Earlier today I was a treating a patient with shoulder pain and the discussion about cortisone injections came up. The patient had asked if I think a cortisone injection would benefit them. I told them that the answer was a bit more complicated so I thought it was a great time to discuss everything that you must know before thinking of using it yourself.
Cortisone is a steroid
Normally a doctor will combine a long acting local anesthetic and mix it with a steroidal anti-inflammatory to create the cortisone injection. Just like the gym junkies, these steroids are not healthy in the long term as they can affect your tissue and bone health. The safe dose is currently said to be up to 3 shots a year before your body starts to feel ill effects.
Will cortisone fix my pain?
Cortisone is used to help calm down an inflammed tissue such as a tendon, muscle or bursa by reducing the inflammation to that tissue. In our experience, there are 3 outcomes after a cortisone injection.
20% of people feel dramatic long term relief
40% of people feel less pain for a period of time, and then the pain comes right back. They can feel great for days, weeks or months and then, boom, pain is back!
40% of people don’t feel any change at all.
Cortisone in many situations is not the only cure but part of a management process. If it can successfully reduce the swelling of an area, then this gives a window of opportunity to help perform therapy such as exercise around the injured area to help regain strength and control.
Should I try physiotherapy or go for a cortisone?
As much as possible we want to reduce the need for injections due to the potential long term side effects. It is always best to try physiotherapy first as this can help correct the initial problem and can help many people avoid a cortisone. If you have done a trial period of physio and still no change, then in discussion with your physio and doctor, it may be worth trialling an injection. But remember after the injection, it is gold standard to continue with physiotherapy as this is still aiming to fix/clear out all other issues which may have inflammed the tissue in the first place
So hopefully this gives you a bit a more insight into cortisone injections. If you or someone you know is thinking of having a cortisone injection, it is always best to discuss other options first with your physiotherapist. If you have any further questions about this, please shoot us an email or call the clinic on 9364 1000 to have a more of an in depth chat about your individual case.
Until then, hope you all continue to work well, play well and live well!
Yours in health
The team at Physio Well-th.