Cortisone injections are used for therapeutic treatment in reducing inflammation and pain in an area of need. Cortisone injections can be an effective form of treatment when treating a number of conditions including, but not limited to conditions such as back pain, bursitis, osteoarthritis, tendinitis and other forms of joint related pain and discomfort.
Sometimes it can be difficult to determine where pain originates from. In these instances, they can be used to confirm or exclude a suspected joint/region being the cause of the pain or contributing to the pain.
Every patient reacts differently to the cortisone injection. The outcome of this depends on the treatment area, the patient, and how often cortisone injections are required.
If you have not had a prior ultrasound, an expert musculo-skeletal Sonographer or Dr Berman (specialist musculo-skeletal radiologist) will usually start by taking a history, examining the painful area and scanning the area of concern.
Once the region of discomfort is identified the procedure is performed. The skin is cleaned with an antiseptic agent. Then under ultrasound control, the area of concern will be injected with a combination of steroid and local anaesthetic mixed together in a single syringe. Depending on the region to be treated, an initial injection of local anaesthetic into the skin and subcutaneous tissues will be performed first.
Overall, most patients experience minimal discomfort throughout the injection. However, the degree of discomfort during the injection varies depending on a number of factors such as the area to be injected, degree of inflammation in the area, number of injections required (usually one), previous experiences with injections and whether or not the patient has a fear of needles.
There can also be a slight increase in pain in the injected area for a day or two afterwards. This usually occurs once the local anaesthetic has started to wear off, but the steroids have not yet had time to work. This discomfort is usually mild and is helped with the use of analgesia (such as Ibuprofen and Paracetamol) and cold packs.
Usually it takes 2-3 days for the steroids to start taking effect. Patients will usually start to experience gradual improvements over 1-2 weeks, with the maximum effect at the 2-3 week mark. After the procedure what you will be able to do will depend on the area injected and reason for the treatment.
Light duties and limited exercise will be recommended for about a week. This will be discussed at the time of treatment or you may be referred back to your referring medical practitioner for appropriate aftercare. If you have any questions or concerns after treatment please contact Dr Berman or your referring doctor.
The response to treatment varies from patient to patient and depends on several factors including: the body part injected, background problems such as local inflammation in an otherwise normal joint versus a flare-up of an arthritic joint. Overall this can be a very effective treatment. This improvement can be quite dramatic in many cases.
The typically used is CELESTONE CHRONODOSE or DEXAMETHASONE (occasionally other agents such as Kenocort are used depending on different doctor’s preference). These are not “anabolic” agents. Their use in sport is permitted as long as they are not injected systemically (i.e. not intramuscular, intravenous, rectally or orally).
For most patients the injection procedure is usually well tolerated and adverse reactions are rare. However, there are several risks and side effects to be aware of which include:
Download a Patient Information Brochure
Patient Fact Sheet on Steroids/Cortisone