Small areas of local injury with swelling can be helped with steroids, and no needle is required. This is done by a process called iontophoresis. Iontophoresis uses electricity to “push” drugs across the skin and into tissue. Sports injuries are the most common use of iontophoresis.
Iontophoresis is used more often because of the side effects of injected steroids. Sometimes, tendons rupture after the use of these drugs. It is not clear whether this happens because of the drugs or as a result of the first tendon injury.
A group of scientists have studied the effects of steroids on tendons in rabbits. Two kinds of steroid treatment were reviewed. The first is by direct injection and the second, by iontophoresis. Both groups received measurable amounts of the steroid. The levels in the blood were checked after one hour, seven days, and 14 days. In both groups, the blood levels are less over time. By 14 days, there are no measurable amounts of steroid left in the blood for either group.
Giving steroids by needle is faster and only requires one visit. Using iontophoresis to give the drug is less painful but needs to be done with several visits. Injection brings more of the drug to the inflamed area right away. Iontophoresis is a slower process with higher levels of steroid present over a longer period of time. It is a good option for patients who don’t like shots.