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Cortisone injections – What they do?

Cortisone injections are one of the most common orthopaedic treatments offered to patients today. When you go to see a doctor for a musculoskeletal injury, that doctor typically offers you 4 options: surgery, physical therapy, medication, or injection. When it comes to injections, cortisone is far and away the most common one received.



Cortisone injections are short for the term corticosteroids. This class of steroids mimics the effects of cortisol which is a naturally occurring hormone produced in the adrenal glands of our body. Corticosteroids help reduce inflammation in an area.


These injections are typically given directly into a joint like the shoulder, hip, or knee; or they are given in soft tissue structures such as tendons or bursa.


While you may read a lot about the negative effects of chronic inflammation or the importance of getting the inflammation down after an injury, inflammation is an important & natural bodily response that helps our body heal after an injury or infection.


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In short: we don’t want to throw cortisone at every single inflammatory response our body has, because most often we need that inflammatory response to heal. However, there are times when our body has a pathological type of inflammation that is not helping our body heal or when inflammation lingers long after it has served its purpose, these are the situation in which cortisone is most helpful.


Cortisone decreases inflammation & provides short-term pain relief. It does not help heal any tissues. With this in mind, there are several diagnoses that it is particularly helpful, such as: frozen shoulder, trigger finger, carpal tunnel syndrome, Osteoarthritis. These often include those that arise from an inflammatory issue.



Cortisone injections can also help to provide a window of pain relief to allow you to address a problem that is currently too painful to address. Most often, when you need to strengthen the muscles around an area but are in too much pain to do so, cortisone can potentially temporarily reduce that pain allowing you to build up your strength & function for more lasting results.


Although helpful for reducing pain and inflammation cortisone shots do come with some drawbacks. Most specifically, then can have negative effects on your soft tissue and cartilage, potentially wearing away these structures over time . For these reasons, many doctors will not give more than two cortisone injections into the same joint in a year and many have moved away from providing them for soft tissue injuries such as tendinopathies & impingement injuries such as: tennis elbow, shoulder sub acromial impingement, hip impingement.


By Andrea Cutrupi


References

  1. Foster ZJ, Voss TT, Hatch J, Frimodig A. Corticosteroid Injections for Common Musculoskeletal Conditions. Am Fam Physician . 2015;92(8):694-699.

  2. St Angelo JM, Taqi M, Fabiano SE. Adhesive Capsulitis. [Updated 2023 Aug 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

  3. Blanchard V, Barr S, Cerisola FL. The effectiveness of corticosteroid injections compared with physiotherapeutic interventions for adhesive capsulitis: a systematic review. Physiotherapy. 2010;96(2):95-107.

  4. Wernecke C, Braun HJ, Dragoo JL. The Effect of Intra-articular Corticosteroids on Articular Cartilage: A Systematic Review. Orthopaedic Journal of Sports Medicine. 2015;3(5). doi:10.1177/2325967115581163

  5. Prehab guys blog – Tommy Mandala


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