Cortisone Injections

What are Cortisone Injections?

Cortisone injections are a type of treatment used to reduce inflammation and relieve pain in various body parts. They are commonly used for joint pain, such as arthritis, tendonitis, bursitis, and other inflammatory conditions.

Who is Suitable for Cortisone Injections?

Cortisone injections can be suitable for a wide range of individuals experiencing pain or inflammation due to various conditions. Common candidates for cortisone injections include:

• Arthritis Patients: Those suffering from osteoarthritis or rheumatoid arthritis often find relief from cortisone injections.
• Tendonitis and Bursitis Sufferers: Inflammation of tendons and bursae can be effectively treated with these injections.
• Individuals with Spinal Pain: Patients with conditions like sciatica or spinal stenosis may benefit from epidural steroid injections.
• Athletes and Active Individuals: Cortisone injections may be used to treat sports injuries, such as tennis elbow or rotator cuff injuries.
• Post-Surgical Patients: In some cases, cortisone injections may be used post-operatively to manage pain and inflammation.

However, not everyone is a suitable candidate for cortisone injections. Those with infections at the injection site, uncontrolled diabetes, or certain other health conditions may need to avoid this treatment. Always consult a doctor to determine if cortisone injections are appropriate for your condition.

Benefits of Cortisone Injections

• Rapid Pain Relief: Many patients experience significant pain relief within a few days of receiving the injection.
• Reduced Inflammation: Cortisone is a powerful anti-inflammatory agent that can help reduce swelling and inflammation in the affected area.
• Improved Function: By reducing pain and inflammation, cortisone injections can help improve joint and muscle function, allowing for better mobility.
• Minimally Invasive: Compared to surgical options, cortisone injections are minimally invasive and can be performed quickly in a clinical setting.
• Localised Treatment: The injection delivers medication directly to the affected area, providing targeted relief.

Types of Cortisone Injections

There are various types of cortisone injections, depending on the specific condition and area being treated:

• Intra-Articular Injections: These are administered directly into a joint, such as the knee, hip, or shoulder, to treat arthritis or other joint-related conditions.
• Epidural Steroid Injections: These injections are given into the epidural space around the spinal cord to treat conditions like sciatica or herniated discs.
• Soft Tissue Injections: These are used to treat inflammation in soft tissues, such as tendons or bursae, and are commonly used for conditions like tendonitis or bursitis.
• Trigger Point Injections: These injections target specific trigger points in muscles that cause pain and discomfort. They are often used for conditions like myofascial pain syndrome.

Alternative Options to Cortisone Injections

• Physical Therapy: A structured physical therapy program can help improve strength, flexibility, and overall function, reducing pain and inflammation.
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen or naproxen can help manage pain and inflammation.
• Hyaluronic Acid Injections: These injections are often used for knee osteoarthritis to provide lubrication and cushioning within the joint.
• Platelet-Rich Plasma (PRP) Therapy: PRP injections use a patient’s blood to promote healing and reduce inflammation in the affected area.
• Acupuncture: This traditional Chinese medicine technique involves inserting thin needles into specific points on the body to alleviate pain and inflammation.
• Lifestyle Modifications: Weight management, exercise, and dietary changes can help reduce the load on affected joints and decrease inflammation.
• Surgery: In severe cases, surgical intervention may be necessary to address the underlying cause of pain and inflammation.

Preparing for a Cortisone Injection

Before receiving a cortisone injection, taking certain steps to ensure the procedure is as safe and effective as possible is important. Here are some guidelines to follow:

Consult with Your Doctor

• Medical History: Inform your doctor about your complete medical history, including allergies, current medications (especially blood thinners), and existing health conditions.
• Discuss Expectations: Understand the injection's benefits, risks, and potential side effects. Ask any questions you may have about the procedure.

Pre-Injection Instructions

• Medications: Follow your doctor’s instructions regarding medications before the injection. You may be advised to stop taking certain medications, such as blood thinners, a few days before the procedure.
• Fasting: Some procedures may require fasting a few hours beforehand, although this is uncommon for cortisone injections.
• Arrangements: Plan for transportation if you’re receiving an injection that may affect your driving ability, such as an epidural steroid injection.

Preparation on the Day of the Injection

• Clean Area: Make sure the injection site is clean. Avoid applying lotions or creams on the day of the injection.
• Clothing: Wear loose, comfortable clothing that allows easy access to the injection site.

What Happens During a Cortisone Injection?

Receiving a cortisone injection is generally straightforward and quick, typically taking only a few minutes. Here’s what you can expect:

• Positioning: You will be positioned to allow easy access to the injection site. Depending on the location of the injection, this may involve sitting, lying down, or reclining.
• Antiseptic Solution: The doctor will clean the injection site with an antiseptic solution to reduce the risk of infection.
• Numbing the Area: Sometimes, a local anaesthetic may be used to numb the injection site. This helps minimise discomfort during the procedure.
• Guided by Imaging: For certain injections, such as epidural steroid injections, imaging guidance (like ultrasound or fluoroscopy) may be used to ensure accurate placement.
• Administering the Injection: The cortisone injection is administered using a needle. As the needle is inserted, you may feel pressure or a brief sting.
• Observation: After the injection, you may be observed briefly to ensure no immediate adverse reactions.

What to Expect After a Cortisone Injection?

Immediate Aftercare

• Rest: It is advisable to rest the treated area for a day or two following the injection. Avoid strenuous activities.
• Ice Application: Applying ice to the injection site can help reduce swelling and discomfort. Use ice packs for 15-20 minutes, several times a day.

Pain and Discomfort

• Initial Soreness: You may experience soreness or discomfort at the injection site for a day or two. This is normal and should subside.
• Pain Relief: Over-the-counter pain relievers, such as acetaminophen, can help manage discomfort.

Activity Resumption

• Gradual Return: Gradually resume normal activities as tolerated. Follow your doctor’s advice regarding specific activity restrictions.

Monitoring for Side Effects

• Watch for Symptoms: Be alert for any signs of infection (such as increased redness, swelling, or warmth at the injection site), unusual pain, or allergic reactions. Contact your doctor if you experience any of these symptoms.

Cortisone Injections Recovery Plan

Follow-Up Appointments

Attend scheduled follow-up appointments with your doctor to monitor progress and address concerns.

Physical Therapy

• Rehabilitation: Physical therapy may be recommended depending on the condition being treated to help strengthen the affected area and improve function.
• Exercise Program: Follow a tailored exercise program designed by your physical therapist or doctor to aid recovery and prevent future issues.

Lifestyle Modifications

• Weight Management: Maintaining a healthy weight can reduce joint stress and help prevent further inflammation.
• Dietary Changes: Incorporate anti-inflammatory foods such as fruits, vegetables, and omega-3 fatty acids into your diet.

Pain Management

• Medications: Continue to use pain relief medications as prescribed by your doctor.
• Alternative Therapies: Consider alternative therapies, such as acupuncture or massage, to help manage pain and improve recovery.

Long-Term Care

• Regular Exercise: Engage in regular low-impact exercises, such as swimming or walking, to keep the joints flexible and muscles strong.
• Monitor Symptoms: Keep track of any recurring symptoms and report them to your doctor promptly.

Cortisone Injections Prognosis

• Short-Term Relief: Many patients experience pain relief within a few days, lasting from a few weeks to several months.
• Long-Term Management: For chronic conditions, cortisone injections may be part of a broader management plan that includes physical therapy and lifestyle changes.

Cortisone Injections Risks

While cortisone injections are generally safe, there are potential risks and side effects:

• Common Side Effects:
• Pain at Injection Site: Temporary pain and swelling, often referred to as a cortisone flare.
• Skin Changes: Lightening of the skin at the injection site.
• Bruising: Mild bruising around the injection area.
• Less Common Side Effects:
• Infection: Though rare, there is a risk of infection at the injection site.
• Tendon Rupture: Repeated injections can weaken tendons, increasing the risk of rupture.
• Nerve Damage: Accidental injection into a nerve can cause damage.
• Increased Blood Sugar: Temporary rise in blood sugar levels, especially in diabetic patients.
• Systemic Effects:
• Hormonal Imbalance: Prolonged use can affect hormone levels and cause side effects like weight gain, osteoporosis, and mood changes.
• Immune Suppression: High doses can suppress the immune system, increasing infection susceptibility.

What if Cortisone Injection is Delayed?

Delaying a cortisone injection may have different implications depending on the condition being treated:

• Progression of Symptoms: The condition might worsen, leading to increased pain and inflammation.
• Impact on Daily Activities: Prolonged discomfort can affect mobility and daily functioning, potentially reducing quality of life.
• Alternative Treatments: Other treatments such as NSAIDs, physical therapy, or alternative injections (like hyaluronic acid) might be used to manage symptoms in the interim.
• Overall Management Plan: Discuss with your doctor to adjust the treatment plan if a cortisone injection is delayed.