Overview

Injections called cortisone shots can reduce swelling and pain in a particular body part. The joints that receive them most frequently include your ankle, elbow, hip, knee, shoulder, spine, and wrist. Your hands or feet’s tiny joints can gain from cortisone injections.
A corticosteroid medicine and a local anesthetic are typically included in the injections. One is frequently available in your doctor’s office. You can typically only have a certain amount of shots per year due to probable negative effects.

Why it’s done

The most effective kind of treatment for inflammatory arthritis, such as rheumatoid arthritis, may be cortisone injections. They are also very effective for: 

• Backache or “Sciatica”
• Elbow, knee, or bursitis pain
• Gout arthritis 
• Knee, shoulder, and hip osteoarthritis
• Psoriatic arthritis (clue is having a worsening chronic red, silvery, scaly rash of arms, legs)
• Arthritis that develops after a sickness or injury
• Flare-ups of rheumatoid arthritis or joint pain in the fingers, hands, or feet
• Injury or overuse resulting in tendonitis in the hands, wrists, shoulders, and knees

Limits on the number of cortisone shots

There is a worry that frequent cortisone injections could harm the cartilage in a joint. As a result, doctors usually limit the quantity of cortisone injections into a joint.
Cortisone injections should typically not be given more frequently than three or four times a year, or more frequently than every six weeks.

After the cortisone shot

• Apply ice to the injection site as needed to relieve pain. 
• Not use a bathtub, hot tub or whirlpool for two days. It’s OK to shower.
• Watch for signs of infection, including increasing pain, redness and swelling that last more than 48 hours.

Results

The outcome of cortisone injections largely depends on the diagnosis. It is possible to have a mild increase in the pain for a day or less, but generally, the pain and swelling in the affected joint should  improve or resolve from 2-12 hours. The treatment depending on the injury or cause of pain may last from 1 week 8 months or more. A repeat evaluation of injection may be needed. 

Alternatives

In addition to the cortisone (steroid) injection. You may be a candidate for a “gel” (lubricating) injection with or without the steroid medication. Platelet Rich Plasma (“plasma, or PRP), is another, “natural alternative, where we take your own blood and remove the plasma. The plasma is then injected into the joint after using topical anesthesia. One must hold off taking anti-inflammatory medications, prior to and after having these healing injections. 

Summary

Prior to investing in receiving steroid (cortisone) joint injections, we recommend initially trying Tyelnol or Advil prior to considering treatment. On the day of evaluation or treatment, do not take Advil / ibuprofen / or oral steroid medication. (Tylenol is ok).  If a large amount of fluid (with swelling)is visible on the day of exam, we will remove joint fluid on the same day using ultrasound guidance. 

Albert Luongo, MS, PA, MBA, DMSc

LUONGO MEDICAL CARE 

90 Morgan St. Stamford, CT 06905

203.461.4767

LuongoMedicalCare.com