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Cortisone Steroid Injections

Cortisone Steroid Injections - Pros and Cons

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Updated January 13, 2011

Cortisone steroid injections are a common treatment for a variety of conditions in which inflammation causes pain, swelling and other problems. Glucocorticoids, particularily prednisone and cortisone, are used in injections for inflammation and pain. These hormones help reduce inflammation and pain in the body. Cortisone is the most well known injected steroid and it has a dramatic anti-inflammatory effect on tissues, particularly joints and tendons. This family of steroids is not the same thing as anabolic steroids, which are used to enhance muscular development, and are largely illegal in international athletic competition.

Glucocorticoids are thought to interfere with immune system processes that result in inflammation, but the exact method by which they do this isn't known. It is known that injections of glucocorticoids can target the area of pain and inflammation better and faster than pill form. Cortisone injections typically result in pain relief in a matter of days, and may last up to a month.

Conditions Treated by Steroid Injections Include

  • Tennis Elbow (Lateral Epicondylitis)
  • Golfer's Elbow (Medial Epicondylitis)
  • Joint pain of varying nature (Osteoarthritis)
  • Bursitis of the shoulder, hip or knee
  • Frozen shoulder
  • Plantar fasciitis
  • Carpal tunnel syndrome
  • Herniated disc and other back pain

Keep in mind that steroid injections can not cure any of these conditions. In fact, new research has found that corticosteroid injections may not be the best long-term solution for tennis elbow (lateral epicondylitis), even though they may ease the pain in the short term.

Corticosteroid injections are generally used as a last resort, after anti-inflammatories and physical therapy have been tried without success. Steroid injections may help with chronic, painful inflammation, but unless the underlying cause is determined and treated, injections will provide only temporary relief. If after a month you continue to experience pain, a second injection may be advised. More than three to four injections in a year in the same area of the body are not recommended, because glucocorticoids can result in the following potentially serious side effects:

  • Weight gain
  • High blood pressure
  • Cataracts
  • Diabetes
  • Puffiness in your face
  • Osteoporosis (thinning of the bones)
  • Reduced immunity and increased risk of infection
  • Long term joint and tendon damage
  • Ulcers

Side effects are more likely to occur with steroid pills than injections, but research indicates that as few as six injections per year can permanently damage a joint or cause risk of tendon rupture. Always consult with your physician regarding the proper use of the injections, and get a clear understanding of the long term and short term effects of the steroids before choosing this course of action.

Sources

Coombes, et al. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. The Lancet, Volume 376, Issue 9754, Pages 1751 - 1767, 20 November 2010

Jobe, et al. "Lateral and Medial Epicondylitis of the Elbow" J. Am. Acad. Ortho. Surg., Jan 1994; 2: 1 - 8.

Regan, et al. Tendinopathies around the elbow. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2009. . Accessed Jan, 2011

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