The discovery of cortisone in 1949 was hailed as a huge medical breakthrough. Cortisone shots are frequently recommended by orthopedic specialists for muscle, nerve and joint pain. They work by eliminating inflammation and the associated pain. Used with a local anesthetic, cortisone injections can also help with diagnosis of orthopedic conditions.
Cortisone is a not pain-reliever, but an anti-inflammatory medication. Local cortisone Injections reduce inflammation in specific, small areas of the body; while systemic cortisone injections reduce widespread inflammation.
Systemic cortisone injections are usually given intramuscularly in the gluteus or deltoid muscles, for skin or multiple joint conditions such as rheumatoid arthritis, allergic reactions and asthma. For severe conditions, injections can be administered intravenously
What is Cortisone, and How Does It Work?
Cortisol is a potent hormone that is produced naturally by the body. Along with adrenaline, cortisol is released by the adrenal gland in response to stress. Cortisone suppresses the immune system, thus reducing inflammation, pain, and swelling at the site of injury
Cortisone is a strong, prescription, anti-inflammatory medicine used to treat muscle, tendon, bone, and joint pains, and many nerve conditions that are associated with inflammation of the tissues.
Cortisone is a type of steroid known as a corticosteroid, that like all drugs and medications, should be administered appropriately. Steroids can be harmful if taken in high does or over long periods of time.
Cortisone medication gives a boost to the normal levels of cortisol in the bloodstream. The medication is restricted to short periods of time, after which levels quickly return to normal.
What Conditions are Treated with Cortisone?
Almost any painful muscle, tendon, bone, or joint problem, and many nerve conditions can be treated with cortisone:
• Rotator cuff injuries
• Tennis elbow
• Trigger fingers and points
• Plantar fasciitis
• Joint inflammation & pain
• Nerve inflammation
• Carpal tunnel syndrome
• Morton neuromas in the foot
• Muscle inflammation
• Neck and back pain
How is Cortisone Administered?
Cortisone can be given orally or by injection. An injection usually takes effect quickly and is given in smaller doses. It delivers the medication directly to the affected area without being diluted through the bloodstream.
The frequency of dosage depends upon the condition and structure of the body being treated. A gap of several months is recommended before repeating the dose. If not effective after several tries, alternative treatments will be recommended.
Sometimes a single injection can cure the problem. On occasion, an additional follow-up injection may be necessary. Physical therapy is often augmented with a cortisone injection. This gives the patient pain-free time to work on rehabilitation after an injury.
Complications with Cortisone
Cortisone is given to counteract reactions, so it usually does not cause a reaction. It is a naturally occurring substance easy to administer and with few, rare, minor lasting side effects.
Oral cortisone usually doesn’t cause any side effects. Patients rarely feel anything other than relief of pain symptoms. Some may complain of a “flushing” sensation. Cortisone may cause sugar imbalance in diabetics, especially those on insulin. Stomach or gastrointestinal upsets are another mild reaction.
Long-term cortisone treatment can cause organ and tissue damage. A standard course of oral cortisone only lasts a little over a week.
Frequent treatments over time can cause tissue damage or tendon rupture, depending on the location of the injection.
In the immediate short term, the injection site can experience some pain, depending on the patient’s pain threshold and the location of the injection. This is known as a “cortisone flare.” A period of numbness lasting several hours may occur. A severe burning pain over 36-48 hours is common and not a cause for alarm.
Long-term relief from pain may start immediately, or within a few days to a few weeks.
Systemic Side Effects
As the human body produces cortisone naturally, systemic side effects from cortisone injections are few and rare. The most common effect is seen in diabetic patients where blood sugar levels may be temporarily elevated, and should be monitored.
Patients, especially women, may experience facial flushing and redness after an injection for a few hours or days.
Cortisone injections are very safe and should always be performed by a properly trained and experienced physician or other health care professional. It is preferable to administer them with direct image guidance technology to ensure the efficacy and safety of the procedure.
The right combination of the patient candidate, the specific medical complaint, and a skilled, experienced physician is key to the success of cortisone treatments. Cortisone, whether administered orally or by injection, when used appropriately is very safe and effective. It remains a common and standard treatment for many types of orthopedic problems.