Cortisone Injection FAQs

How long does it take a cortisone shot to take effect?

A cortisone shot usually takes two to seven days to come into effect. The effect is gradual in onset and it may take up to three weeks to show full effect by decreasing the inflammation. The effect of cortisone may last up to three months.

What I can expect after a cortisone shot?

After a cortisone shot, there may be worsening of pain after a few hours. The cortisone shot is mixed with some local anesthetic and, therefore, the pain is decreased for a few hours after the shot. To prevent worsening of pain after a cortisone shot, the patient should use ice as well as anti-inflammatory medications. The cortisone shot starts working in two to seven days and patient may need to take anti-inflammatory medications until the cortisone comes into effect.

How bad are cortisone shots for you?

Cortisone shots are very similar to the shots that a dentist gives for dental procedures. There is good relief for a few hours after a cortisone shot but the pain may worsen for the next 24-48 hours and the patient should use ice as well as anti-inflammatory medications until the cortisone starts working in two to seven days.

Do cortisone shots make you gain weight?

Cortisone shots, as compared to oral steroids, do not cause weight gain as they act locally, and a very small amount of the cortisone is absorbed systemically. If used in high amounts or too frequently, then they may also cause systemic effects as oral steroids.

How many times can you get a cortisone shot?

A cortisone shot at a specific site can be given almost every three months to a max of three to four per year. The cortisone shots also have some detrimental effect on the joints and the tendons and, hence, should not be given more frequent than three months. There are certain other risks associated with a cortisone shot.

What are the side effects of taking cortisone shots?

Cortisone shots can cause systemic effects due to absorption which are usually minimal after a single shot. The cortisone shot also increased the chances of infection by decreasing the immunity locally and may be detrimental in immunocompromised patients. Cortisone injection also cause transient increase in blood sugar levels. Patients with diabetes must keep a close watch on their blood sugar levels and may have to consult their PCP.

What kind of doctors give a cortisone shot?

A cortisone can be given by a primary physician, pain physician, rheumatologist, orthopedic surgeon, sports physician, sports surgeon and many other specialties. It depends on the training of the physician as well as the complexity of the injection.

Can a cortisone shot help a torn meniscus?

A cortisone shot can help decrease the inflammation and pain caused by a torn meniscus. A cortisone shot usually does not help in healing of the meniscus and, hence, does not improve any mechanical symptoms. If a meniscus is repairable, then a cortisone shot is not preferred as it may impair healing of the meniscus.

What does a cortisone shot do to a bursitis?

Cortisone shot helps in decreasing the inflammation and, hence, decreasing the pain caused by the bursitis. It may give a long enough effect which may be helped with physical therapy or modification in activities to be lasting long enough to not require another form of treatment.

What are the conditions of the knee where a cortisone injection can be given?

The most common indication for cortisone injection in the knee joint is arthritis. It is usually given to provide relief from pain and swelling. Before giving cortisone injection, other associated pathologies should be ruled out. Patients who have early arthritis get good results which may last longer. In patients who have longstanding arthritis or advanced osteoarthritis, cortisone injection is given if they are not ready for joint replacement surgery in the near future.

A cortisone injection for arthritis should not be given within three months of a joint replacement surgery. Other indications for cortisone injection in the knee joint are patellofemoral pain or syndrome, nonoperative treatment of meniscus tear, synovitis, conservative treatment of Plica syndrome, prepatellar, infrapatellar and pes anserine bursitis, chondral damage to the knee joint, etc.

What are the conditions of the shoulder where a cortisone injection can be given?

A cortisone injection can be given in various conditions of shoulder. Most common condition is rotator cuff tendonitis in which there is inflammation of the rotator cuff. This helps in decreasing inflammation, pain and swelling and helps in rehabilitation, regaining strength and range of motion. Partial and complete rotator cuff tears can also be treated with cortisone injection leading to pain relief, with no effect on the tear itself, if surgical treatment is not opted for.

A cortisone injection should not be given within two to three months of a rotator cuff repair surgery. Frequent and too many cortisone injections can be detrimental to the rotator duff especially in the presence of tear, and also to the joint. Cortisone injection can also be used for acromioclavicular arthritis, impingement syndrome, shoulder arthritis, biceps tendonitis, etc.

What are the conditions of the elbow where a cortisone injection can be given?

Cortisone injection can be used for lateral and medial epicondylitis of the elbow. It can also be used for arthritis of the elbow joint.

What is a bone stimulator used for?

A bone stimulator is used for promoting healing or union of the bone with or without surgical intervention. This is specifically used in patients who have low healing potentials usually due to systemic problems which lead to decrease blood supply to the fracture area.

Which stress fractures are potentially serious?

Stress fractures which are at high risk of displacement are potentially serious. These involve stress fracture of the neck of the humerus, neck of the femur, stress fracture in tibia, if untreated and becomes complete may also require surgical intervention. Stress fracture of the fifth metatarsal base called Jones fracture also may require surgical treatment if it is displaced.

If x-rays often do not show stress fractures, so why should I get x-rays?

X-rays are the primary modality to screen for fractures. They are done to rule out frank fracture or break in the bone as well as any other pathology in the bone. If they are normal, then further radiological investigation in the form of MRI or CT can be done to confirm or rule out a stress fracture.

What is an insufficiency fracture?

Insufficiency fracture also known as a stress fracture is caused by repetitive microtrauma to a specific part of the bone. The patients with decreased vitamin D or calcium in the body are at higher predisposition for such fractures.

Is Jones fracture a stress fracture?

Jones fracture is a stress fracture usually caused in athletes due to repetitive microtrauma in the base of the fifth metatarsal.

Why does it take so long for a Jones fracture to heal?

A Jones fracture is present in area with decreased blood supply and therefore good opposition as well as rest is required for healing. If the bones at the Jones fracture site are not opposed well, then the patient may require surgical intervention to compress the bones together and allow early healing.

What is metatarsal stress fracture?

Metatarsal stress fracture means stress fracture of the rays of the toes. These are usually present in the patients who have repetitive stress on these bones like in runners.

How do you detect a stress fracture?

Stress fractures are usually diagnosed with radiological imaging like x-rays. Occasionally if the suspicion is high and the x-rays are normal, then an MRI may be helpful in the diagnosis of stress fracture.

Do stress fractures hurt to touch?

Stress fractures and any other fractures are tender and hurt to touch at the area of the fracture. It may also be associated with redness, swelling and weakness.

What likely causes a stress fracture?

Stress fractures are caused due to microtrauma with repetitive activities. The general systemic disorders like hypovitaminosis D may be contributory to the stress fracture.

Can you walk with the stress fracture in the foot?

The patients are usually able to walk with stress fracture in the foot. These patients usually develop this fracture over a period and initially may have soreness which worsens over time and with activity.

How do stress fractures feel?

Stress fractures as opposed to complete fracture do not present with sudden onset of deformity or pain. They usually present with soreness, with worsening pain especially after activities. They may be associated with swelling. The patients with stress fractures usually have point tenderness at a specific spot where the fracture lies.

Do stress fractures heal on their own?

Most of the stress fractures are usually treated conservatively with rest, bracing along with anti-inflammatory medications and calcium and vitamin D. These fractures usually heal well over a span of 8 to 12 weeks and lead to complete resolution of symptoms. The patients are also asked to avoid activities that worsen the pain or may risk their stress fractures to become a complete fracture.

These questions have been personally answered by:

I am Vedant Vaksha, Fellowship trained Spine, Sports and Arthroscopic Surgeon at Complete Orthopedics. I take care of patients with ailments of the neck, back, shoulder, knee, elbow and ankle. I personally approve this content, and have written most of it myself.