should avoid overuse of injected joints for 24 hours following intra-articular therapy, but complete immobilization is discouraged and normal activity is recommended. 1

Key Aftercare Recommendations

Activity Restrictions

• Avoid overuse or excessive activity of the injected joint for 24 hours
• Complete immobilization (bed rest, joint splinting, or bandages) is not beneficial and should be avoided 1, 2
• Resume normal activities after 24 hours
• Studies have shown that 24-48 hour post-injection immobilization adds no benefit compared with normal activity 1

Monitoring for Specific Patient Populations

• For diabetic patients:
  • Monitor blood glucose levels for 1-3 days after injection
  • Be aware of potential transient hyperglycemia, especially in patients with suboptimal diabetes control 1, 2
  • No severe adverse events like hyperosmolar hyperglycemic state or ketoacidosis have been reported, but monitoring is still recommended

Pain Management

• Inform patients about the possibility of post-injection pain flare
• Local pain at the injection site is common and typically resolves within 24-48 hours
• Patients may use ice for comfort if needed

Warning Signs

• Instruct patients to seek medical attention if they experience:
  • Severe pain that worsens after 48 hours
  • Increasing redness, warmth, or swelling around the injection site
  • Fever or chills
  • Drainage from the injection site

Follow-Up Considerations

Evaluating Treatment Response

• A 30-day follow-up is appropriate to evaluate treatment response 2
• Consider benefits from previous injections when making decisions about repeat injections 1
• The decision to reinject should be individualized based on treatment options, compound used, systemic treatment, and comorbidities 1

Frequency of Injections

• Although not evidence-based, a generally accepted rule is to avoid more than 3-4 glucocorticoid injections in the same joint per year 1
• For patients planning joint replacement surgery, intra-articular injections should be performed at least 3 months prior to surgery 1, 2

Special Considerations

Prosthetic Joints

• Intra-articular glucocorticoid injections in prosthetic joints should generally be avoided in routine practice
• If necessary, they should be considered only after strict screening for prosthetic infection and in consultation with the orthopedic surgical team 1, 2

Radiopharmaceutical Injections

• For radioisotope injections, splinting for 48 hours may be considered to minimize radioisotopic radiation leakage into extrasynovial tissue 1

While some older studies suggested that 24-hour bed rest might prolong the duration of clinical response 3, more recent evidence and current guidelines clearly recommend against immobilization, as it provides no additional benefit and may be counterproductive 1, 2, 4.