When a joint or chronic source of pain doesn’t respond to other treatments, we often utilize the injection of a corticosteroid. Commonly known as cortisone, these steroid injections can help relieve pain and inflammation for a period of weeks or even months.
How Do Cortisone Injections Work?
Cortisone is a very powerful anti-inflammatory medication. It reduces inflammation that is causing pain. When cortisone is injected into a painful joint, for instance, the pain is relieved as the inflammation is reduced or fully resolved. Cortisone injections are injected directly into the joint in high concentrations. This provides maximum relief while limiting potential side effects.
Cortisone injections start to work relatively quickly, usually within a few days. They may cause a temporary flare in pain and inflammation for up to 48 hours after the injection. After that, the patient’s pain and inflammation in the affected joint should decrease, and this can last for several months.
People often confuse cortisone with anabolic steroids that are used by athletes and bodybuilders but have dramatic side effects. Cortisone is not the same kind of steroid. It does not work in the body to build muscle mass.
What Conditions or Injuries Can Cortisone Injections Treat?
At Orthopedic Associates of Long Island, we use cortisone for a wide variety of conditions, including:
Where Are the Injections Placed?
We place these injections directly into the joint or around the area of inflammation in a tendon. Many injections are done using ultrasound guidance, to ensure the cortisone is delivered into the correct location.
Do Cortisone Injections Speed Healing After an Injury?
Cortisone works by reducing inflammation, which then reduces pain. These injections do not speed injury healing.
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Are There Risks Involved With Cortisone Injections?
A single cortisone injection is typically safe, but there can be some short-term side effects, along with potential effects from too many injections. There is concern that repeated cortisone injections can damage the cartilage within a joint. That’s why we limit the injections to no more often than every six weeks, and not usually a total of more than 3-4 per year. Injecting cortisone directly into a tendon can weaken the tendon and increase the chance of rupture.
These are some systemic side effects, due to a small amount of cortisone entering the bloodstream:
- Elevated blood sugar — most common in diabetic patients
- Facial flushing — more common in women, can last a few days
- Infection – a small risk with any injection procedure. Signs include: redness, warmth, fever, chills. Great care is taken to properly clean the area and prevent this.
These are local side effects:
- Pain — Cortisone flares are increased pain for 24-48 house after injections.
- Skin pigment changes — Darker skin pigments can notice lightening of the skin color around the injection site with more superficial injections.
- Loss of fatty tissue — Sometimes cortisone injected into fatty tissue can cause fat atrophy.
Side effects that can occur with higher doses and repeated injections. These are generally not a problem, as we limit the number of injections. These are possible side effects:
- Cartilage damage
- Tendon weakening or rupture
- Thinning of nearby bone
- Nerve damage
Should I Use Ice or Heat After Cortisone Injection?
If you’re having pain from a cortisone flare during those first 24-48 hours, you can apply ice to the injection site. Do not use a heating pad.
Are Cortisone Injections Painful?
The cortisone is often combined with a local anesthetic. This provides more rapid pain relief before the cortisone begins to reduce inflammation. Sometimes the injections can be painful, but they are well-tolerated by patients. If possible, we use a very small needle for these injections, but sometimes a larger needled may be necessary. Most people feel injections into larger joints, such as the shoulder, are less painful that those into finger joints, feet, and tendons.