Injections of cortisone are effective in treating joint inflammation and pain, however they are not without limitations. Here we discuss some of those limitations.
As Part of a broader treatment plan, cortisone is injected
Temporary relief is provided by these injections. If long-term relief is desired, patients are usually advised to:
- Exercise as part of your physical therapy. Pain and other symptoms of arthritis can be relieved by strengthening muscles and other soft tissues. Physical therapy was better long-term than cortisone injections in one study1.
- Reduce your body weight. Losing extra pounds can make your joints more comfortable. Patients who are obese may be less likely to benefit from cortisone injections for their knee osteoarthritis pain.
- Adopt a new lifestyle. By simply changing footwear, you can reduce the number of microtraumas your joints experience every day.
As a result, joint biomechanics can be improved and cortisone shots can possibly be reduced or eliminated.
Over time, joint pain is likely to worsen without other treatments
Over time, patients who receive repeated cortisone shots may experience shorter and shorter periods of pain relief. Patient tolerance to the medication may not necessarily be the cause, as the joint may be degrading. A change in daily life and physical therapy can stop joint degradation or slow it down.
Gradually increasing activity is recommended
You might need to wait for a few days for the effects of the cortisone injection to fully kick in. It is common practice to tell patients to rest and reduce normal activities during this time.
A patient who has had joint pain relieved may be tempted to start exercising as soon as it is relieved.
A doctor will usually advise patients to gradually resume normal activities and increase intensity over time in order to avoid injuries or making their condition worse.
Injections repeated too often can damage soft tissues
It is possible to damage the tendons, ligaments, and articular cartilage at the injection site if you use too many injections within a short period of time.3 This is why:
- When more than one injection needs to be administered at the same time, the injections should be spaced several weeks apart. Many doctors would rather wait longer-for at least 3 to 4 months.
- The number of injections at the same location per year should not exceed three or four.
- Before operating on an affected joint, a surgeon typically requires a 3-month waiting period after receiving a cortisone injection.
A cortisone injection is particularly likely to cause degeneration and injury to tendons. Doctors will not administer cortisone directly to a tendon due to this risk, even if the source of the discomfort is suspected to be a tendon. An injection of cortisone placed near a tendon can still reduce inflammation since it works locally.
As a matter of fact, the Achilles and patella tendons are particularly susceptible to injury post-injection, regardless of whether an injection was administered in or near the tendon. Therefore, doctors try to avoid cortisone injections for Achilles tendinopathies and patellar tendinopathies.