Pros And Cons Of Cortisone Injections

Common Conditions Cortisone Injections Are Used In Treating

Cortisone injections are successfully used to treat a variety of joint, and soft tissues conditions in the body. Frequently, cortisone injections are used to treat:

• Inflammation of a bursa. Referred to as bursitis, bursitis can occur in may areas of the body including the hip, knee, elbow, or shoulder.
• Inflammation of a tendon, or tendon sheath is also treated by cortisone injections. Such as treating a common cause of elbow pain “tennis elbow” or achilles tendon complaints.
• They can also be used effectively in the management of forms of arthritis, such as osteoarthritis of the hip, knee or ankle. 
• Or to provide pain relief and assist in restoring mobility with someone suffering from a a frozen shoulder.
• Epidural injections in the spine, can be used to help relieve back pain, neck pain and sciatica. This is where cortisone is injected into a specific location/level in the spinal canal of the back. 

Benefits Of Cortisone Injections?

A cortisone injection can provide relief of localised inflammation in a specific area of the body. Its effect can be more rapid and powerful than with oral anti-inflammatory medications. Whilst avoiding certain side effects of many oral anti-inflammatory medications, such as irritation of the stomach.

What Are The Potential Side Effects And Disadvantages?

There are a few potential side effects associated with having cortisone that need to be considered when weighing up the pros and cons. 

• Local infection would be the most significant side effect. Especially in the use of a injection into a joint. However the risk of this is extremely low with appropriate preparation.
• Some patients will find having a cortisone injection a very painful experience. And a small percentage of patients will develop a ‘steroid flare.’ Where their pain may worsen for a period of 2-3 days after having the injection. If this occurs then it can be managed with ice and simple pain killers, till the “flare” settles.
• Some patients may also experience short term local tenderness and bruising at the site of the injection. Not to dissimilar to receiving a vaccination. 
• Some patients may also experience a ‘steroid flush’ where they feel red, flushed, and hot in the face. Again this is another short term side effect. 

Other reported side effects can include:

• Shrinkage and lightening of the colour of the skin, this occurs locally at the injection site.
• Tendons can potentially be weakened by corticosteroid injections administered to, or near tendons. Tendon ruptures as a result of having prior cortisone injections have been reported.
• Some patients will report feeling mildly anxious or agitated. Suffering difficulty with sleeping for the first 1-2 nights following an injection.
• Elevated blood sugar levels. A common side-effect in diabetic patients. Who will need to monitor their blood sugar levels after a cortisone injection.
• A mild rise in blood pressure. Hypertensive patients need to be made aware of this side effect so they can monitor changes after having a corticosteroid injection.

How Often Can Someone Have A Cortisone Injection?

The frequency of administering cortisone injections is based on the reason for the injection. Something that is determined on a case by case basis. Further injections aren’t necessary if the initial injection is curative. Although injections are not generally continued on a regular basis, sometimes a series of injections or subsequent injections might be necessary. This is sometimes the case in conditions like osteoarthritis of the knee, or a trigger finger.

There is no standardized absolute maximum number of cortisone injections an individual may receive. However, the risk of side effects increases as the number of injections increases. Meaning the risk to benefit ratio of each individual injection should always be considered prior to administering any cortisone injection. This is obviously regardless of the number of injections given prior.

Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Pros And Cons Of Cortisone Injections should consult his or her physiotherapist, sports medicine specialist, orthopedic surgeon or otherwise appropriately skilled practitioner.