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Should I Get a Cortisone Shot?

Woman sitting on a bench outside, holding her knee in pain. Suffering from joint pain and considering a cortisone shot.

Chronic pain can be extremely disruptive and limiting to everyday life. Thankfully, modern medicine has achieved various pain remedies and solutions, including cortisone shots, which can provide relief to a variety of conditions. But when should you consider getting one?

Michael J. Cunningham, M.D., orthopedic surgeon at Bayshore Medical Center, explains what a cortisone shot is and when a doctor may recommend one.

What Is a Cortisone Shot?

“A cortisone shot or steroid shot is a potent anti-inflammatory medication,” says Dr. Cunningham. It delivers a high dose of a man-made drug that resembles the hormone cortisol directly to a problem area of the body.

The injection reduces inflammation in a given area, and in case of systemic inflammation, it can dampen the body’s immune response and provide significant pain relief within 24–48 hours after the injection.

Who Should Get a Cortisone Shot?

Dr. Cunningham says there are many conditions that might need a cortisone shot, including:

  • Joint pain in shoulders, knees, hips, etc.
  • Osteoarthritis 
  • Rheumatoid arthritis
  • Inflammatory conditions
  • Tennis elbow (irritation of the tissue connecting the forearm muscle to the elbow)
  • Bursitis (inflammation of the bursae, fluid-filled pads that cushion spaces around bones)
  • Trigger finger (condition that makes the fingers difficult to move)

“Generally, cortisone shots are only considered after other therapies have failed. But sometimes, steroid shots can be given as an initial treatment if the pain is really severe, and we want to pinpoint the area we are treating,” Dr. Cunningham says.

Downsides to Cortisone Shots

Cortisone shots are not the first line of defense for a few reasons:

The effects of a shot don’t last forever. Everyone responds differently, but relief typically lasts for a few weeks to a few months. For some people, the shot provides enough relief to break the inflammation cycle, allowing the body to heal. But for those with chronic pain conditions, a series of shots might be needed.

Shots must be limited in use. As Dr. Cunningham explains: “Most orthopedic surgeons don’t like to give cortisone shots repetitively because, while it’s good to relieve inflammation and pain, it can also lead to degenerative changes of the cartilage lining the joint.” Doctors usually won’t give a patient more than three to four shots per year.

Due to the risk of joint degeneration and the potential need for repetitive shots, in many cases, other treatments may be considered first, such as: 

  • Massages
  • Hot and cold presses 
  • Other less aggressive anti-inflammatories
  • Physical therapy

Who Shouldn’t Have a Cortisone Shot?

Cortisone shots are generally safe for most people, with a few exceptions, Dr. Cunningham notes.

  • People with diabetes, because steroid shots can elevate the blood sugar for a short period of time after the injection
  • People who may be allergic to one of the preservatives in the shots

“While cortisone shots may not be the best option for firstline treatment, they can be a safe and effective option for people who are experiencing significant pain or who cannot find relief through other treatments,” says Dr. Cunningham.

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