Cortisone injections, are they good? Are they bad? When should you get it? In this episode of the Move More podcast powered by Omega Sports, Dr. Scott Jablonka (Carolina Movement Doc) wants to clear the air and answer some of the most commonly asked questions about cortisone injections.
This is not meant to be taken as medical advice as Dr. Scott Jablonka is not your medical doctor; his intention is to educate and guide you through the different options when it comes to pain and inflammation.
Listen to Dr. Scott Jablonka full episode on The Omega Sports Move More Podcast.
Cortisone, what is it?
Cortisone is a specific injection meant for a specific part of your body to help alleviate pain and inflammation. Cortisone is made up of a cortisone steroid and some form of anesthetic, like lidocaine, for example. Problem areas for relief usually include major joints like ankles, shoulders, hip, spine, knee, and spine. It also helps treat stuff like osteoarthritis, rheumatoid arthritis (on occasion), bursitis, and any general non-specific back pain. With the cortisone injection, patients will feel relief almost immediately; at least that is what it is designed for.
Generally speaking, doctors won’t administer more than three injections a year, although there are patients who may request the injection every six weeks. Yet, it is not recommended because cortisone has a metabolic effect. What does that mean exactly? It means it can eat away at tissue, and not just bad tissue but good tissue as well. Some of the side effects include the possibility of joint infection, temporary flare-up, tendon damage, and a sudden sharp increase in blood sugar. For patients who are diabetic, it is imperative that they absorb as much information as possible and visit other avenues of treatment before considering getting the injection.
That being said, does it work? Absolutely it does! If cared for properly, effects can last up to several months, if not on a permanent basis. Cortisone is often labeled as a miracle drug, and in many ways, it is, though it’s important to recognize that it is more like an opportunity than a cure.
Now is it bad? The simplest way to answer this would be yes and no. Cortisone is meant to be more of a Band-Aid so that you can address the issue that is causing the pain so you don’t ever have to come back.
Cortisone research
In a 2017 study done by the Journal of Orthopaedic & Sports Physical Therapy, “Dry Needling Versus Cortisone Injection in the Treatment of Greater Trochanteric Pain Syndrome: A Noninferiority Randomized Clinical Trial”, the study found that there was no significant difference between dry needling and cortisone injections.
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Dr. Jablonka being a fan of dry needling himself raises the question of how many needling sessions had to be done to reach the desired effect. This is not to say one is better than the other, as both show to have the same benefits. Rather, it is important to look at it from all angles.
The study also mentions osteoarthritis and whether it is safe. And the answer is yes when administered in high sterile environments though there is no comment on the longevity of it, which ideally is what we are aiming for.
Are there alternatives to cortisone injections?
Say you injure yourself, and you go to a general practitioner. Most of the time, the doctor will prescribe ibuprofen and may even administer a cortisone injection. After your doctor visit, if not treated correctly, most often the pain will remain or come back, which means that the next step is to see a specialist.
While at the specialist, they will most likely perform an MRI that will show inflammation and then you will be diagnosed with arthritis. Keep in mind that in between doctor visits are weeks of waiting time, where you are experiencing pain and discomfort.
After your diagnosis from the specialist comes physical therapy, and by this time, the patient is often fed up and wants a quick and easy fix. But with physical therapy comes commitment and consistency. While it is understandable to want a hit of cortisone to relieve the pain, visiting a physical therapist first could have avoided weeks of pain. Instead of coming back every three months to request the injection, it’s best to deal with the root cause and stop it on its track.
Does Dr. Jablonka recommend cortisone injections?
Yes, to an extent. There is no opposition to getting the injection if you have not had one before, but only after visiting the physical therapy route. What we are looking for is longevity and education, if you wish to have it done multiple times a year.
Want more movement tips from Dr. Scott Jablonka? Listen to older episodes of our Move More Podcast.
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