Cortisone Injection: FAQs

What is cortisone?

• Many orthopaedic conditions such as arthritis, bursitis or tendonitis cause inflammation that leads to pain and discomfort in the affected area.
• Cortisone is a type of medication known as corticosteroids, or “steroids.” These medicines are powerful anti-inflammatories that act on irritated tissues to decrease pain and swelling.
• These are powerful medications that when used properly are very safe and effective.

How is cortisone used?

• A cortisone injection is commonly done with the goal of decreasing inflammation. The steroid medication works directly on the involved tissue to limit the release of chemicals that produce and prolong inflammation.
• Injecting steroid medication into an area of inflammation can provide pain relief more quickly and efficiently. There are several oral anti-inflammatory medications available, but these work indirectly, while an injection delivers effective medication directly into the affected area.

What happens after the injection?

• As with any injection, you may feel pain after the injection. Icing the area for 20 minute periods every 2 to 3 hours in the first 24 hours should help. It is best to avoid activities that put stress on the area the first 5 -7 days after the injection.
• A local anesthetic or numbing medicine (such as Lidocaine) may be mixed and injected with the steroid medication in order to decrease pain from the injection. In these cases, pain will diminish immediately, but will recur to the same intensity as prior to the injection after several hours as the numbing medicine wears off (similar to what happens after dental work). This does not mean that the injection is not working.
• Approximately 10 percent of patients may experience an increase in their pain several hours after the injection. This is due to an initial ‘flare’ reaction of the tissue in response to the steroid that actually causes a brief increase in the inflammation. Simply use ice and rest the area overnight – the reaction should resolve in 24-36 hours.
• Infection following an injection is extremely rare, but will occur with steadily increasing pain as well as tenderness, warmth, redness, and swelling at the injection site. Contact your doctor immediately if these symptoms occur.

How long will it take for the steroid injection to work?

• A corticosteroid injection will usually take 3 to 7 days to begin to have a positive effect.
• It may take up to two weeks for the medicine to decrease the inflammation to a point where pain is improved.
• The full benefit of the corticosteroid may not be felt until 6 weeks after injection.

How long will pain relief last?

• This will vary according to the type and severity of the symptoms being treated and the severity of the condition. Symptom relief may last from several weeks to up to a year.

How many cortisone injections can I get?

• When utilized properly, corticosteroids are safe and effective drugs. In general, though, it is not advisable to get more than 2 to 3 injections a year into a particular area.
• Multiple injections in the same area can produce adverse effects such as tissue atrophy, decreased healing potential, and degeneration of tendon or cartilage.

News reports talk about athletes abusing steroids – are they the same as corticosteroids?

• No. There are different types of steroids. The type abused by athletes is a group of steroids called anabolic steroids, which are chemically different from the corticosteroids used to threat inflammation.
• You will not become stronger, faster, or able to hit more home runs after a cortisone injection!

If I have diabetes will this injection affect me?

• If you are a diabetic, an injection of a corticosteroid can raise your blood sugar level requiring more insulin for a brief period of time. You should monitor your blood sugar carefully and adjust your insulin dose accordingly after the injection.