The Chartered Society of Physiotherapy falls information page has useful information. This includes practical advice and exercises that may reduce the risk of falling. 

If you are worried about falling at home, or sometimes feel unsteady on your feet, the Falls Prevention Scheme offers free home safety visits to residents in York. The service provides practical advice and support to help reduce the risk of falls.

Corticosteroid Injection Therapy - Information for patients, relatives and carers

 

Why have an injection?

 A corticosteroid injection is given to reduce pain. The pain relief may be temporary or permanent. People usually do better for longer if they have physiotherapy as well as the injection.

What is in the Injection? The injection is a corticosteroid. Corticosteroids are drugs used to treat inflammation, which can help to relieve pain. Your injection may also include local anaesthetic to numb the area being injected. Your injection may also include saline (sterile water) to increase the amount of fluid injected.

How fast does it work?

It can take between two and seven days for the injection to start working.

You should not have the injection if you:

• Have an infection, feel unwell or are taking antibiotics.

• Are allergic to anaesthetic or steroid.

• Due surgery or have had surgery in the last six weeks

• Have had live vaccines within the last four weeks (MMR, polio, yellow fever) or flu/covid-19 jab in the last 14 days.

• Are taking some types of oral antifungal medication (those whose name end in ‘azole’).

• Are pregnant or breastfeeding.

• Are under 18

• Are a type 1 diabetic with high or unstable blood sugars.

• Do not want the injection.

Please inform us if:

• You have received any corticosteroid injections in the past 12 months.

• If you take other steroids. This might be in tablet form or an inhaler.

• If you take warfarin.

• If you blood thinning medications. These have names such as: Apixaban, Rivaroxaban, Edoxaban, Dabigatran, Warfarin.

What are the side effects?

• Symptom flare (one in 25). This means you could have more pain and or tiredness soon after the injection. This usually settles within two to seven days.

• Facial flushing (one in a 100). These symptoms should settle within four weeks.

• Skin changes – very occasionally some thinning or discoloration of the skin may occur at the injection site with loss of some of the fat tissue under the skin. This is often temporary, and the skin may recover over the course of a year. In some cases, these changes are permanent.

• Menstrual disturbance / breakthrough bleeding Women may have some changes in their normal cycle after an injection. If it lasts longer than one cycle you should see your doctor.

• Diabetic patients may notice a temporary increase in blood sugar levels. Contact your diabetes specialist for advice if your blood sugar is high.

• Disturbance to INR- if you are on Warfarin you should make arrangements for your INR to be checked 48 to 72 hours after the injection.

• If you take Apixaban, Rivaroxaban, Edoxaban, Dabigatran, we may ask you to stop a dose before the injection. This might, in theory, lead to an increased risk of having a stroke.

What are the risks?

• Infection- there is a very small risk of infection with a recorded rate of one in 40,000. If the area injected becomes red, hot and swollen and you feel unwell please attend the Emergency department of your local hospital with this leaflet.

• Allergic reaction- extremely rare and occurs within 15 minutes of the injection.

Do I need to rest afterwards?

It is recommended to reduce your normal day to day activities if these involve heavy lifting for the upper limb or impact activities for the lower limb. You will be provided with specific advice following your injection.

Patient Initiated Follow Up (PIFU)

When you have had your Musculoskeletal (MSK) Physiotherapy appointment, you have the option of a Patient Initiated Follow Up (PIFU) appointment.This means that you can contact the MSK Physiotherapy Team anytime within 6 months to arrange a follow up appointment with the Physiotherapist.A Patient Initiated Follow Up appointment allows patients or carers to tell us when they need to see a Physiotherapist. It is a move away from us telling them when to come in and see us. This gives patients control over their follow-up care and the ability to be seen when they feel it necessary. It also means the MSK Physiotherapy team can deliver better, high quality, personalised care within the NHS. If after your first appointment you feel better and are no longer in pain, there is no need for you to contact us. Allowing you to avoid unnecessary appointments.If your circumstances change, you can contact us to be seen again with a PIFU appointment.

Frequently asked questions

 

What does PIFU mean?

 

PIFU means Patient Initiated Follow-Up.

PIFU gives patients and their carers the flexibility to arrange their follow-up appointments as and when they need them, based on their symptoms and individual circumstances. It gives you the control of your follow up if appointment rather than us booking you in for one routinely. 

Why would I be offered the option of a PIFU?

You will be offered the option of a PIFU if both the physiotherapist and you think that you do not require a follow up appointment arranging automatically.

This might be because:

• you are happy with the treatment & self-management advice your physiotherapist has given and that you feel able and confident in managing your problem yourself.

• your symptoms are already improving well and are likely to resolve in due course without the need for a physiotherapy follow up review. 

Using your PIFU means that you wish to arrange a follow up with your physiotherapist.

Please contact the MSK Physiotherapy service on: 01904 725390.

If you have a different MSK problem to the one you were initially referred and seen for, you cannot use your PIFU for this reason. Instead, you will need to either complete a new ‘self-referral’ form or speak to your GP.

For example, if your Physiotherapist has seen you for a knee complaint, you cannot use your PIFU to then ask your physiotherapist to see you about a shoulder complaint.