16/01/2021 09:33
FAQ’S: CORTISONE INJECTIONS
WHAT DOES A CORTISONE INJECTION DO?
Cortisone can provide short-term pain relief, usually for up to a month. It does not improve joint function or stiffness. Cortisone suppresses the immune system, thus reducing inflammation and attendant pain and swelling at the site of the injury. Risks exist, in particular the long-term use of cortisone.
Simply put: Cortisone can help pain for a short time. Which might provide you a window to follow your exercises and movement rehabilitation.
SHOULD I HAVE A CORTISONE INJECTION?
A cortisone injection does not cure the condition but may provide a window of symptom relief via inflammation reduction.
This then allows pain free rehabilitation exercises to be performed, improving joint motion and muscle strength and function, which ultimately prevents the condition from recurring.
All cortisone injections should ideally be followed up with a exercise and rehab program including manual therapy and appropriate exercise prescription.
ARE CORTISONE INJECTIONS SAFE?
They mimic a natural hormone that your body releases in response to stress, but they can also affect your body’s blood sugar and blood pressure regulation and your immune system if overused.
Doing too many injections also risks damaging to other treated tissues, particularly tendons. Repeated use of cortisone for conditions like tendonitis has the potential to weaken the treated tendon permanently.
Tendons have the highest tensile strength of all our connective tissue, thanks to the high proportion of collagen in tendon fibers.
Cortisone works by shutting down collagen production in the tendon cells. As a result, when you get a cortisone shot, your tendon tissue stops making new collagen. Over time, repeated injections may weaken tendon tissue, and have even been known to cause tendon ruptures.
WHO CAN GIVE ME A CORTISONE INJECTION?
Cortisone injection administered in a doctor’s office or radiology clinic. The procedure involves several steps and typically takes less than 5 minutes. It may be mildly to moderately painful.
The injection is generally guided by medical imaging such as an ultrasound to make sure the cortisone gets injected in the correct location.
WHAT IS A CORTISONE INJECTION?
Cortisone treats inflammation and pain. It is a man-made version of a natural hormone called cortisol.
HOW LONG DOES A CORTISONE INJECTION LAST?
It will likely take 7-10 days to work.
Most surgeons currently recommend having injections at least three months apart and avoiding repeat injections within a short-time period.
WILL A CORTISONE INJECTION FIX MY PROBLEM?
Cortisone itself is not a pain medication. Instead, cortisone is an anti-inflammatory that works by preventing collagen production. The injection shuts down collagen-producing cells in the tendon or joint; this action suppresses inflammation and calms nerves, indirectly reducing pain.
It’s important to note that cortisone doesn’t actually heal the underlying problem triggering the inflammation.
HOW DOES A CORTISONE INJECTION WORK?
By reducing inflammation, a cortisone injection can alleviate pain, swelling, skin redness, and warmth over the joint. A cortisone injection will not necessarily treat the underlying condition.
WHAT CONDITIONS DOES A CORTISONE INJECTION FIX?
Cortisone reduces the inflammation associated with conditions such as osteoarthritis, tendonitis, bursitis, rheumatoid arthritis, and gout.
WHAT ARE THE BENEFITS OF A CORTISONE INJECTION?
Cortisone injections are useful in the treatment of various musculoskeletal conditions, particularly those of acute inflammation (such as acute bursitis), and degenerative joint and tendon conditions.
Pain management is the major benefit.
WHAT ARE THE SIDE EFFECTS OF CORTISONE INJECTION?
Local cortisone injections may cause some side-effects.
These would include:
- Systemic absorption. Care should be taken in diabetics as blood sugar levels may rise
- Infection – The medical literature suggests this occurs in less than 1:20,000 cases. It can be avoided by using a sterile ‘no touch’ technique with the needle and an alcohol swab
- Skin changes – Skin atrophy & pigment loss may occur around the injection site. This is generally a minor cosmetic problem and occurs in less than 1:100 patients
- Bleeding (especially if patient has a bleeding tendency)
- Neuritis – The cortisone may cause minor irritation to nerves if injected around them
- Frequent injections into the same area can cause the bone, ligaments and tendons to weaken over time.
WILL A CORTISONE INJECTION WORK FOR ME?
Will it work for you? It depends. There are plenty of treatment options before we start injecting things…
Have you tried everything possible?
Have you tried a 3-6 month strength and rehabilitation program?
Spoken to your GP, physio or chiro?
It is important the you have been compliant to the recommendation of your physio/chiro OR have you half assed with your REHAB?
WHAT CONDITIONS DO CORTISONE INJECTIONS TREAT?
- Pain relief. Cortisone injections provide excellent pain relief for short periods of time.
- Cortisone injections are an effective diagnostic tool that delivers rapid results. When cortisone is injected into a problem joint and relieves pain, it helps physicians to confirm the pain source.
- Arthritis flare-up treatment. When arthritis patients experience a painful flare-up, cortisone can help to quickly soothe the worst of the pain.
- Delay or eliminate joint replacement. Cortisone has a place in the treatment of elderly arthritis patients who need help coping with the pain of deteriorating joints. The pain relief provided by the injections can help to postpone or avoid joint surgery. However, as a maintenance treatment over a long period of time, cortisone has limitations.
WILL CORTISONE WEAKEN MY BONES AND MAKE ME FAT?
Taking oral cortisone (or prednisone) for long periods of time can certainly have side-effects.
These would include weight gain, osteoporosis, diabetes and high blood pressure. A small amount of cortisone is absorbed after an injection, but quickly cleared within 2-3 days.
WHAT ARE THE ALTERNATIVES TO IMPROVING MY JOINT PAIN?
At Auckland Health and Performance, we have a least invasive to most invasive policy. We start with conservative management with all conditions. If we can do it naturally with minimal intervention why not start there. Cortisone injections have their place in some conditions, but they are not a one trick pony which some people believe they are.
You generally have to do the work to get well.
As explained earlier in the article. Cortisone will help with inflammation for a time in most cases.
But does not help the tendon and ligaments reform.
Tendons respond to load. Which means they respond to the appropriately prescribed and consistently done resistance exercise.
Once we get pain managed. Then the answer is always in movement or improving how we move. Then getting that bit stronger and more injury resistant.
#better #stronger #fitter
BEFORE YOU TAKE THE SHOT, CONSIDER THESE TIPS THAT CAN IMPROVE YOUR JOINT HEALTH.
- Maintain your weight.
- Speak to your health professional.
- Keep moving – Within your comfort zone. Just walk. Stationary Cycle. Get 5 thousand steps a day.
- Keep stretching – 2-10 mins of yoga and deep breathing will make a big difference done consistently.
- Resistance training – Will help build muscle and reform collagen to support the joint
- Sleep – When you sleep well you heal.
- Stress – Happy hormones make healing faster.
- Water intake – 8 glasses to keep muscles nicely hydrated
- Reduce your sugar intake. Sugar can cause stiff joints when consumed in excess and feeds joint injections.
- Eliminate any foods that affect your immune response. A blood test can help identify some of the foods you may be sensitive to, while your body will signal other inflammation triggers such as fried foods, processed meats, or refined grains.
- Maintain good digestive function. Your body needs a sufficient amount of enzymes to properly break down food and fight both infection and autoimmune disease. You can heal your digestive function with food-based enzymes that include fermented foods (e.g., pickles, sauerkraut,), pineapple, papaya, avocado, raw honey, coconut oil, and raw dairy.
I hoped this helped
Dr Kylie
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