Give Me a Shot of Cortisone Doc

15 Jan Give Me a Shot of Cortisone Doc

Today a patient told me to just give him a cortisone injection in his knee and he’ll be good to go. This quick-fix attitude has certainly made practicing Orthopaedic Surgery quite challenging over the last 20 years. Cortisone has helped many of my patients, but it doesn’t come without risk and is a double-edged sword.

“Cortisone” is a group of medications that act as a powerful anti-inflammatory. It is not a pain reliever so if it makes you better after injecting into your joint, the inflammation was the cause of the pain.

Over the years I have always been very cautious about injections of cortisone. My hesitation and judicious use of cortisone have been recently validated by several research studies.

1. Recently it has been shown that the results and healing rates of rotator cuff repair are negatively affected by multiple cortisone injections prior to the surgery. This is something I have suspected for years and research now backs it up.

2. Studies have shown that with joint injections of cortisone within 3 months of joint replacement and hip arthroscopy, the risk of surgical infection is significantly increased.

3. Tennis elbow was traditionally treated with cortisone injections. I’m still shocked when I have patients come in who have had 6 or more shots and still they are in pain. Many studies have proven that cortisone does not alter the natural history of tennis elbow. In addition, multiple cortisone injections decrease the chance of surgery working if needed.

These are just many examples of how cortisone should be used wisely and with caution.

When you ask for a quick fix of cortisone realize that there is more to it than meets the eye.