What Are Cortisone Injections?

Have you ever heard a friend or doctor mention that a cortisone shot could help with your pain?

Here we have explained many of the points you would need to know to make an informed decision with your healthcare professional.

What is cortisone?

Cortisone is derived from cortisol, which is a steroid hormone that occurs naturally in your body. It is produced by your adrenal cortex and is released when your body is under stress to reduce inflammation throughout your body. It was initially isolated in the 1930s, and a synthesized version has been used in medical injections for many different conditions since the 1940s as a means of managing inflammation.

How does cortisone work?

Cortisone is classified as a steroidal anti-inflammatory medication, which sets it apart from other non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen. Although cortisol is a naturally occurring substance, the cortisone that is injected is frequently more powerful and concentrated than anything your body produces. Once injected, cortisone stops structural protein collagen from being produced in the cells of the tendon or joint, as well as calming down your immune system which helps to suppress inflammation and immune histamine response. Although cortisone is technically not a pain medication, it can also calm nerves, which can help to reduce your experience of pain. The effects can take anything from a few hours to several days before an individual receiving a cortisone injection will feel the benefit.

What are the benefits of cortisone injections?

Cortisone can improve quality of life thanks to reducing inflammation and pain. In some cases where pain and inflammation are limiting the ability to participate in active rehabilitation, a single injection can improve joint movement and function for long enough that participation in an exercise or rehabilitation program is possible and full recovery is achieved. In other instances regular injections can allow for long term management of a condition or injury to maintain a higher quality of life and either postpone or prevent the need for surgery. Cortisone injections can also be used as a diagnostic tool, since their efficacy (or lack thereof) can support or disprove a medical diagnosis.

What are the consequences of cortisone injections?

Because cortisone acts to suppress collagen production, its use can result in weakness in the tendons surrounding the area of injection and loss of cartilage. Repeated exposure increases the risk of tendon and cartilage damage. This is why you will often hear that there is a limit to the number of injections you can get in a particular joint or timeframe. While Cortisone can provide short term relief of symptoms, it’s important not to overdo it too soon while an underlying injury is still healing.

Cortisone injections can temporarily increase blood sugars, which is a consideration for anyone experiencing blood glucose dysregulation such as someone with diabetes.

In some rare cases, injected cortisone can crystallize in the body and cause a “cortisone flare” when both the pain and inflammation is worse than prior to the injection.

Although uncommon, those with uteri may experience impact in their menstruation, lactation (if breastfeeding), and increased hair growth.

Although not specific to cortisone, there are also the intrinsic risks associated with any injection or use of a needle, e.g. infection, pain, skin discolouration, allergic reaction, contact with a blood vessel or nerve, etc.

Should you get a cortisone injection?

That is a conversation between you, your doctor and rehab professional. It’s important to be informed and to take both the pros and cons into consideration when making any decision. Then, based on your unique situation, you can make the decision that will be best for you!