Concierge MSK · London
Cortisone shots, done properly and image-guided.
A cortisone (corticosteroid) injection into a joint, bursa, tendon sheath or epidural space — delivered by a consultant MSK physician, rheumatologist or interventional radiologist, with ultrasound or fluoroscopy where it matters.
Why patients choose us
- 01
Consultant MSK physician or rheumatologist
Not a walk-in room and not a trainee. The injection is done by a consultant MSK physician, rheumatologist or interventional radiologist who does these every week.
- 02
Image-guided when it matters
Ultrasound for shoulders, hands and small joints; fluoroscopy for hips, facet joints and epidurals. Landmark-only when the evidence says it is fine.
- 03
Honest about what a shot can and cannot do
A cortisone shot is a window, not a cure. We say how long relief usually lasts and when a repeat is sensible — or when it is not.
Indicative pricing
What a private cortisone shot costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
Ultrasound-guided joint injection in our network: £350–£650, home the same visit.
| Injection | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Ultrasound-guided joint injection (shoulder, knee, hip) | £350–£650 | 20 min | Same visit |
| Ultrasound-guided soft-tissue injection (bursa, tendon sheath) | £300–£600 | 20 min | Same visit |
| Landmark injection (knee, small joint) | £200–£400 | 15 min | Same visit |
| Fluoroscopy-guided hip or facet joint injection | £650–£1,200 | 30 min | Same visit |
| Fluoroscopy-guided epidural steroid injection | £900–£1,600 | 30–45 min | Same visit |
| Consultation only | £200–£400 | 30 min | Same visit |
Prices vary by clinic, by which clinician does the case, by whether image guidance is used, and by whether a consultation is included on the day. We come back with a firm quote within one working day.
The problem
The right clinician, the right target, the right guidance.
Cortisone shots are widely offered and often given blind, into the wrong tissue, or repeated past the point of benefit. We fix all three before you agree.
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Is a shot really the next step?
Sometimes physiotherapy, weight loss or a different drug is the better answer. We say so before booking an injection.
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Where exactly is the pain from?
A shoulder shot is worthless if the pain is coming from the neck. A proper assessment — sometimes with ultrasound in the room — decides.
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Image-guided when accuracy counts
Hips, facet joints, epidurals and most soft-tissue targets need ultrasound or fluoroscopy. Landmark-only for those is a false economy.
The journey
From assessment to response check — what happens, in order.
One clinician from first message to the four-week check that decides what happens next.
Phase 1 · Before your injection
Concierge, off-stage for you
Phase 2 · On the day
Around an hour at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. The joint or tendon, how long, previous scans and any injections already tried.
- 02
Before
We come back with a recommendation
Within one working day: the right clinician, whether image guidance is needed, and whether a shot is actually the right next step.
- 03
Before
We arrange the appointment
Usually within one to two weeks. Blood thinners and diabetes control are reviewed with the team beforehand.
- 04
On the day
Arrival and assessment
A brief examination, a look at your scan, and a consent chat covering the flare, the diabetes spike and the rare risks.
- 05
On the day
The injection itself
Skin cleaned, local anaesthetic drawn up with the steroid, image guidance if agreed. The shot itself takes seconds; you are in the room around fifteen minutes.
- 06
On the day
A short observation, then home
Fifteen to thirty minutes of rest, a dressing, and home the same day. No driving after epidural or hip injections done under fluoroscopy sedation.
- 07
After
Response check
A brief review at four to six weeks. If relief is good we plan a repeat only if needed; if there is no response we rethink the diagnosis rather than inject again.
Typical end-to-end: 1–2 weeks from enquiry to injection. Response check: 4–6 weeks.
When it helps
When a cortisone shot is the right step.
The situations we see most, plus the red flag that means an emergency rather than an appointment.
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Osteoarthritis flare
A painful flare in the knee, hip or shoulder that has not settled with painkillers or physiotherapy — a shot can buy weeks to months of relief.
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Rotator cuff tendinopathy
Painful arc, night pain and difficulty lifting the arm — a subacromial injection can settle the pain enough to rehab properly.
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Subacromial bursitis
Focal shoulder pain from an inflamed bursa. Ultrasound-guided injection places the steroid exactly where it needs to be.
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Adhesive capsulitis (frozen shoulder)
A stiff, painful shoulder in the freezing phase. An intra-articular shot can shorten the painful phase and unlock physiotherapy.
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Trigger finger, De Quervain’s, carpal tunnel
Common hand and wrist problems that often settle with a single well-placed injection rather than surgery.
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Plantar fasciitis, tennis and golfer’s elbow
Considered with caution — the evidence is short-term only and repeated peritendinous shots risk tendon rupture. Used selectively.
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Facet joint and epidural pain
Fluoroscopy-guided facet joint injections and epidural steroid injections for radicular back or leg pain, done by an interventional radiologist.
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Red flag: a hot, swollen joint with fever
A joint that becomes hot, red and swollen with fever after an injection is possible septic arthritis — same-day A&E, not a clinic booking.
Injection options
Not every shot is the same shot.
What each option on the table actually involves — and which fits which problem.
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Landmark-guided injection
The clinician uses anatomical landmarks — appropriate for large accessible joints like the knee, where accuracy is high without imaging.
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Ultrasound-guided injection
A portable ultrasound places the needle tip exactly in the joint, bursa or tendon sheath. Standard for shoulders, hips, small joints and soft-tissue targets.
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Fluoroscopy-guided injection
Live X-ray with a small amount of contrast. Used for hip joints, facet joints and epidurals where blind injection is unreliable and unsafe.
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Intra-articular joint injection
Steroid plus local anaesthetic placed inside the joint capsule — the mainstay for osteoarthritis flare and adhesive capsulitis.
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Peritendinous / bursal injection
Steroid placed around a tendon or into a bursa, never into the tendon substance — that is what causes rupture.
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Epidural steroid injection
For radicular leg pain from a disc or foraminal narrowing. Done under fluoroscopy by an interventional radiologist or pain specialist.
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Keloid or scar injection
Triamcinolone injected into a raised, itchy or painful scar to flatten and soften it over several months.
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Consultation only
An honest discussion of whether a shot is the right step at all — sometimes physiotherapy, weight loss or a different drug is the better answer.
Our vetted London network
A small panel of MSK clinicians, we picked them.
Consultant MSK physicians, rheumatologists and interventional radiologists across central, north, west and south London. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every clinician in our network.
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Consultant MSK physicians, rheumatologists and interventional radiologists — not trainees
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Ultrasound and fluoroscopy guidance available on site, not landmark-only
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Injection frequency capped in line with BSR guidance — no more than 3–4 per joint per year
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A named clinician who reviews response at 4–6 weeks and rethinks if there is no benefit
Safety and recovery
What to expect afterwards — honestly.
A cortisone shot is a common, safe outpatient procedure — but it has real trade-offs. Onset takes days, benefit is temporary, and repeats have a cap for good reason.
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Onset in 24 to 72 hours
Most people notice benefit within one to three days. The local anaesthetic wears off first, so pain can briefly return before the steroid takes over.
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Relief lasts weeks to months
Typical duration is six weeks to six months. It is a window to rehab in — not a permanent fix — and it works better in some joints than others.
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Post-injection flare
A brief flare of pain in the first 24–48 hours affects up to one in ten people. Ice and simple painkillers usually settle it.
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Skin depigmentation and fat atrophy
A small dimple or pale patch at the injection site can happen, especially with superficial injections. Usually cosmetic and often improves over months.
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Tendon rupture with repeated shots
Repeated peritendinous injections — especially around the Achilles or patellar tendon — carry a real rupture risk. We limit frequency for this reason.
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Hyperglycaemia in diabetes
Blood glucose can spike for several days after a shot. If you have diabetes, check more often for a week and speak to your team about insulin.
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HPA axis and cortisol suppression
Frequent or high-dose steroid injections can suppress your body’s own cortisol. Ophthalmic-adjacent shots also risk cataract and glaucoma over time.
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Rare septic arthritis
Infection inside an injected joint is rare (roughly 1 in 10,000–50,000). It is why sterile technique matters — and why any hot, swollen joint with fever is treated as an emergency.
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Red flags
Fever with a hot swollen joint, sudden severe pain in an Achilles or patellar tendon, new weakness or numbness after an epidural — call the clinic or A&E the same day.
Reading your injection note
Your injection note in four parts. Read the last one first.
Whichever drug and target were chosen, the note the clinician sends you keeps to the same shape.
A quiet reminder
Injection notes are terse and drug-heavy — we translate them for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and target
Which joint or soft-tissue target was injected, and why — the OA flare, the tendinopathy, the radicular pain.
- 02 Technique
Drug, dose and guidance
Which steroid (methylprednisolone, triamcinolone or dexamethasone), the dose in milligrams, the anaesthetic used, and whether ultrasound or fluoroscopy was used.
- 03 Findings
What was seen and any complications
Notes on effusion, tendon integrity or fluoroscopy contrast spread, plus any immediate reaction such as a vasovagal episode.
- 04 Impression
Aftercare, when to expect benefit, review
Read this first: expected onset, the 24-hour flare warning, when to check response, and when a repeat may or may not be offered.
Recognised by major UK insurers
Cover for cortisone injections varies by insurer and by indication — usually funded when medically indicated with a referral. We confirm cover before booking.
Frequently asked
Everything we get asked about cortisone shots.
Quick answers on onset, duration, safety, diabetes, and how many is too many.
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What is a cortisone shot?
A corticosteroid — commonly methylprednisolone, triamcinolone or dexamethasone — mixed with a local anaesthetic and injected into a joint, bursa, tendon sheath, epidural space or scar. It reduces inflammation in one specific place, unlike oral steroids that act on the whole body.
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How quickly does it work and how long does it last?
The local anaesthetic gives an hour or two of numb relief, then wears off. The steroid itself kicks in over 24–72 hours. Relief typically lasts anywhere from six weeks to six months, depending on the joint, the diagnosis and how it is used alongside rehab.
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How many cortisone shots can I have in one joint?
BSR and NICE guidance is a maximum of three to four injections per joint per year, with at least three months between them. Repeated shots — especially peritendinous — increase the risk of tissue and tendon damage.
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Does the injection hurt?
The sting of the local anaesthetic is the sharpest part. Once the area is numb, the steroid itself is usually a pressure sensation rather than pain. Small joints and tendon sheaths can be more uncomfortable than large joints.
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Are ultrasound or fluoroscopy really needed?
For large, easily palpable joints like the knee, landmark injection is accurate enough. For shoulders, hips, facet joints, epidurals and most soft-tissue targets, image guidance measurably improves accuracy and safety — and is what we default to.
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What are the risks?
Post-injection flare, skin depigmentation or fat atrophy at the site, tendon rupture with repeated peritendinous shots, a temporary blood-glucose spike in diabetes, cortisol and HPA axis suppression with frequent doses, and — very rarely — septic arthritis or, with epidurals, subdural or vascular injection.
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Can I have a shot if I am diabetic?
Yes, but expect your blood glucose to run higher for three to seven days. Monitor more often, keep in touch with your diabetes team, and do not stop your usual medication without their advice.
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Can I have a shot if I have had a recent live vaccine or am immunosuppressed?
A recent live vaccine (yellow fever, MMR, live-attenuated flu) is a reason to defer or discuss carefully — steroids blunt the immune response. If you are on immunosuppressants, we still often proceed, but only after a proper consent conversation.
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What are the red flags after a cortisone shot?
A hot, red, swollen joint with fever, sudden severe pain in an Achilles or patellar tendon that suggests rupture, new leg weakness or bladder problems after an epidural, or a severe allergic reaction — any of these mean same-day A&E, not a call back to the clinic the next week.
Related
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X-ray
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All tests
Every test and procedure we arrange.
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Hypertension
Related condition guide.
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Type 2 Diabetes
Related condition guide.
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Blood Tests
Related diagnostic test.
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Health Assessments Select
Related diagnostic test.
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In practice, in London
How cortisone shots tends to unfold when you go private
For cortisone shots, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. The wait for cortisone shots on the NHS depends heavily on where you live and how urgently the referral is graded. Central and West London private clinics can normally book within a week, with imaging or a procedure slot to follow shortly after. It’s worth being honest about the reason for going private: usually it’s time, not a fundamentally different test.
A private cortisone shots pathway in London usually looks like this: an initial consultation, any diagnostics booked at a nearby facility (most within Zone 1 or 2), and a written report sent to you and your GP within a few days. The consultants we work with hold NHS posts alongside their private lists, which keeps the standards consistent across both settings. For cortisone shots in particular, we bias towards consultants who do this every week rather than every month.
Honesty about expectations is part of the job. A private cortisone shots appointment in London won’t change the underlying medicine — the guidelines, the consultants, and the equipment are largely the same as on the NHS. What it changes is speed, continuity, and the amount of time you get to actually talk through the findings. Everyone we route to is GMC-registered and works within CQC-regulated facilities.