How Do Cortisone Shots Work?
Learn about how cortisone shots provide pain relief.
Inflamed joints make favorite activities less enjoyable. Cortisone shots offer a very appealing option for pain relief. Widely prescribed for a variety of conditions, cortisone is generally safe, inexpensive, and covered by insurance. And it usually provides fast relief. Understanding how cortisone works and when it works best can help you make an informed decision about whether this is a good treatment option for you.
What is cortisone?
Cortisone is a synthetic version of cortisol, a steroid produced in the adrenal gland and released into the bloodstream in response to stress. Cortisone works like cortisol, but is available in a more powerful range of strengths. However, although cortisone and cortisol are steroids, they shouldn’t be confused with the anabolic steroids like testosterone. Anabolic steroids enhance male characteristics and improve athletic performance. By contrast, cortisone and cortisol are anti-inflammatories that act to suppress the immune system and decrease inflammation in irritated tissues.
How do cortisone shots work?
As an orthopedic treatment, cortisone is injected directly into a site of inflammation. Because it is used to treat pain, cortisone is sometimes confused with pain-relieving medications. However, cortisone itself is not a pain medication. Instead, cortisone is an anti-inflammatory that works by preventing collagen production. The injection shuts down collagen-producing cells in the tendon or joint; this action suppresses inflammation and calms nerves, indirectly reducing pain. Also, it’s important to note that cortisone doesn’t actually heal the underlying problem triggering the inflammation.
Cortisone begins to work as soon as it is injected. Nevertheless, the time frame until patients feel relief varies. Some people report immediate relief, while others report gradual pain reduction over a period of days or weeks. If inflammation is severe, or if it is ongoing and chronic at the time of treatment, pain relief may be less robust.
What orthopedic conditions are treated with cortisone shots?
“Cortisone shots have an important place in orthopedic care,” explains arthritis specialist Dr. Dane Hansen. “They provide very effective short-term relief for pain caused by conditions ranging from arthritis to tendinitis. Injections are commonly used to ease pain in hip, knee, ankle, spine, shoulder, elbow, and wrist joints. Smaller joints in the hands and feet can also benefit from cortisone treatment.” At Summit, injections are used in a variety of ways, including the following:
- Pain relief. Cortisone injections provide excellent pain relief for short periods of time.
- Cortisone injections are an effective diagnostic tool that delivers rapid results. When cortisone is injected into a problem joint and relieves pain, it helps physicians to confirm the pain source.
- Arthritis flare-up treatment. When arthritis patients experience a painful flare-up, cortisone can help to quickly soothe the worst of the pain.
- Delay or eliminate joint replacement. Cortisone has a place in the treatment of elderly arthritis patients who need help coping with the pain of deteriorating joints. The pain relief provided by the injections can help to postpone or avoid joint surgery. However, as a maintenance treatment over a long period of time, cortisone has limitations.
Are there risks with cortisone treatments?
Cortisone injections have a long history of safety and effectiveness when used properly. This treatment is well tolerated by most people, has few side effects, and can be delivered with little discomfort. Because injections provide effective but temporary pain relief, patients often want to repeat injections over time. Unfortunately, cortisone pain relief diminishes with continued use. “Cortisone injections in joints are safe approximately every three months without concern,” explains Dr. Hansen. “However, we don’t want to do injections more often because there is the potential for more frequent injections to worsen joint damage. Doing too many injections also risks damaging to other treated tissues, particularly tendons. Repeated use of cortisone for conditions like tendonitis has the potential to weaken the treated tendon permanently.
The risks associated with cortisone treatment of tendons are tied to the way cortisone works. Tendons have the highest tensile strength of all our connective tissue, thanks to the high proportion of collagen in tendon fibers. But cortisone works by shutting down collagen production in the tendon cells. As a result, when you get a cortisone shot, your tendon tissue stops making new collagen. Over time, repeated injections may weaken tendon tissue, and have even been known to cause tendon ruptures.
Finally, cortisone injections can cause a temporary elevation of blood sugars in diabetic patients. “This is a self-limiting side effect,” notes Dr. Hansen, “but it may require closer monitoring of diabetic patients or temporary adjustment of any medications and insulin.”
Talk with your doctor about whether cortisone shots are right for you
If you are considering cortisone shots, it’s valuable to understand that cortisone is an effective short-term solution. It is also important to discuss with your doctor whether your medical history makes cortisone a beneficial treatment for you. Remember, there are reasons not to use cortisone, even when it continues to provide pain relief. If these reasons apply to you, you may be advised to limit your use of cortisone. Or you may want to exhaust other treatments before considering cortisone.
When to seek treatment for your arthritis
Arthritis doesn’t have to spell the end of an active life. If you are experiencing worrisome symptoms or persistent pain, the renowned arthritis specialists at Summit Orthopedics can help. We work with you to confirm a diagnosis and develop an appropriate conservative treatment plan. If nonsurgical treatments fail to support your lifestyle goals, fellowship-trained orthopedic surgeons will consult with you and discuss appropriate surgical options. Summit is home to innovative joint replacement options. Our Vadnais Heights Surgery Center is one of only two surgery centers nationally to receive The Joint Commission’s Advanced Certification for Total Hip and Total Knee Replacement.
Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.
More resources for you
- Read about the difference between tendinitis and tendinopathy
- Learn more about managing arthritis pain without surgery
- Watch the video: Exercise and Arthritis
“Arthritis patients have high expectations for their activity level. With advanced training in minimally invasive surgical techniques and quick-recovery joint replacement, I strive to help my patients return to their fully active lifestyle as quickly as possible.”
The demand for total knee and total hip joint replacements is on the rise. Summit orthopedic surgeon Dr. Dane Hansen explains the causes of joint injury and how these conditions may be managed with nonsurgical treatments.
Ask the Expert: Arthritis Video Series
We think of arthritis as an old person’s disease, and view knee and hip replacements as procedures reserved for elderly patients. Dr. Hansen talks about the common myths surrounding arthritis, and how these beliefs may prevent younger arthritis patients from enjoying a vibrant active life.