Cortisone shots, otherwise known as steroid injections, are a low-cost, first-line treatment against joint pain. If conservative treatments such as R.I.C.E (rest, ice, compression and elevation) and anti-inflammatory pain medications haven’t helped, your medical team may suggest giving Cortisone shots a try.
What is cortisone?
Cortisone is a powerful drug that lowers inflammation. Many joint and tendon diseases such as arthritis lead to increased inflammation. Injecting cortisone into a joint or tendon lowers inflammation producing pain relief.
What conditions can cortisone shots treat?
In general, cortisone injections are useful for the following conditions:
- arthritis such as hip or knee osteoarthritis
- shoulder tendonitis
- frozen shoulder
- hand and wrist conditions such as trigger finger, De Quervain’s tenosynovitis, carpal tunnel syndrome, and thumb arthritis
- greater trochanteric syndrome
- Iliotibial band syndrome (often called IT band syndrome)
- foot and ankle conditions such as plantar fasciitis, Morton’s neuroma, big toe arthritis, chronic ankle sprains
How is a cortisone injection delivered?
At Dayton Orthopedic Surgery, we perform cortisone shots either blind or with ultrasound guidance. Guidance is better as it improves accuracy and effectiveness. Ultrasound has many advantages over X-ray. First, ultrasound can be performed in a clinic room rather than an operating theater, reducing cost. Second, unlike X-ray, ultrasound has no radiation. Finally, using ultrasound means you can avoid important structures like blood vessels and nerves that you don’t want to inject.
What are the pros and cons of Cortisone shots?
There is good evidence to suggest that cortisone improves pain and function for between 6 weeks and 6 months. However, the injections don’t work for all. Also, there are a few recent concerns that repeated injections lead to cartilage loss. In addition, there is some worrying evidence that having repeated injections lead to faster conversion to joint replacement. Overall, there are some question marks about the use of
Cortisone shots work best for those people who need a quick pain-relief fix. Usually, people with a swollen and painful joint are most suitable for a cortisone injection. A perfect example would be a swollen knee joint from acute gout. However, cortisone is not suitable for a longer-lasting effect on a painful joint.
There can be no doubt about it, however, that Cortisone shots help reduce pain and increase mobility in the vast majority of people who suffer with joint pain. Your doctor will be able to guide you through the decision making process to see whether the potential benefits of being pain-free via Cortisone injections is right for you.
What other treatments are available for painful joints?
Aside from Cortisone shots, we also recommend hyaluronic acid injections. Hyaluronic acid is a naturally occurring substance found in joints and bones. In joints, it forms part of the synovial fluid and acts as a lubricant and shock absorber. However, in a diseased joint, the amount of hyaluronic acid reduces.
Hyaluronic injections also known as gel injections involve injecting joints with hyaluronic acid to decrease pain and improve function. Similar to cortisone, it is important to make sure the hyaluronic acid is injected into the joint. So, ultrasound guidance is recommended.
Unlike cortisone, the effect of hyaluronic acid is not immediate. It often takes up to 4 weeks to notice an effect. However, the effect often lasts longer than cortisone averaging 6 to 12 months.
PRP injections can also reduce or even temporarily eliminate joint pain.
Platelet-rich plasma also known as PRP is obtained from your own blood. This blood is spun in a centrifuge to concentrate the platelets and separated from the other cells. We then inject this plasma into a joint. Platelets release growth factors that induce healing and pain reduction.
Recent evidence comparing PRP, hyaluronic acid, and cortisone suggests that PRP might have a better effect at 6 and 12 months.