Pros & Cons: Cortisone Injections

Health Care 2009Cortisone shots are given as symptomatic treatment for a wide variety of repetitive stress injuries, arthritis, and other ailments. Commonly the injection consists of a mixture of a corticosteroid anti-inflammatory and a local anesthetic to minimize pain from the injected medicine.

Most cortisone injections are conducted in a doctor office and may take as little as a 10 minute visit. The site of injection is cleaned and may be sprayed with a local anesthetic. Then the needle is inserted directly into the painfully inflamed joint for medicine delivery.

After receiving the shot, one might be advised to minimize use of the joint for 24-48 hours. For example, in the case of a shoulder injection immediate heavy lifting should be avoided. Sometimes a cortisone flare occurs when the cortisone crystallizes which can cause intense pain for up to 48 hours even worse than before the shot.

While rare, severe side effects such as joint infection, nerve damage, and weakening of nearby tendons and bones are possible. More shots increase the risk of severe side effects so many doctors limit the number of injections to three or less. Since cortisone shots offer pain relief for only several weeks and work for only about half of those receiving a shot, they should be considered a treatment aid at best, not a cure.

One approach to avoid using cortisone injections is to systemically minimize inflammation in the body and focus on treating underlying causes of pain and inflammation. That’s one reason cortisone shots don’t work for everyone — sometimes they are attempting to treat the wrong kind of pain.

There are two types of pain, muscular or tissue based pain and nerve based pain. Treating the wrong type of pain may result in no impact on levels of pain. That’s why a proper diagnosis of the underlying conditions leading to inflammation is critical for long-term pain relief.

Pros for cortisone injections:

  • Can reduce inflammation in localized areas
  • May relieve pain related to inflammation
  • May be helpful as part of a broader treatment program

Cons for cortisone injections:

  • Provides pain relief for only about half of shot recipients
  • May cause more pain in short term
  • Can cause severe permanent side effects

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  2. Back Pain Treatment Options
  3. What You Can Learn About Pain Relief From Olympic Level Athletes
  4. 3 Ways to Eliminate Joint Pain
  5. Glucosamine and Chondroitin: Miracle Joint Cure?

6 Responses to “Pros & Cons: Cortisone Injections”

  1. Brian Stowe says:

    I have had deteriorating right thumb base joint for over a year, and am waiting for a third injection. Meanwhile my left thumb is also affected.
    My surgeon would like to take out a part of the joint, and replace it with other wrist material.
    But it appears that I wil lose gripping power – which makes me delay any such treatment.
    Please is there no other alternative ?
    Thank you.
    Brian Stowe

  2. Brian,
    If it is basal joint arthritis, I have had the surgery. It comes with a fairly long recovery period, but I’m so glad I did it. I was losing grip power w/o the surgery, and after surg and hand therapy, I am much better. I wish I hadn’t put it off so long.

  3. JANTI RAMJI says:

    SOME MONTHS AGO I HAD SEVERE PAIN IN MY LOWER BACK AND HAD TO GO A & E AT THE LOCAL HOSP, THEY TOOK XRAYS AND COULDN’T FIND ANYTHING BUT AFTER MORE INVESTIGATION AND C.T. SCANS OVER THE NEXT FEW WEEKS DOCTORS DISCOVERED I HAD A PROLAPSED DISC AND IT HAS BEEN CAUSING ME PAIN FOR MONTHS NOW, FINALLY I DECIDED TO GO WITH A C.T.GUIDED INJECTION INTO MY BACK BUT EVEN A WEEK LATER IT HADN’T STARTED TO WORK.I HAVE BEEN ON PAIN KILLERS TO NUMB THE PAIN.NOW TWO WEEKS LATER THE PAIN IS NOT AS SHARP AS IT USED TO BE MAYBE THE INJECTION DID WORK BUT I AM STILL TAKING THE PAIN KILLERS BECAUSE USUALLY HALF WAY THROUGH THE DAY IT STARTS TO GET PAINFUL AGAIN.

  4. shorty4062 says:

    I’ve had lower back pain for years. Nothing as worked. I started with therapy, had electronic stimulation, did the epidural injections, saw a chiropractor. All procedures seem to give temporary help. The injections made me blow up like a balloon. I gained weight really quickly. So much weight that I felt like my stomach was growing. I went as far as having liposuction (which turned out bad, I was scarred) except for the medication used after the surgery. Whatever that medication was, it worked. It took a year to recover fully. Once I was off the medication, the pain came back. My L-5 is almost bone to bone. I wear a high wasted body brief that gives some support. I try walking 2 miles, 3 days a week, but must recover from the pain two days a week. I work out using weights also on those two off days or when I don’t feel like walking. I also cut the grass once a week, but also have to recover from the pain. All of this and I’m still over weight. I just had a birthday (turned 58) and feel like I’m 80. I take Celebrex because it’s the only thing that helps somewhat. I don’t look my age and want to enjoy getting out more like I used to.

  5. Marilena Paolucci says:

    To those of you with osteoarthritis symptoms such as worn-out cartaledge. Have you looked into prolotherapy?

    Google it and you’ll find a practitioner in your local area.

  6. anna says:

    I’ve had severe upper neck pain due to whiplash and being a hair stylist thru the years,so for the first time I had the cortisone injections and at first it was very painful but after about a week I hardly had any pain at all.I wasn’t sure if I was imagining it because I would have pain daily,I couldn’t remember what it was like to not have any.My pain was more tissue damage,so that’s why I think it worked.It still hurt a little,but not as much,it was like putting a band-aid on a raw open wound.We shall see how it long it lasts,but I highly recommend it,cuz if your gonna take pain meds your just covering up the pain as is with this,only temporary relief,but probally healthier?

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