Cortisone shots are used to treat a variety of conditions that may affect the upper limb. These conditions may include but are not limited to arthritis, carpal tunnel syndrome, Dupuytren’s Contracture, tendonitis, tennis elbow, and more. Cortisone shots are widely used in the treatment of many joint and soft tissue conditions affecting the legs, feet, hips and other body parts.

Cortisone shots do provide patients with relief from their symptoms, but as with any medication it is not without its risks and drawbacks. Your physician may use cortisone shots as part of a larger treatment plan or sometimes to confirm a diagnosis.


Key Facts

Prior to treatment, your doctor needs to know about any pre-existing conditions and all medications you are currently taking. Certain medications may interact with the cortisone injections.

An example of this is blood thinners. Patients on blood thinners must stop taking their medication several days before injection to prevent excessive bleeding and bruising.

If you have had a fever of at least 100.4F in the two weeks prior to injection, your physician may have you wait to receive your injection.

Patients who are pregnant, breast-feeding, suffer from certain mental illnesses, or have recently had a vaccination may be advised against receiving cortisone shots.

If you are not finding relief from cortisone injections 24 to 48 hours after, you should notify your physician. Severe side effects are rare, but if you are concerned you should also alert your physician.

Ultrasound guided injections should be preferred when available. By using an ultrasound, they can precisely pinpoint where the pain is and target it with the medication. This also helps avoid unwanted complications from injecting the medication into the wrong spot. 


Pros of Cortisone Shots

Cortisone injections are a standard treatment for inflammation that causes patients severe pain and discomfort. These shots should always be administered by trained physicians in order to minimize risks. Benefits of having cortisone injections includes:

  • Cortisone injections may be used as a diagnosis tool. They can help confirm the exact source of pain and eliminate the possibility of another potentially more serious condition.
  • Injections provide more rapid and localized pain relief than typical anti-inflammatory medications.
  • Most patients experience little to no side effects after injection.
  • The injection can be done with little to no discomfort.


Cons of Cortisone Shots

While cortisone shots are an excellent form of treatment for a variety of conditions, they are not without problems. Aside from standard side effects, there are other cons to cortisone shots:

  • Cortisone shots only provide temporary relief. Without other treatments, it is likely conditions will only worsen over time.
  • Cortisone injections may also mask symptoms. This may lead a patient to believe their condition is improving, when it could in fact be deteriorating.
  • Cortisone shots can only be administered every six weeks, sometimes even less. This is because the shots can lead to cartilage damage in a joint or deterioration of the tendons in the injected area.
  • Repeated use of cortisone shots may also mask irreversible nerve damage which may need to be treated by surgery.
  • Cortisone shots lower the immune system and reduce the body’s ability to fight off infections. If you are already immunocompromised, your doctor may recommend against cortisone injections


Cortisone Shots as a Treatment Plan

Cortisone shots should only be one piece of a larger treatment plan for any given condition. The effects of cortisone shots are temporary, and prolonged use can lead to further damage. Patients who are seeking long-term relief may be advised to:

  • Lose excess weight
    • Excess weight can cause stress on the joints. Losing weight may allow the effects of cortisone shots to be stronger and last longer.
  • Go to physical therapy
    • Stretching and strengthening the affected muscles, as well as surrounding muscles, can go a long way in preventing further damage and improving a patient’s condition.
    • Some physical therapists may also utilize massage techniques and other efforts to reduce inflammation
  • Lifestyle changes
    • Diet and exercise, along with changes in your daily routine may help reduce inflammation and improve your condition.


Side Effects

Side effects of cortisone shots are normally mild and do not always occur. They may include:

  • Cortisone flare
  • Allergic reaction (rare)
  • Rise in blood sugar
  • Thinning of skin
  • Cartilage damage
  • Joint infection
  • Nerve damage


What is a Cortisone Flare

Cortisone flare, sometimes called steroid flare, is a common side effect of cortisone injections. It is characterized by pain at the injection site, normally in the joint. It is caused by the slow-released crystals the shots contain. While these crystals are what reduce inflammation, they can also irritate the joints.

Pain will normally begin to show up 24 to 48 hours after injection. Cortisone flares can be easily managed by icing the inflamed area and taking over-the-counter medications such as ibuprofen or acetaminophen.


Cortisone Shots: Final Thoughts

Cortisone shots are a great short-term option for pain relief. They are not meant to be a permanent solution and can actually cause permanent damage if they are overused. As with all medications, cortisone shots are not without their risks. Be sure to express any questions or concerns to your physician prior to treatment.

When it comes to the hand and wrists, overtime you may end up requiring surgery to permanently heal the condition. Dr. Brutus is a successful surgeon who treats a variety of conditions including carpal tunnel syndrome.