Cortisone Injection

  • Orthopaedic doctors have used injectable corticosteroid mediations, commonly called “cortisone” since the 1950’s to help treat a variety of conditions.   It works by reducing the body’s inflammatory response to injury.
  • These are NOT performance enhancing “steroids” that have been on the news. They are powerful anti-inflammatories that are COMPLETELY LEGAL to use.
  • Corticosteroids are injected along with local anesthetics into bursae, around tendons and ligaments, and in joints. The local anesthetic in the injection works immediately and will last for several hours. If it improves your symptoms temporarily, it helps us know that the medicine was delivered to the correct location.
  • Corticosteroids are powerful anti-inflammatory medications that will become effective in 3-7 days and may last for several weeks to months (or help cure the condition altogether).
  • The effectiveness of steroid injections is not always predictable. Some people get long lasting pain relief while others do not.
  • For the first 24-48 hours, you should be protective of the joint or area of the body that was injected and rest. It is OK to go about you normal daily activities, but you should avoid running, working out, and playing sport during the first two days.
  • If the injection has been given around a nerve, you may find that the local anesthetic will cause numbness in the area of that nerve distribution. This should resolve over a period of several hours.
  • In some cases, there will be local bleeding from penetration of the needle and you may experience some pain for 12-24 hours.
  • If you are a diabetic patient, you should check your blood sugars more frequently for the first 48 hours after injection and adjust your medications as directed by your primary care doctor. A cortisone injection can elevate your blood glucose level due to absorption of the medication into the bloodstream.
  • Complications from the injection are very uncommon but may include:
    • Sterile technique is used to minimize the risk of infection.
    • “Cortisone flare” is a reaction to the steroid itself. This reaction happens in about 2% of patients and may cause increased local redness and worse pain. It usually does not last long and resolves within 12-48 hours.
    • Fat atrophy where there is a thinning of the layer of fat just under the skin giving a small sunken appearance to the skin.
    • Whitening or lightening of the skin pigmentation at the site of injection in patients with darker skin tones.
    • In rare cases, steroid can weaken a tendon or ligament and lead to tendon rupture.
  • If you experience swelling, redness, heat, or pain at the injection site, an ice or cold pack may be helpful. A mild pain pill such as Tylenol or Advil may help as well.
  • If these symptoms persist for more than 24 hours, please contact our office.
  • It is important that you keep a record of how the injection made you feel so that you can communicate this to Dr. Taylor on your next visit. In particular we want to know how much improvement you had in your symptoms immediately after the injection and how long you had improvement (days, weeks, months.). This will help us direct your treatment in the future.