Cortisone & Steroid Injections Belfast

What is Injection Therapy?

Injection therapy delivers medication directly to the site of pain or inflammation, providing targeted relief when oral medications or other conservative treatments haven't been effective. At our Belfast clinics we offer a comprehensive range of injection therapies for the knee, foot, and ankle, performed privately with no GP referral needed.

All injections are performed using real-time ultrasound guidance, ensuring the medication reaches exactly the right location for maximum effectiveness and safety. This precision approach significantly improves outcomes compared to landmark-guided (blind) injections.

We offer three specialist injection types, each designed to target different conditions and stages of pathology:

Common Symptoms

Persistent joint pain and stiffness
Swelling and chronic inflammation
Pain that limits daily activities or sport
Mid-portion Achilles tendon thickening and pain
Early to moderate osteoarthritis symptoms
Burning or tingling sensations (neuromas)
Pain not responding to other conservative treatments
Joint stiffness and reduced range of motion

Common Causes

Morton's neuroma
Plantar fasciitis
Knee, ankle & foot osteoarthritis
Mid-portion Achilles tendinopathy
Bursitis (knee, heel, ankle, or forefoot)
Capsulitis (joint inflammation)
Insertional tendinopathy
Synovitis and joint effusion

Our Treatment Approach

We offer three distinct types of injection therapy, each selected based on your specific diagnosis, the stage of your condition, and your treatment goals:

Corticosteroid (Cortisone) Injections

Corticosteroid injections are a powerful anti-inflammatory treatment used to rapidly reduce swelling, pain, and inflammation in joints, bursae, and soft tissues. They are one of the most widely used and evidence-based injection treatments in musculoskeletal medicine.

Commonly used for: plantar fasciitis, Morton's neuroma, bursitis (heel, ankle, forefoot), capsulitis, synovitis, and acute inflammatory joint conditions.

How it works: A corticosteroid (such as methylprednisolone or triamcinolone) is injected directly into the affected area under ultrasound guidance. The steroid suppresses the local inflammatory response, providing significant pain relief. This is often combined with a local anaesthetic for immediate comfort during the procedure.

What to expect: Relief typically begins within 3–7 days and can last from 6 weeks to several months. We generally limit corticosteroid injections to 2–3 per year in any one area to protect tissue integrity.

Hyaluronic Acid Injections (Viscosupplementation)

Hyaluronic acid (HA) injections provide natural replenishment of joint lubrication for patients with early to moderate osteoarthritis. Hyaluronic acid is a naturally occurring substance found in healthy synovial (joint) fluid. It acts as both a lubricant and a shock absorber within the joint.

Commonly used for: early to moderate osteoarthritis of the ankle, midfoot, and first metatarsophalangeal (big toe) joint. Particularly suitable for patients who want to avoid or delay surgical intervention, or those who cannot tolerate repeated corticosteroid use.

How it works: The injection supplements the joint's depleted natural hyaluronic acid, restoring the viscosity and elasticity of the synovial fluid. This reduces friction between cartilage surfaces, decreases pain, and improves joint mobility. Unlike corticosteroids, HA injections work by restoring the joint's natural environment rather than simply suppressing inflammation.

What to expect: Benefits may take 2–4 weeks to develop fully and can last 6–12 months. A course of 1–3 injections may be recommended depending on the joint and severity. HA injections are well-tolerated with minimal side effects and can be repeated as needed.

High Volume Injections (HVI) for Mid-Portion Achilles Tendinopathy

High volume injection (HVI) therapy is a specialist treatment for chronic mid-portion Achilles tendinopathy, a condition characterised by tendon thickening, pain, and stiffness in the middle section of the Achilles tendon, typically 2–6cm above the heel bone.

How it works: Under real-time ultrasound guidance, a large volume of injectable fluid (typically a combination of normal saline, local anaesthetic, and a small amount of corticosteroid) is injected into the space between the Achilles tendon and the surrounding paratenon (Kager's fat pad). The high volume of fluid mechanically disrupts and strips away the abnormal neovascularisation (new blood vessel and nerve ingrowth) that develops in chronic tendinopathy. These abnormal vessels are strongly associated with pain.

The evidence: Research has shown that HVI can significantly reduce pain scores and improve function in patients with chronic mid-portion Achilles tendinopathy, particularly when combined with a structured eccentric loading rehabilitation programme. It is considered when conservative management (physiotherapy, shockwave therapy, load management) has plateaued.

What to expect: The procedure takes approximately 10–15 minutes. You may feel pressure as the volume is injected. Some patients notice immediate improvement, while others respond over the following 2–4 weeks. A structured rehabilitation programme is essential following the procedure to optimise outcomes.

What to Expect

Clinical Assessment

Thorough examination and diagnostic ultrasound to confirm the diagnosis, assess the stage of your condition, and determine the most appropriate injection type.

Treatment Selection

We'll explain which injection type is recommended for your condition: cortisone for acute inflammation, hyaluronic acid for osteoarthritis, or high volume injection for chronic Achilles tendinopathy.

Informed Consent

We'll explain the procedure, expected benefits, potential risks, and aftercare in detail. Written consent is obtained before proceeding.

Ultrasound-Guided Injection

The area is cleaned and the injection is administered under real-time ultrasound guidance. The procedure typically takes 5–15 minutes depending on the injection type.

Post-Injection Care

You'll rest briefly in the clinic. Detailed aftercare instructions are provided, including activity modifications for the first 24–72 hours and a rehabilitation plan where applicable.

Follow-Up Review

We'll review your response at 2–4 weeks. For hyaluronic acid, additional injections may be scheduled. For HVI, a structured rehab programme is prescribed.

Ready to book your injection therapy appointment?

Book Injection Therapy 028 9013 9185

"Have been attending the Lower Limb Clinic for a number of weeks and can not recommend them high enough. Darren is professional, so thorough, and explains everything fully. Diagnosis is accurate with the help of the scanner, which gives you comfort that the treatment is the best course of action. Just wish I had gone here much sooner!"

Denise Brown

Treated for: Diagnosis & Treatment · Google review

Frequently Asked Questions

Common questions about Injection Therapy at Lower Limb Clinic.

What's the difference between cortisone and hyaluronic acid injections?

Cortisone (corticosteroid) injections are anti-inflammatory. They rapidly reduce swelling and pain in inflamed tissues. They work best for acute inflammatory conditions like bursitis, neuromas, and plantar fasciitis. Hyaluronic acid injections work differently. They replenish the joint's natural lubricating fluid, making them ideal for early to moderate osteoarthritis where the goal is to restore joint function and reduce friction rather than suppress inflammation.

What is a high volume injection and who is it suitable for?

A high volume injection (HVI) is a specialist treatment specifically for chronic mid-portion Achilles tendinopathy. It involves injecting a large volume of fluid under ultrasound guidance to break up the abnormal blood vessels and nerves that grow into a damaged tendon and cause pain. It's typically recommended when other treatments like shockwave therapy and rehabilitation have reached a plateau.

Are injections painful?

You'll feel a brief sharp sensation as the needle enters, followed by pressure as the medication is injected. Local anaesthetic is included in all our injections for immediate numbing. High volume injections involve more pressure sensation due to the larger fluid volume. Most patients find all injection types much more tolerable than expected.

How long do injection results last?

This varies by injection type and individual response. Corticosteroid effects typically last 6 weeks to 6 months. Hyaluronic acid benefits usually last 6–12 months and can be repeated. High volume injection effects, when combined with proper rehabilitation, can provide long-term resolution of chronic Achilles symptoms.

Is hyaluronic acid safe? Are there side effects?

Yes, hyaluronic acid is very well tolerated because it's a naturally occurring substance already present in your joints. The most common side effect is mild temporary swelling or stiffness at the injection site for 24–48 hours. Serious side effects are extremely rare. It's a particularly good option for patients who want to avoid repeated steroid use.

How many injections will I need?

For corticosteroid injections, often a single injection provides sufficient relief. We limit these to 2–3 per year in any one area. For hyaluronic acid, a course of 1–3 injections may be recommended depending on the joint. High volume injections for Achilles tendinopathy are typically a single procedure combined with a structured rehab programme.

Can I walk after an injection?

Yes, you can usually walk immediately after all injection types. We may advise reduced activity for 24–72 hours depending on the injection. After a high volume injection for Achilles tendinopathy, you'll follow a specific return-to-activity protocol. Avoid high-impact exercise for a few days following any injection.

Clinically reviewed by Paul McMullan, BSc(Hons) MSc FRCPSGlasg MRCPod

BSc (Hons) Podiatry · MSc Podiatric Sports Medicine (QMUL) · FRCPSGlasg · MRCPod

Lead Podiatrist & Clinical Director, Lower Limb Clinic Belfast

Cortisone & Steroid Injections