Cortisone injections

Indications:  Cortisone injections are given to reduce pain and swelling caused by multiple inflammatory conditions such as bursitis, tendonitis, osteoarthritis, rheumatoid arthritis, and gout.

How it works: Cortisol is a hormone naturally produced by the adrenal gland to reduce the immune system’s response. Semi‐artificial derivatives including Celestone, Kenalog, and DepoMedrol are used to suppress inflammation.

Expectations: The corticosteroid is oftentimes given in combination with a local anesthetic such as Marcaine and Lidocaine. The anesthetic typically provides pain relief roughly 10 minutes after injection. This is temporary and will wear off in 4 to 8 hours after the injection. Generally the cortisone begins working in 2 to 3 days. Patients will often feel more pain the day after the injection once the anesthetic has worn off and before the cortisone has taken effect. Relief can range from a few weeks to several months, though it is unpredictable exactly how long the injection will provide relief.

Risks include local infection, irritation, or depigmentation at the injection sight. Patients with diabetes must watch their blood sugar levels and adjust their medications accordingly as the steroid can often elevate blood sugars for approximately 72 hours. There is a mild amount of systemic absorption though most of the medication stays fairly localized.

Call immediately if you notice redness or warmth at the injection sight.

Frequency of the injections varies depending on the site. For example oteoarthritic joints can typically be injected up to 4 times a year so long as the cortisone remains to be effective. Tendonopathies often tolerate less frequent injections as cortisone can weaken the tendons and ligaments with repeated use.