The Pros And Cons Of Cortisone InjectionsJune 13, 2011
For musculoskeletal issues, cortisone shots may be very helpful. Also called corticosteroid shots, they offer anti-inflammation that may offer excellent pain reduction for arthritis in joints or a soft tissue problem like tennis or golfer’s 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 joint or soft tissue injections offer pain relief, but this help is not permanent. The pain relief may wear off after a few weeks to a few months, and it actually might take a few days for the effects to start working. Usually some numbing substance is included in the injection as well for instant help too.
People often ask if the corticosteroid injection assists with restoring cartilage. These injections do not alter the disease, they manage the symptoms and are simply meant to reduce pain.
What exactly are the benefits of a corticosteroid injection?
1. Pain relief – This is the main benefit, as the injection of steroid doesn’t alter the course of arthritis. But it does make life more tolerable by decreasing pain for what may be quite a few months.
2. Low Risk – a steroid injection maintains a significantly lower risk profile compared to surgery.
3. Low Cost – Also compared with surgery, an injection cost exponentially less.
4. Focused Injection – The steroid is injected into either a joint which is a confined space or into a soft tissue area where the medication stays predominantly local.
5. Outpatient – The injections are done either in the doctor’s office or as an outpatient procedure. No overnight stays necessary.
6. Can delay the need for surgery – If a patient is in his 50′s and has terrible osteoarthritis, doing a knee replacement may only last for 15 years. This may lead to the need for a revision surgery which typically has a less satisfactory result. So the injections may provide an impressively tolerable delay for years.
7. Can be placed in multiple joints – If a person has arthritis and pain in multiple joints, such as the shoulders, knees, and spine, corticosteroid injections can be applie in multiple joints (making sure not too many at one time).
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 appropriate sterile technique obtaining an infection after a steroid injection is rare, much less than 1%. Prophylactic antibiotics are not necessary.
For the majority of patients, corticosteroid shots are a great pain relief treatment. Moderation is the key.