Cortisone Injection FAQs

Yes, healthcare providers typically aim to prescribe the lowest effective dose of cortisone for the shortest duration necessary to manage the underlying medical condition. Following recommended guidelines can help minimize the risk of developing avascular necrosis.

A cortisone shot usually takes two to seven days to come into effect. The effect is gradual in onset and it may take up to three weeks to show full effect by decreasing the inflammation. The effect of cortisone may last up to three months.

After a cortisone shot, there may be worsening of pain after a few hours. The cortisone shot is mixed with some local anesthetic and, therefore, the pain is decreased for a few hours after the shot. To prevent worsening of pain after a cortisone shot, the patient should use ice as well as anti-inflammatory medications. The cortisone shot starts working in two to seven days and patient may need to take anti-inflammatory medications until the cortisone comes into effect.

Cortisone shots are very similar to the shots that a dentist gives for dental procedures. There is good relief for a few hours after a cortisone shot but the pain may worsen for the next 24-48 hours and the patient should use ice as well as anti-inflammatory medications until the cortisone starts working in two to seven days.

Cortisone shots, as compared to oral steroids, do not cause weight gain as they act locally, and a very small amount of the cortisone is absorbed systemically. If used in high amounts or too frequently, then they may also cause systemic effects as oral steroids.

A cortisone shot at a specific site can be given almost every three months to a max of three to four per year. The cortisone shots also have some detrimental effect on the joints and the tendons and, hence, should not be given more frequent than three months. There are certain other risks associated with a cortisone shot.

Cortisone shots can cause systemic effects due to absorption which are usually minimal after a single shot. The cortisone shot also increased the chances of infection by decreasing the immunity locally and may be detrimental in immunocompromised patients. Cortisone injection also cause transient increase in blood sugar levels. Patients with diabetes must keep a close watch on their blood sugar levels and may have to consult their PCP.

A cortisone can be given by a primary physician, pain physician, rheumatologist, orthopedic surgeon, sports physician, sports surgeon and many other specialties. It depends on the training of the physician as well as the complexity of the injection.

A cortisone shot can help decrease the inflammation and pain caused by a torn meniscus. A cortisone shot usually does not help in healing of the meniscus and, hence, does not improve any mechanical symptoms. If a meniscus is repairable, then a cortisone shot is not preferred as it may impair healing of the meniscus.

Cortisone shot helps in decreasing the inflammation and, hence, decreasing the pain caused by the bursitis. It may give a long enough effect which may be helped with physical therapy or modification in activities to be lasting long enough to not require another form of treatment.

The most common indication for cortisone injection in the knee joint is arthritis. It is usually given to provide relief from pain and swelling. Before giving cortisone injection, other associated pathologies should be ruled out. Patients who have early arthritis get good results which may last longer. In patients who have longstanding arthritis or advanced osteoarthritis, cortisone injection is given if they are not ready for joint replacement surgery in the near future.

A cortisone injection for arthritis should not be given within three months of a joint replacement surgery. Other indications for cortisone injection in the knee joint are patellofemoral pain or syndrome, nonoperative treatment of meniscus tear, synovitis, conservative treatment of Plica syndrome, prepatellar, infrapatellar and pes anserine bursitis, chondral damage to the knee joint, etc.

A cortisone injection can be given in various conditions of shoulder. Most common condition is rotator cuff tendonitis in which there is inflammation of the rotator cuff. This helps in decreasing inflammation, pain and swelling and helps in rehabilitation, regaining strength and range of motion. Partial and complete rotator cuff tears can also be treated with cortisone injection leading to pain relief, with no effect on the tear itself, if surgical treatment is not opted for.

A cortisone injection should not be given within two to three months of a rotator cuff repair surgery. Frequent and too many cortisone injections can be detrimental to the rotator duff especially in the presence of tear, and also to the joint. Cortisone injection can also be used for acromioclavicular arthritis, impingement syndrome, shoulder arthritis, biceps tendonitis, etc.

Cortisone injection can be used for lateral and medial epicondylitis of the elbow. It can also be used for arthritis of the elbow joint.