Cortisone shots are used to treat a variety of musculoskeletal injuries and complaints. What problems can they help? When is it appropriate to get one? In this article, I offer my thoughts on cortisone shots, how they work, and what patients can expect.

What is a cortisone shot?

A cortisone shot is a common name for a corticosteroid injection. This treatment is usually performed in an office setting. The doctor injects a steroid into a joint or bursa to treat a variety of conditions. The steroid is an anti-inflammatory medication, so the injection can decrease pain and swelling from that problem.

What types of pain and injuries can cortisone shots treat?

Cortisone shots can be administered into most joints and other structures around the body. They can be used to treat pain related to degenerative conditions like osteoarthritis. They can help with inflammatory conditions of joints, like rheumatoid arthritis. They can treat an inflamed bursa. They can be used for disorders of tendons, muscles, and more.

How does a cortisone shot work?

As mentioned earlier, the steroid is an anti-inflammatory medication. The shot can provide pain relief mainly by decreasing inflammation, which decreases pain and swelling in the area. Depending on the problem, the injection might not resolve the underlying condition. For example, a cortisone shot might provide pain relief from articular cartilage breakdown in osteoarthritis of the knee, but it doesn’t correct the underlying cartilage damage.

Doctor giving cortisone shots

How often can I get cortisone shots?

It is believed that receiving too many cortisone injections into one location in too short a period of time can have detrimental effects. For injections into joints, concern over possible breakdown of the articular cartilage with repeated shots exists. Most orthopedic surgeons limit patients to 3-4 cortisone shots into a single joint within a year for that reason. There is also concern that cortisone can soften the cartilage within a joint, so many surgeons are hesitant to use them on younger patients.

Are there any other risks with cortisone shots?

In theory, a steroid administered into tendons can weaken the tendon and increase the risk that it ruptures. Whitening of the skin at the site of the injection can occur in a small percentage of the population. As with any injection into a joint, infection of that joint is possible.

What can a patient expect?

The surgeon cleans the injection site with a solution to decrease the chance of infection. He might use a local anesthetic to numb up the area prior to the injection. The injection itself has the steroid as well as a local anesthetic to provide short-term pain relief.

Often the cortisone takes several days to start decreasing pain, so it can still be uncomfortable for the first few days due to swelling of the joint. The patient can apply ice or use other forms of cold therapy to minimize swelling. He should monitor for redness, warmth, or increasing pain which could signify a developing infection.

It is important for patients to keep in mind that cortisone shots can be part of a comprehensive treatment plan for many injuries. It is important to discuss the condition with the orthopedic surgeon to review additional treatments, like physical therapy, that could keep the problem from returning in the future.

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