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Pain Injections/Cortisone

For those who experience pain in their joints, it can be hard to carry out daily activities. Pain-relieving injections like cortisone, however, often provide the relief patients need to get on with their day. Whether given over a short period of time to manage an injury or used to maintain pain associated with a chronic ailment, the shots work the same. See a doctor to determine if a cortisone shot, or series of shots, is a good fit for you.

About

Cortisone shots are most commonly injected into joints such as the ankle, elbow, hip, knee, shoulder, spine or wrist. The shots relieve pain for a short or long period of time because the steroid injections treat localized or widespread inflammation, a common cause of pain.

In other cases, the injections are given in a tendon to relieve swelling, or to treat inflammation that is widespread throughout the body such as is common with allergic reactions, asthma and rheumatoid arthritis. Allergy sufferers sometimes receive corticosteroid shots to relieve symptoms associated with seasonal allergies that are especially bothersome. These shots typically last three months.

It takes approximately three to five days for a cortisone shot to reach its full effect and after that the pain relief typically lasts for anywhere from a few days to a few months. Many people continue to get cortisone shots over a longer period of time to manage injuries or flare ups caused by disease.

In most cases the shots are not too painful, however, when given in the palm of the hand or the sole of the foot, pain is increased—the smaller the space being targeted by the shot, the more painful it typically is. The size of the needle used can also affect how painful the shot is. Luckily, cortisone shots are a mix of the corticosteroid drug and a local numbing agent, which should help reduce some of the pain caused by getting the shot, and a numbing spray can be used beforehand in some cases to reduce pain caused by the injection.

Before the shot is administered, the area around the injection site is cleaned and an anesthetic spray may be used. Depending on where the shot is being administered, you may need to change into a gown before the procedure. In some cases, an ultrasound or a type of x-ray called a fluoroscopy may be used to watch the needle’s progress inside your body, most commonly if the injection spot is small or tricky to reach. There will likely be a feeling of pressure when the needle is inserted but the pain should be combated by the numbing spray and local anesthetic.

Purpose

Those who suffer from inflammatory arthritis often receive routine cortisone shots to manage pain and inflammation in their joints. Other times cortisone shots are given to athletes or people who have suffered an injury in one of their joints often due to overuse. Other ailments that a doctor may recommend a cortisone shot for include: bursitis, a painful condition that affects the small, fluid-filled sacs that cushion the bones, tendons and muscles near your joints; gout, a form of arthritis characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints, often affecting the joint at the base of the big toe; plantar fasciitis (also known as policeman’s heel) causing pain due to inflammation of a thick band of tissue that connects the heel bone to the toes; psoriatic arthritis, a type of arthritis suffered by people who have the skin condition psoriasis; reactive arthritis, joint pain and swelling caused by an infection in another part of the body; rheumatoid arthritis, a chronic inflammatory disorder that affects the joints; and tendonitis, a condition in which the tissue connecting muscle to bone becomes inflamed.

Benefits

The benefits of a cortisone shot depends on the reason a person is getting one. In most cases, the biggest benefit is reduced pain caused by inflammation in chronic sufferers of joint pain, including several types of arthritis. In other cases, cortisone shots are used to treat physical injuries often experienced by athletes such as overuse injuries in tendons, like tennis elbow or an aching Achilles.

For those who suffer from seasonal allergies, cortisone shots may provide relief from symptoms for three months, often the entire length of a sufferer’s season. Some people get cortisone shots to eliminate deep acne or pimples.

Pain often takes three to four days to resolve following a cortisone shot but some shots, depending on the location, can work as fast as 24-48 hours. Immediately following an injection, patients typically feel temporary pain relief immediately due to the local anesthetic that numbs the area. Once it wears off, pain could return temporarily until the shot takes full affect.

Risks

Cortisone shots are steroids that, when overused, can become harmful. Because of this, doctors will usually put a limit on the number of cortisone shots a person can receive over the course of a year, often three or four depending on the diagnosis. The limits are imposed to reduce the risk of damage to the cartilage within a joint, which can deteriorate with too many cortisone shots. Problems occur when shots are repeatedly given in the same tendon or joint.

According to the Mayo Clinic, complications of cortisone shot injections include: joint infection, nerve damage, thinning of skin and soft tissue around the injection site, temporary flare of pain and inflammation in the joint, tendon weakening or rupture, thinning of nearby bone (osteoporosis), whitening or lightening of the skin around the injection site, death of nearby bone (osteonecrosis) and a temporary increase in blood sugar. If you have diabetes, this temporary increase your blood sugar levels can be harmful if not managed.

Because of possible complications, some patients need to take steps to prepare for a cortisone shot, such as stopping blood thinners to reduce bleeding or bruising risk or changing your diet prior to the shot. After the shot, you may experience redness or a feeling of warmth on the chest and face. Injection site pain, redness or swelling are always possible.

Symptoms it solves

Cortisone injections temporarily relieve inflammation that causes pain in the joints or tendons. In allergy sufferers, cortisone shots can reduce symptoms of seasonal allergies for up to three months. Cortisone shots are also sometimes used to treat allergic reactions and asthma.

In some cases, cortisone shots are used to reduce the appearance and discomfort caused by deep acne and cysts such as zits.

Alternatives

It is possible to manage pain and inflammation without a cortisone shot. Start by using over the counter anti-inflammatory drugs as well as heat and ice therapy to relieve pain and swelling. In some cases, a joint lubricant can be used instead of the corticosteroid drug. Other people use prolotherapy and prolozone therapy instead of cortisone shots. These are forms of regenerative injection therapy that stimulate the reconstruction of joints, ligaments and tendons with no recovery time.

Payments/cost

The cost of a cortisone shot varies depending on the payment schedule at your doctor’s office and your insurance. Most injections range from $100-$300 for those without insurance. Injections used to treat acne or cysts cost $25-$100.

Professionals in your area

Your doctor will typically administer a cortisone shot in the doctor’s office. Ask your physician if they are equipped to handle the injection in office or if you need to go to an outside clinic to receive treatment.

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