The Pros And Cons Of Cortisone Injections

For musculoskeletal problems, cortisone injections can be very helpful. Also termed corticosteroid shots, they give a significant anti-inflammatory effect that can provide excellent pain reduction from a joint issue, such as arthritis, or a soft tissue diagnosis, like tennis elbow.

Steroid medication contains some of the identical hormones that adrenal glands make in humans. These corticosteroids are important for humans, such as in times of stress providing anti-inflammation.

These injections into either joints or soft tissues provide pain relief, but it is not permanent. The effects wear off after a few weeks to months, and it may actually take a few days for the pain relief to kick in. Typically some numbing medicine is included with the steroid to give immediate relief.

Patients frequently ask if the cortisone will help with cartilage restoration. Steroid injections are not disease altering treatments, they are simply symptom altering and meant to decrease pain.

So what are the benefits of a steroid injection?

1. Pain relief – This is the biggest benefit, as the corticosteroid injection doesn’t change the course of arthritis. It does reduce pain for a few weeks to months.

2. Low Risk – corticosteroid injections maintain a largely lower risk profil compared to surgery.

3. Low Cost – Injections also cost a lot less than surgery.

4. Focused Injection – The cortisone is either injected into either a confined joint space or soft tissue region and the steroid medication stays locally and slowly gets absorbed.

5. Outpatient – The steroid injections are either performed in the doctor’s office or as an outpatient. No overnight hospital visits necessary.

6. Can delay the need for surgery – If a person has terrible osteoarthritis and is in his 50’s and, performing a total knee replacement may only last for 10-20 years. A revision surgery may then be necessary which often has a less than satisfactory outcome. So the steroid injections can give a nice delay for years.

7. Can be placed in multiple joints – If an individual has arthritis and pain in numerous joints, such as the spine, knees, and shoulders, cortisone may be injected into multiple joints (with care not too many in one setting).

What are the risks of a steroid injection?

1. Temporary blood sugar raise – typical in diabetics and can elevate blood sugars temporarily for one to two days. It would be uncommon for this to become a true clinical issue, but individuals should be cognizant of it, especially diabetics.

2. Cartilage damage – In humans it’s not clear if this is clinically relevant. Animal studies have shown cartilage damage with repeated injections. The key is moderation with the number of injections.

3. Adrenal gland suppression – this type of complication may occur with oral steroid medication on a repetitive basis, it would be very unusual for a steroid injection to cause this complication.

4. Infection – with sterile technique an infection occurs much less than 1%.

For the majority of patients, corticosteroid shots are a great pain relief treatment. Moderation is the key.

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