The role of cortisone injections for pain relief
What is cortisone?
Cortisone is made up of a corticosteroid drug, which is made to replicate our natural body hormones. In our body, they are involved in our immune response and assist in the regulation of inflammation. It can be delivered into the blood stream, into the joint or applied over the skin.
When is it prescribed?
Some of the most common uses of cortisone injections are for the treatment of:
- Joint pain driven by Osteoarthritis or Rheumatoid arthritis
- Bursitis in Shoulder or Hip
- Acute and chronic lower back pain
- Nerve related pain
But where does the evidence lie?
Cortisone is used for a range of conditions. Evidence suggests that it is most effective when used for:
- Dequervains tenosynovitis ¹
- Trochanteric bursitis ²’³
- Carpal Tunnel ³
- Shoulder impingement/bursitis ³
- Rheumatoid and osteoarthritis ¹’³
- Lower back pain related to disc herniation ³·¹
Risks of cortisone
Cortisone can come with certain risks which can include:
- Weakening of bone
- Death of cartilage within the joint
- Weakening of muscle tendons
- Skin infections
- Increased blood sugar levels
The risk of these side effects is more associated with repeated cortisone injections within a short time span, or a high dose of cortisone at any one time.
Is this the right option for me?
This is the “million dollar question”. Cortisone will not work for every condition and more often than not shows to be ineffective. The effectiveness of cortisone first starts with thorough assessment of your pain and injury and an accurate diagnosis.
What we recommend!
Cortisone comes with its own risks and should not be used as a first line of defence. We aim to reduce your pain with exercise, hands on approaches and lifestyle modifications. If this isn’t proving to be effective or if your pain is just plain old stubborn, then a cortisone injection could be considered under consultation with your GP.
It is important to note that the underlying cause of your injury is often unresolved. It is always important that after an injection you continue with your rehabilitation or consult a physiotherapist to prevent your injury form returning.
1 Evidence-Based Knee Injections for the Management of Arthritis (2012) Olivia cheng et al (systematic review)
2 Update on trochanteric bursitis of the hip. OA Orthopaedics Haviv B. 2013 Jul 13;1(1):10.
3 Mark B. Stephens, CDR, MC, USN; Anthony I. Beutler, MAJ, USAF, MC; and Francis G. O’Connor, COL, MC, USA, Uniformed Services
University of the Health Sciences, Bethesda,Maryland Am Fam Physician. 2008 Oct 15;78(8):971-976.
3.1 Treatment of lumbar disc herniation: Evidence-based practice Andrew J Schoenfeld and Bradley K Weiner: Int J Gen Med. 2010; 3: 209–214