Posted By:

Dr. Richard Rowley

The Problems With Cortisone Injections

Talk to anyone who has joint or injury pain associated with arthritis, bursitis, tendonitis or chronic back problems and most likely they ...

Talk to anyone who has joint or injury pain associated with arthritis, bursitis, tendonitis or chronic back problems and most likely they will tell you that their doctor is giving them cortisone shots.

They will also tell you that while the shots may work for a short time, the pain they experience in between shots can be debilitating and that they would do anything to have their life back. While this may seem dramatic to someone who has never experienced this, the emotional struggle that goes along with the pain can make one feel like they don’t have a life anymore.

The truth is there are a lot of problems with cortisone injections and while they do ease the pain, but they do absolutely nothing to solve the problem of the condition or injury.  So a person getting these shots is going through the roller coaster of having pain, getting a shot, pain eases then pain comes back, get another shot, pain eases then pain comes back again. 

Cortisone also decreases its effectiveness with use. Patients receiving several cortisone shots tend to see no benefit at all from receiving additional injections but receive all of the side effects.


Why People Get Cortisone Injections

There are lots of reasons why people choose to get a cortisone injection. However, one of the main reasons is that they do not know of any alternative method to treat their injury. A close second is that the doctor tells them they need one!

Typically people will seek cortisone injections when they have inflammatory arthritis or other conditions like:

  • Tendonitis
  • Bursitis
  • Gout
  • Rheumatoid Arthritis


The injections are not used as a pain killer. Instead, they are used to reduce inflammation of the joints, and once the joints are not inflamed that is when the pain starts to subside.


How It Works

Here is how it works. Cortisone is injected directly into the area where inflammation and pain are present. The powerful dosage of cortisone acts quickly to lower the inflammation. The individual receiving the injection experiences pain for a few days, but then the pain levels start to decrease. The person starts to feel somewhat normal again and can do some of the things they weren’t able to do when in pain. Unfortunately, cortisone carries risk factors, so doctors usually limit injections to once every 6 months. Having cortisone injections more than once every 6 months, can increase the risk of you getting the following side effects.


Side Effects of Cortisone Shots

The following are some of the side effects associated with cortisone injections:

  • Infection - While this side effect is rare, infection at the injection site can occur. As long as the injection site is properly sterilized, the chances of infection are minimal
  • Tissue Damage - Some individuals have experienced weak tendons at the injection site. The individual may also notice pain associated with cartilage softening at the injection site
  • Cortisone flare-ups - Only 2% of individuals injected with cortisone have experienced this. During a "flare-up," the cortisone crystallizes in the joint, causing a lot of pain. Icing the area after the injection can reduce the “flare-up” within a day or two. The cause of this flare up is through the corticosteroids that are injected into the joint during the procedure. The corticosteroids can irritate the joint causing sever pain.
  • Bone Thinning or Death -  Repeated cortisone shots near bones can cause thinning of the bone (osteoporosis) or death of the bone (osteonecrosis)
  • Cushing’s Syndrome - Individuals who have high levels of cortisol being injected over a long period of time, face significant reactions associated with Cushing’s Syndrome. Increased bruising, weakness in bones, increased hair growth, and infertility are among the symptoms associated with Cushing’s Syndrome
  • Increased Blood Sugar - Diabetics should be closely watched for a day or two after a cortisone injection, as the cortisone can increase blood sugar
  • Headaches - Although rare, painful headaches may occur 



With these side effects in mind, individuals with joint disorders should exercise extreme caution when considering cortisone injections. This is especially true for chronic joint problems.The risk of side effects greatly outweighs the benefits of the cortisone injections. And, when you factor in that they do nothing to cure the problem, it sets the individual up on a cycle of injections that will have long-term damaging effects.


Alternative Treatments

There are other alternative treatments that have minimal side effects:

  • PRP Injections - Platelet Rich Plasma Therapy has helped individuals with chronic pain and osteoarthritis. A small amount of the individual's blood is taken and placed in a centrifuge to separate out the platelets. These Platelet Rich Plasma cells are re-injected into the affected joint area and stimulate repair of the damaged tissue
  • Stem Cell Therapy - New adult stem cells are taken from the patient’s own fat deposits, usually around the stomach or hip, spun in a centrifuge and re-injected into the area where tissue damage is present. The new cells help to heal and stimulate the growth of new tissue at the injured site. There are little to no side effects associated with stem cell therapy
  • ViscosupplementationUsing image guidance technology, a lubricated gel is injected in between rubbing bones. A successful round of Viscosupplementation treatment should reduce the pain completely. However, the effects of the injected gel substance do not last forever. You may need additional treatment regimens
  • Medical Ozone Therapy - This therapy is a homeopathic anti-inflammatory treatment that is injected into the injured area. After the injection, the area is medicated with minerals and vitamins to accelerate the healing process. Lastly, oxygen, in the form of ozone, is gradually introduced to the injured area. This helps the damaged tissues get what is needed for healing.



If you are currently receiving cortisone shots or have a doctor that is recommending them, you should get a second opinion. Doctors who only offer cortisone injections often do so because they don’t perform the alternative pain treatments. A second opinion is always a wise course of action, so why not get one from a doctor who does offer the alternative treatments. Your long-term health and quality of life could depend on it.

stem cell therapy

As with any form of medical treatment, you should consult with your physician before embarking on any treatment plan. The information contained in this article is for informational purposes only and should not be deemed accurate for the purposes of diagnosing your particular medical condition.


Dr. Richard Rowley

Richard, a board certified Chiropractor has been with SoCal Regenerative Medical Clinic since 2011. His passion for regenerative medicine and getting patients better has been experienced by the 1000’s of people he has advised. With a young family most of his free time is spent enjoying his children, but when he can, he likes to sneak out for a weekend ride on his road bike.

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