Jenny L. F. Andrus, MD
Chronic pain is a common and often debilitating condition that can significantly impact a person’s quality of life. It is defined as pain that lasts longer than three months and can be caused by a wide range of conditions, such as arthritis, nerve damage, or injury. While there are many treatments available for chronic pain, cortisone injections are a common intervention due to their effectiveness in reducing pain and inflammation. While there are some risks associated with their use, they can be a valuable tool in managing chronic pain and improving quality of life for many patients. It is important to discuss the potential benefits and risks of cortisone injections with me before we move forward with treatment.
Cortisone is a type of steroid hormone that is naturally produced by the adrenal gland. It is involved in regulating the body’s response to stress and inflammation. It has potent anti-inflammatory properties and is used to treat a variety of inflammatory conditions. In a cortisone injection, a synthetic version of the hormone is injected directly into the affected area to help reduce inflammation and relieve pain. Cortisone injections are commonly used to treat conditions such as arthritis, bursitis, tendonitis, and back or limb pain caused by sciatica or herniated discs due to mechanical or neuropathic spinal issues.
The use of cortisone injections as an interventional treatment for chronic pain has been well documented in clinical research. Studies have shown that cortisone injections can significantly reduce pain and improve function in patients with a wide range of conditions. For example, a 2015 systematic review and meta-analysis of 39 randomized controlled trials found that cortisone injections were effective in reducing pain and improving function in patients with knee osteoarthritis.
Cortisone injections can be administered in a variety of ways, depending on the location and severity of the pain. They can be given directly into a joint, such as the knee or shoulder, or into soft tissues, such as tendons or ligaments. The injection itself can be performed under local anesthesia, which helps to minimize discomfort. At OSC, for joint injections we use ultrasound to guide us to just the right spot within the joint capsule. For injections into the epidural space of the spine, we use live x-ray, called fluoroscopy, and contrast agent, to guide us to the specific pain generator.
The procedure for a cortisone injection is relatively simple. The patient is positioned to allow access to the affected area, and the skin is sterilized. The doctor then inserts a needle into the affected area and injects the cortisone. The procedure is usually done under cold spray or local anesthesia, and the patient goes home shortly thereafter.
The duration of pain relief provided by cortisone injections can vary, depending on the individual patient and the condition being treated. In some cases, patients may experience significant pain relief for several months, while in others, the effect may only last a few weeks. In general, cortisone injections are most effective when used in conjunction with other treatments, such as physical therapy or medication. However, cortisone injections are not a cure for chronic pain, and they may need to be repeated periodically to maintain pain relief.
While cortisone injections can be an effective intervention for chronic pain, there are risks associated with their use. Common side effects include pain and swelling at the injection site, as well as temporary increases in blood sugar levels. In rare cases, cortisone injections can also lead to more serious complications, such as infection, bleeding, nerve damage, or joint damage. However, these risks are relatively low, and most patients experience no complications from the procedure. For epidural steroid injections, we ask patients to remain in the waiting room for twenty minutes post-injection to ensure there are no allergic reactions to the medication.
While they are not a cure for chronic pain, cortisone injections can provide significant relief and improve quality of life for many patients. If you are experiencing chronic pain, talk to me about whether cortisone injections may be an appropriate treatment option for you.