Cortisone Injections – is it the right option for me?
You are in a lot of pain and have just seen your doctor who has recommended a cortisone injection. You have probably heard many conflicting opinions from friends and family on their experiences with cortisone, some will have great stories of miraculous pain relief, some people may have found it an invasive procedure that offered little, if any relief. It can be a tricky decision. We are going to explain how cortisone injections work and hopefully help you make an informed decision on whether it is the right treatment option for you.
What does cortisone do?
Cortisone is made up of a corticosteroid drug aimed to replicate our natural body hormones. These hormones are involved in our immune response to tissue damage and assist in controlling inflammation.
Cortisone injections can have an immediate and profound pain relieving effect locally, if used appropriately for inflammatory conditions. However, it is imperative the steroid is placed in the right area under CT or ultrasound guidance, by an experienced clinician.
Why is inflammation important?
It must be remembered that the inflammatory process is the body’s natural way of healing. There needs to be a level of inflammation to allow tissue regeneration and enable normal function to return over time. The pain associated with inflammation is a guide to tell us how much to move and load the injured tissue to allow recovery.
Will cortisone fix my problem?
Not necessarily. Cortisone works to treat pain and inflammation but the underlying cause of your pain will often still need to be addressed with, for example, modifications to postures or movement patterns and strengthening exercises.
Some potential risks of cortisone
Cortisone can come with certain risks which may include:
- weakening of bone
- death of cartilage within the joint
- weakening of muscle tendons
- skin infections
- increased blood sugar levels
It is important to note that these risks are more often associated with repeated cortisone injections within a short time span or a high dose of cortisone at any one time.
So what should I do?
Well, let’s summarise…
- Cortisone comes with risks and should not be used as the first treatment option, as discussed. Jumping immediately to a cortisone injection can significantly reduce the bodies’ natural ability to heal, causing longer term problems.
- Cortisone will not work for every condition and often may be completely ineffective.
- Often degenerative tissue drives pain and often coexists with an inflammatory component. Cortisone helps with inflammation, but exercise has shown to have much longer term benefit for degenerative conditions and pain.
What do we recommend?
Conservative treatment aims to reduce your pain with hands-on treatment, exercise and lifestyle modifications. As a general rule you should try conservative measures for a minimum of six to twelve weeks.
If this approach isn’t proving effective and your pain is inflammatory driven, then a cortisone injection could be considered under consultation with your GP or Specialist.
It is important to note that the underlying cause of your injury is often still unresolved. After a short period of rest to allow the cortisone to work, it is always important that you continue with your rehabilitation or consult a physiotherapist to prevent your injury from returning.
Please contact us and let our experienced Physios help you back on the path to recovery.
- Evidence-Based Knee Injections for the Management of Arthritis (2012) Olivia cheng et al (systematic review)
- Update on trochanteric bursitis of the hip. OA Orthopaedics Haviv B. 2013 Jul 13;1(1):10.
- Treatment of lumbar disc herniation: Evidence-based practice Andrew J Schoenfeld and Bradley K Weiner: Int J Gen Med. 2010; 3: 209–214