So your doctor suggested doing a cortisone injection to treat your pain?
You are not sure what you should do? Today I will answer some of the most
common questions that patients have about cortisone shots.
1 Is cortisone a steroid? 2 How do cortisone shots work?
3 Are cortisone injections good for arthritis? 4 Does it help with tendonitis and bursitis?
5 How long until the effect starts? 6 How long does the pain relief last?
7 Does it help low back pain and sciatica? 8 Does it hurt?
9 Can cortisone increase blood sugars? 10 Can steroid injections cause weight gain?
So, let’s talk about cortisone injections today.
1) Is cortisone a steroid?
Cortisone is a type of steroid. But they are different from the
anabolic steroids used to increase muscles. Cortisone or corticosteroids are a type of
anti-inflammatory drugs. They are artificially made in laboratory. We have our own natural
steroid hormone called cortisol, which is produced in the adrenal glands. There are many types of
corticosteroids made in laboratory: prednisone, hydrocortisone, dexamethasone, triamcinolone,
These corticosteroids can be taken by mouth in tablets, capsules or syrups, in inhalers,
intranasal sprays, eyedrops, topical creams or by injections.
2) How do cortisone shots work? Corticosteroids inhibit the immune system,
therefore, they reduce inflammation. When we inject corticoid inside of a joint,
this medication will take a long time to be removed by the body. Because there is no blood
supply inside of the joint, the corticosteroid will stay there for weeks or months. And that is
what makes the effect of these injections last so long, sometimes up to 6 months.
3) Are cortisone injections good for arthritis?
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Corticosteroids reduce inflammation
very quickly, and this alleviates the pain and pressure inside of the joint. However,
we can’t be giving cortisone shots too often to the same joint. If we do this, the cartilage
and the bone will become weaker and this will actually be more damaging and cause an accelerated
process of joint destruction. So, we don’t do more than 3 injections per year in the same joint.
4) Does it help with tendonitis and bursitis? Yes, when there is an inflammation of a tendon
or a bursa, these are outside of the joints, around the joints.
Then, it might be helpful to reduce that inflammation quickly by doing a steroid injection.
5) How long until the effect starts? When we inject corticosteroid inside of the joint,
it may take up to 3 days for the patient to notice the pain relief. That is because when we inject
inside the joint, that is a closed space, and we will be increasing the pressure inside the joint.
That will cause more pain, just because of the pressure. Once the pressure diminishes,
the pain improves, and the steroid is also starting to exert its anti-inflammatory effects.
6) How long doe the effect last? If the injection is inside of the joint,
then it may last between 3 and 6 months. When the injection is around a tendon or bursa,
the effect is a few weeks. But if the problem is resolved, then the pain may not come back.
7) Does it help with low back pain and sciatica? In people who have arthritis of the facet
joints of the spine, or people who have sciatica due to a acute disc herniation,
the injection of corticosteroids in these areas can be very helpful to alleviate the pain.
8) Does the injection hurt? Yes, it does. The doctor may mix
a local anesthetic with the corticosteroid. This will block the pain for a few hours.
9) Can cortisone increase blood sugars? Yes, and that sometimes is a contraindication.
If the patient takes insulin for diabetes, we need to alert the patient
that they need to monitor their blood sugars the day of the injection, because they may go up.
10) Can steroid injections cause weight gain? Yes. All corticosteroids cause water retention
and weight gain. They may also cause the blood pressure to go up,
they can upset the stomach and cause insomnia and restlessness.
So, if your doctor offers you a cortisone shot for the treatment of pain, you have more information
to decide if you want or not this treatment. Please remember that this video is for educational
purposes only and that you need to talk to your doctor about the pros and cons of cortisone
shot for you. In case of emergency go to the nearest emergency department or call an ambulance.
Watch my next video here Good bye