Cortisone shots are commonly used to treat pain and inflammation in various joints such as the knees, hips, shoulders, elbows, and ankles. They provide quick pain relief by reducing inflammation, but the effects are temporary. Here is an in-depth look at whether cortisone shots offer a permanent solution.
What is a Cortisone Shot?
A cortisone shot, also known as a steroid shot, involves injecting a synthetic corticosteroid into the affected joint. The corticosteroid resembles the effects of the hormone cortisol, which is produced naturally in the body. When injected into the joint, cortisone can provide powerful anti-inflammatory effects and pain relief.
Cortisone shots are used to treat a variety of conditions including:
- Arthritis – osteoarthritis, rheumatoid arthritis
- Bursitis – inflamed fluid-filled sacs between bone and soft tissue
- Tendinitis – inflamed tendons
- Carpal tunnel syndrome
- Trigger finger
- Plantar fasciitis – heel pain
- Tennis elbow
- Golfer’s elbow
- Rotator cuff injuries
The fast-acting anti-inflammatory effects make cortisone an appealing treatment option when other conservative treatments like rest, ice, compression, medication, or physical therapy have not provided sufficient relief.
How do Cortisone Shots Work?
Cortisone shots work by delivering a high concentration of corticosteroid directly into the inflamed tissue. This helps to:
- Reduce inflammation – corticosteroids suppress the immune response and inflammatory processes.
- Relieve pain – by reducing inflammation, cortisone shots can ease pain.
- Decrease swelling – the powerful anti-inflammatory effects also help decrease swelling.
Many patients experience nearly instant pain relief from a cortisone shot. The effects are often felt within a few hours, though maximum results can take up to a week. Some doctors recommend resting the joint for 1-2 days after the shot.
Are the Effects Permanent?
While cortisone shots can provide rapid and dramatic pain relief, the effects are temporary. They do not address the underlying cause of the pain and inflammation. Once the corticosteroid medication wears off, symptoms generally return.
Most doctors recommend spacing cortisone injections at least 4-6 weeks apart to avoid side effects. The duration of pain relief varies by individual and which joint is injected, but typically ranges from 1-6 months:
| Joint | Average Duration of Relief |
|---|---|
| Knee | 1-4 months |
| Shoulder | 2-6 months |
| Hip | 3-4 months |
| Thumb | 1-2 months |
| Ankle | 1-3 months |
Repeated cortisone injections may have diminishing returns and provide shorter pain relief each time. They do not stop the progression of underlying conditions like osteoarthritis.
Benefits of Cortisone Shots
When used appropriately, the benefits of cortisone shots include:
- Fast pain relief – Patients often experience a rapid reduction in pain and inflammation.
- Improve function – By providing temporary pain relief, cortisone shots can help resume normal activities.
- Delay surgery – In some cases, cortisone shots can delay or eliminate the need for joint surgery.
- Well tolerated – Cortisone shots are generally very safe and well tolerated when proper precautions are taken.
For some patients, the temporary pain relief from repeated cortisone injections may be sufficient to manage their symptoms long term. Using cortisone shots along with other treatments can provide lasting relief in some cases.
Risks and Side Effects
Cortisone shots are generally safe when used judiciously, but potential side effects include:
- Increased pain – Some patients experience a cortisone flare reaction with worsening pain for 2-3 days before improving.
- Infection – Rarely, introduction of bacteria into the joint can cause a serious infection.
- Nerve damage – There is a small risk of damage to nerves around the injection site.
- Tendon weakening – Repeated injections can weaken nearby tendons and increase the risk of rupture.
- Thinning cartilage – Cortisone may thin out joint cartilage with repeated use.
- Skin issues – There may be thinning/lightening of the skin and soft tissue at the injection site.
Doctors usually recommend spacing out cortisone injections and limiting the number per year to minimize complications. Proper injection technique helps reduce the risk of side effects.
Cortisone Alternatives for Pain Relief
Other conservative treatment options may provide more sustained relief of joint pain. Alternatives to discuss with your doctor include:
- Rest/ice/compression
- Activity modification
- Physical therapy
- Supportive devices – braces, tape, sleeves
- Topical pain relievers
- Oral anti-inflammatory medication
- Joint lubrication injections
- PRP (platelet-rich plasma) injections
- Stem cell therapy
Treatment plans will vary depending on the joint involved and severity of damage. A combination approach is often most effective. Maintaining a healthy weight and building muscle strength around the joint can also minimize pain.
Are There Any Permanent Solutions?
For severe joint damage, surgery may offer a more permanent solution. Surgical options include:
- Joint repair – Scopes can repair torn cartilage and remove loose bodies causing inflammation.
- Osteotomy – The joint is realigned to shift pressure away from damaged cartilage.
- Joint replacement – Damaged joint surfaces are replaced with artificial components.
- Joint fusion – Bones are fused together with rods/screws to eliminate painful motion.
Surgery can relieve pain and restore function in badly damaged joints. It is usually reserved for those who do not get sufficient relief from conservative treatments. The benefits must be carefully weighed against the risks of surgery for each individual.
Conclusion
While cortisone shots can offer rapid short-term relief of joint pain, they do not provide a permanent solution. The pain relief is temporary, lasting from 1-6 months typically before wearing off. Cortisone does not address the underlying structural damage causing the pain.
For some patients, repeated cortisone injections combined with other conservative treatments may manage symptoms long term. But often joint pain is progressive, eventually requiring surgical solutions like joint replacement or fusion for permanent pain relief. Discuss all your treatment options with your doctor to develop the best plan for your individual needs.