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Should I Get a Steroid Injection?

September 19, 2017

Cortisone Injections: What are they?

Cortisone, also known as corticosteroid, shots are injections that may help relieve Inflammation and associated pain in various parts of the body. They're most commonly injected into joints-- such as your ankle, elbow, hip, knee, spine, wrist as well as shoulder. Even inflammation in the small joints of the hands and feet might benefit from corticosteroid shots. When these injections are given, your doctor will often use image guidance like ultrasound or fluoroscopy to make sure that the needle is in the correct position before injecting the medication.

What Kind of Medication is Used?

The medication injected usually includes a local anesthetic like Xylocaine or Sensorcaine along with a corticosteroid such as triamcinolone, Depo-Medrol, or dexamethasone. Corticosteroid injections are usually performed in an office setting if they are in peripheral joints such as the ankle, elbow, hip, knee, or shoulder. Injections in smaller joints such as wrists, ankles, fingers, and toes are also usually performed in an office setting. Corticosteroid injections of deeper structures such as the spine may be performed in a specialized procedure suite in an office or may be performed in a hospital or an ambulatory surgery setting.

What Can I Expect?

In most cases, your doctor will numb the area of the injection prior to injecting the corticosteroid. This is particularly true if the injected steroid is composed of suspended crystals as in the case of Depo-Medrol or triamcinolone. However, if a particle free formulation such as dexamethasone is used, your doctor may be able to use a very thin needle that is much less painful and may not require the discomfort of an injection for local anesthetic.

How Many Steroid Injections Can I Have?

There is usually a limit on the number of corticosteroid injections you can receive in one year because of potential side effects of receiving too much corticosteroid medication. Your doctor can assess the risks and recommend appropriate dosages. However, recent research has indicated that beneficial effects of corticosteroid injections in some parts of the body can be obtained with much lower dosages than we had previously thought.
Some of the conditions that corticosteroid injections can be helpful for include herniated discs, rheumatoid arthritis, tendinitis, bursitis, gout, carpal tunnel syndrome, and plantar fasciitis. In addition to these problems, steroid injections have been used to treat many other inflammatory conditions.

What Are Some of the Risks Associated with Steroid Injections?

Corticosteroid injections, however, are not without risk. Some of the potential side effects or complications of these injections include:

  • Bleeding
  • Infection
  • Steroid flare (temporary flareup in pain at the site of the injection)
  • Thinning or weakening of bone (Osteopenia or Osteoporosis)
  • Color changes in the skin around the site of the injection.
  • Osteonecrosis or death of bone
  • Elevations in blood glucose
  • Temporary decrease in immunity from infection

As a general rule, you shouldn't obtain cortisone injections more than three or four times a year.  The main limitation is the total dose of corticosteroid per year.  Your doctor can advise you on the current recommendations.

The area around the injection site is cleaned up. Your medical professional could additionally apply an anesthetic spray to numb the area where the needle will be placed. In many cases, your doctor could use ultrasound or a kind of X-ray called fluoroscopy to see the needle's progression into the targeted structure-- to assure it in the ideal place.

You'll likely feel some pressure when the needle is inserted. If you have a lot of discomfort, let your physician know.

The medication is then injected. Generally, cortisone shots consist of a corticosteroid medicine to alleviate pain and inflammation gradually and also an anesthetic to supply prompt pain alleviation.

After the cortisone shot.

Some individuals have soreness and also a sensation of warmth of the upper body and also face after a cortisone shot. A cortisone shot might raise your blood sugar levels if you have diabetics issues.

Outcomes of cortisone shots generally depend on the reason for the treatment. Cortisone shots commonly create a short-term flare hurting and inflammation for as much as 2 days after the injection. Afterwards, your pain and also inflammation of the affected joint will likely reduce and the relief could last several months.

References/Additional Resources:

Should You Get a Cortisone Steroid Shot? - Arthritis-health

Cortisone shots - Overview - Mayo Clinic

Q&A: Can Cortisone Injections Ease My Joint Pain? – Health ...

 

About the Author

Dr. John B. Adams is board certified in Pain Management by the American Board of Medical Specialties and the American Board of Interventional Pain Physicians. With almost 2 decades of experience, he offers patients access to state-of-the-art pain management, emphasizing a multidisciplinary approach to pain management utilizing precision injections, neuromodulation technology, physical therapy, behavioral medicine and judicious use of medications including help with patients titrating off opiates (narcotic pain medications).

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