To expect a local anaesthetic before main injection into painful shoulder like I had before

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Another pissed off with GP thread.

Waited 2 weeks for todays appt for a steroid shoulder injection having been on max painkillers and not sleeping. Todays GP didnt even examine me or talk to me about my symptoms and problems. He just sat me in a chair facing wall and started to clean my shoulder with antiseptic then podded and poked me and then injected me with what I thought was local anaesthetic which hurt like crazy and brought tears to my eyes.

He then took out needle and pumped my arm about a bit ( 10 seconds max) . I said, good thats the local in then and he said that he does not use local and that I had had the steroid injection done.

I was really shocked. Three years ago I had a similar problem with the other shoulder and my then lovely GP gave me a thorough exam and local before the main injection, and instructions post injection, more painkillers etc. I was in this room for 5 mins tops today. He barely spoke to me or asked me anything about my arm or the pain I was in. No follow up appt or advice. I dont really know if the injection has got into the right place this time. It was so different from my last experience.

Is this acceptible or shall I complain?

Shoulder really throbbing and stiff at present and feel a bit teary.

I have never had a local anesthetic before a steroid injection.

He should have checked you over and given aftercare instructions though

I can see you are annoyed at how quickly you were in and out etc, But you had the injection and thought that it was the local anaesthetic going in. So what would be the difference between the local anaesthetic injection being painful and the steroid injection being painful?

I've had steroid injections in my shoulder and was never given a local anaesthetic, and I know someone else who has had them too, and never mentioned being given a local anaesthetic, so in that respect I don't imagine that the Dr has done anything 'wrong' iyswim. And I was warned that it would probably hurt more for about 24 hours before I started to feel relief, which is exactly what happened.

If you are not happy with his attitude or whatever, I'd say that is something that only you can judge yourself, as you were the one who was there.

some injection do have LA in with them.

Didn't you ask any questions, either in the appoinment or last appoinment.

I have had many steroid injections in my knees and I have only had a cold spray put on them first to supposedly numb the skin - it doesn't however.

They tend to just have a feel, occasionally mark the site with a biro ( ) and then dive straight in with the needle. I do have fluid asperated first then the steroid but 9/10 they have to take the needle out and reposition it before they get any fluid.

What I dislike the most is how it can be anyone from any department of the hospital doing mine even though I go to the Rheumatology dept. The worst was from a&e and he had just made a grown man cry before starting on me!

I have had many steroid injections in my knees and I have only had a cold spray put on them first to supposedly numb the skin - it doesn't however.

They tend to just have a feel, occasionally mark the site with a biro ( ) and then dive straight in with the needle. I do have fluid asperated first then the steroid but 9/10 they have to take the needle out and reposition it before they get any fluid.

What I dislike the most is how it can be anyone from any department of the hospital doing mine even though I go to the Rheumatology dept. The worst was from a&e and he had just made a grown man cry before starting on me!

I have had many steroid injections in my knees and I have only had a cold spray put on them first to supposedly numb the skin - it doesn't however.

They tend to just have a feel, occasionally mark the site with a biro ( ) and then dive straight in with the needle. I do have fluid asperated first then the steroid but 9/10 they have to take the needle out and reposition it before they get any fluid.

What I dislike the most is how it can be anyone from any department of the hospital doing mine even though I go to the Rheumatology dept. The worst was from a&e and he had just made a grown man cry before starting on me!

I have had many steroid injections in my knees and I have only had a cold spray put on them first to supposedly numb the skin - it doesn't however.

They tend to just have a feel, occasionally mark the site with a biro ( ) and then dive straight in with the needle. I do have fluid asperated first then the steroid but 9/10 they have to take the needle out and reposition it before they get any fluid.

What I dislike the most is how it can be anyone from any department of the hospital doing mine even though I go to the Rheumatology dept. The worst was from a&e and he had just made a grown man cry before starting on me!

I have had many steroid injections in my knees and I have only had a cold spray put on them first to supposedly numb the skin - it doesn't however.

They tend to just have a feel, occasionally mark the site with a biro ( ) and then dive straight in with the needle. I do have fluid asperated first then the steroid but 9/10 they have to take the needle out and reposition it before they get any fluid.

What I dislike the most is how it can be anyone from any department of the hospital doing mine even though I go to the Rheumatology dept. The worst was from a&e and he had just made a grown man cry before starting on me!

I have had many steroid injections in my knees and I have only had a cold spray put on them first to supposedly numb the skin - it doesn't however.

They tend to just have a feel, occasionally mark the site with a biro ( ) and then dive straight in with the needle. I do have fluid asperated first then the steroid but 9/10 they have to take the needle out and reposition it before they get any fluid.

What I dislike the most is how it can be anyone from any department of the hospital doing mine even though I go to the Rheumatology dept. The worst was from a&e and he had just made a grown man cry before starting on me!

I have had many steroid injections in my knees and I have only had a cold spray put on them first to supposedly numb the skin - it doesn't however.

They tend to just have a feel, occasionally mark the site with a biro ( ) and then dive straight in with the needle. I do have fluid asperated first then the steroid but 9/10 they have to take the needle out and reposition it before they get any fluid.

What I dislike the most is how it can be anyone from any department of the hospital doing mine even though I go to the Rheumatology dept. The worst was from a&e and he had just made a grown man cry before starting on me!

I have had many steroid injections in my knees and I have only had a cold spray put on them first to supposedly numb the skin - it doesn't however.

They tend to just have a feel, occasionally mark the site with a biro ( ) and then dive straight in with the needle. I do have fluid asperated first then the steroid but 9/10 they have to take the needle out and reposition it before they get any fluid.

What I dislike the most is how it can be anyone from any department of the hospital doing mine even though I go to the Rheumatology dept. The worst was from a&e and he had just made a grown man cry before starting on me!

Thanks all. I just thought it was normal to have a local first. Now see that is not the case and I was being a bit precious. I do wish he had engaged with me more or even seemed slightly interested.

Sorry about your Knees Whoop.

I'm having some chocolate cake to cheer myself up and It seems to be making me less grumpy.

Cake always helps

Hope your shoulder feels better tomorrow.

I had a local in my knee at the doctors but he didn't have time to wait for it to take effect, and then the steroid injection really hurt. It didn't work so I had another one done privately. This time, they massaged the local in for quite a while and I didn't feel anything with the steroid. A completely different experience.

The NHS leaves so little time for appointments, that its probably a waste of money giving a local anaesthetic.

I had a general for my hip! But that was so they could manipulate the hip to get the right place. I had bruises in the shape of fingers afterwards. Was told for hips either GA or heavy sedation. DH had local when steroid injection into his wrist. TBH would expect a LA for any injection like that.

i thought they often combined local anaesthetic with hydrocortisone, but perhaps that depends what they do,

i think i had simply a hydrocortisone injection, deep into the bone,
but it did work.
has your injection helped?

tbh i wouldn't have thought you would need a local anaesthetic injectionbefore a steroid injection, it is only a sharp scratch

ok, it is only a needle

I've had several steroid injections into both ankles and I've had cortisone every time. I still found them quite uncomfortable, I dread to think how it would have felt without LA. Mine were x-ray or ultrasound guided, not sure if that makes a difference. I've have intramuscular regularly which don't have LA, was yours into muscle or joint?

Judging from this Welsh NHS PDF I would think it is the norm to have local first. Doctors avoiding this are likely cutting corners. At the very least it should be discussed with you. It should be your choice really given that LA is cheap stuff. www.wales.nhs.uk/sitesplus/documents/866/Pain%20Clinic%20-%20Local%20Anaesthetic%20and%20Steroid%20Injections.pdf

That PDF is really useful. Thanks ukatlast.

I do wonder if he now if he had combined local with the steroid but Im pretty sure there was only one vial on his very cluttered desk. There was no pre injection at all to numb anything.

Feels really sore, tight and heavy now. Throbbing like I've been kicked by a cow or something large and heavy.

Not going back to work tomorrow, dont feel I can drive yet as this has been a big aggrevating factor, its my gear stick arm and I need to drive for work and carry heavy stuff.

Can I ask how long people have taken off work afterwards and when it really starts to feel better.

Apologies for the duplicated posts - that's what I get for mn at work .

To the poster that said it is just a scratch - yes it is on the skin but the needle goes into an inflamed joint (in my case anyway) and hurts like hell. Especially when they wiggle it about to get more fluid out.

I heard yesterday that it is common practice to have it guided by a scan so that it is put in the correct place first time. Sadly this is private and as I said before the nhs way is to mark the spot with a biro.

Ipswichwitch I have always been advised to rest for 24 hours following the injection to give it a chance to work. I hope you feel the benefits soon .

I have nerve blocks done on a nerve in my thigh, so the injection goes in through my groin. I've always had a local done first! I have it done by pain management in a theatre though.

Conversely, I've had several steroid injections during both pregnancies when I've gone into premature labour & bloody hell, they hurt without a local!

I had steroid injections in my leg in labour and they really hurt! So much that i asked for an anaesthetic before the second one, but they said no (and i didn't know it was a real possibility so i accepted it).

My dad has had steroid injections into his knee and shoulde both with local beforehand.
And because he said the shoulder one brought tears to his eyes

Local anaesthetic injected into the joint (as described in the PDF) isn't to make the injection less painful, it's to ease the pain in the joint (in combination with the steroid) for which you're having the joint injection in the first place .

In terms of making the actual injection less painful, you can inject local anaesthetic [LA] into the skin but this is in itself painful, as the anaesthetic stings, and it won't dull any of the pain once the needle passes through the skin and into muscle. At best it will dull the pinprick sensation of the needle first pricking the skin. Overall though, many patients complain that the LA is worse than the pinprick from the needle which is probably why the GP didn't use it.

If you have to have another joint injection, you could buy some EMLA cream from a pharmacist and apply it to the area 30 minutes beforehand. This will only numb the skin so the injection will still hurt once the needle is through the skin, but at least the first bit will be painfree.