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 will tell you that their doctor has given them cortisone shots.
They will also tell you that while the shots may have worked for a short time, the pain they experienced in between shots was 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, they do absolutely nothing to solve the problem of the condition or injury. So, a person getting these shots is going to go through the roller coaster of having pain, getting a shot, have pain ease, have pain come back, get another shot, and so on.
One thing people don’t realize is that cortisone decreases its effectiveness with continued use. Patients receiving several cortisone shots may see little benefit at all from receiving additional injections, but receive all of the side effects.
What Are Cortisone Shots?
Cortisone is a synthetic version of cortisol, a steroid produced by the body’s adrenal glands. In large quantities, cortisol suppresses the immune system’s inflammatory and allergic responses. Cortisone medications mimic the action of cortisol but tend to be more powerful.
Cortisone shots may help relieve inflammation and pain in a specific area of your body. They are most commonly injected into joints — such as your ankle, elbow, hip, knee, shoulder, spine and wrist. Even the small joints in your hands and feet might benefit from cortisone shots.
Two examples of injectable cortisone are triamcinolone and betamethasone, both of which are sold under different brand names.
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:
- Psoriatic Arthritis
- 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 shots carry risk factors, particularly that they might cause the cartilage of the joint to deteriorate. So, doctors usually limit injections to no more than 3 times per year.
Given this limitation, you can understand how people may experience pain in between shots.
Side Effects of Cortisone Shots
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. This can affect your soft tissue and hard tissue.
- Cortisone flare – 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 severe 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. This would be considered a long term effect of cortisone shots.
- 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.
- Pain After Cortisone Injection- some people may experience pain in the area that they got the cortisone injection in.
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.
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 having with stem cell therapy.
- Viscosupplementation – Using 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.
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