When the knee or hip joint lose the smooth cartilage surface of the joint and develops arthritis, your body responds with inflammation, swelling, and pain. The symptoms of arthritis can wax and wane where you have a flare up of intense pain some days then other days, the pain and swelling are not so bad. There are several treatment options for arthritis including anti-inflammatory medication such as ibuprofen or naproxen, rest, weight loss, ice therapy, exercise, and physical therapy. When these conservative treatments stop working effectively, your doctor may recommend a cortisone injection to decrease the inflammation and pain.
Cortisone is a strong anti-inflammatory medication that can be effective in treating several conditions including osteoarthritis, rheumatoid arthritis, bursitis, gout, tendinitis, back pain, reactive arthritis, and psoriatic arthritis. For certain injections, your doctor may use imaging such as ultrasound or x-ray for more precise placement of the medication, which can improve the effectiveness.
Frequently Asked Questions:
When should a cortisone injection be considered?
If you have tried several conservative therapies such as dietary changes, exercise, and over-the-counter anti-inflammatory pain medication such as ibuprofen or naproxen but are still struggling with your arthritis pain, you may consider trying a cortisone injection.
How is the injection given?
The cortisone is injected directly into your hip or knee joint. Oftentimes, we will use some medication to numb your knee and we may utilize ultrasound or x-ray guidance to assist the procedure.
How many cortisone injections can I have in my lifetime?
There is no limit in the number of injections, but they can lose their efficacy over time as your arthritis worsens. As a general rule, we do not give cortisone injections more frequently than every three months or no more than four injections into the same joint in one year.
Does it hurt to get a steroid shot?
Just like a flu shot, a cortisone injection can be a little uncomfortable at the time of injection, but many people feel that this is not as bad as they feared.
What result should I expect?
Results of cortisone shots typically depend on the reason for the treatment. Some people may have immediate pain relief, but it may take several days before the cortisone takes full effect. How long the cortisone provides symptomatic pain relief varies tremendously. For some patients, they only work for a few weeks to months; for others, a single injection can provide relief for a year or longer.
What should I do after an injection?
You should be able to return to normal daily activities but avoid excessive strain on your knee such as jogging, heavy lifting or prolonged sitting. You can take acetaminophen or ibuprofen and apply ice to your knee as needed following an injection.
What are the side effects of a cortisone injection?
Most people have steroid injections without any side effects. Some people have redness and a feeling of warmth of the chest and face after a cortisone shot. If you have diabetes, a cortisone shot might temporarily increase your blood sugar levels.Occasionally people notice a “post-injection flare” in their joint where the joint is much more painful than before the injection within the first 24 hours after an injection. This usually resolves by applying ice and taking acetaminophen or ibuprofen.
Long-term side effects or results of getting cortisone injections too often include:
cartilage damage, death of nearby bone, joint infection, nerve damage, temporary facial flushing, temporary increase in blood sugar, tendon weakening or rupture, thinning of nearby bone (osteoporosis) or thinning of skin and soft tissue around the injection site.
Are there risks to having an injection?
The risks are very minimal. Some patients will experience an inflammatory response or reaction at the point of injection. They may also experience pain and discomfort during the injection. Of course, there is always the risk of infection, but this risk is very minimal.In fact, injected steroids for arthritis have a lower risk of side effects than oral corticosteroids.
Can I drive after a cortisone injection?
Yes, you should be able to drive following a cortisone injection.
Is cortisone the same as a steroid injection?
Cortisone is a type of steroid so quite often the terms are used interchangeably. Some steroids such as cortisol, are produced naturally in the human body by the adrenal glands. Artificial steroids act like our natural steroids to reduce inflammation. Cortisone is one type of synthetic or artificial steroid. A cortisone injection into a joint can reduce inflammation, which in turn should reduce pain. Not to be confused, the steroid we use for arthritis is not the same as anabolic steroids used by body builders to increase their muscle size and strength.
Is cortisone an alternative treatment for people looking to avoid surgery?
For people with severe arthritis, cortisone injections are not a substitute for total knee replacement. Surgery is an important treatment option for severe knee arthritis when other treatment options have not proven successful. A knee replacement is extremely effective when knee arthritis becomes severe and fairly advanced.