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In many instances of shoulder bursitis, arthritis, tennis elbow, or carpal tunnel syndrome, cortisone shots are often a prescribed medication. But what is cortisone and how does it work?
Cortisone is a powerful anti-inflammatory medication, not a pain reliever. When pain is decreased from cortisone, it’s due to the inflammation being diminished. By injecting the cortisone into a particular area of inflammation, very high concentrations of the medication can be given while keeping potential side effects to a minimum. Cortisone injections usually work within a few days, and the effects can last up to several weeks.
Inflammation is an underlying problem of bursitis, arthritis, trigger finger, tennis elbow, and carpal tunnel syndrome, making them all amenable to cortisone shots. The shot can be slightly painful, especially when given into a joint, but in skilled hands, it usually is well tolerated.
Often the injection can be made with a very small needle causing little discomfort. Sometimes, a slightly larger needle must be used, especially if your doctor is attempting to remove fluid through the needle prior to injecting the cortisone. Numbing medication, such as Lidocaine or Marcaine, is often injected with the cortisone to provide temporary relief; topical anesthetics can help numb the skin in the injected area, too.
There can be side effects, the most common being “cortisone flare,” a condition where the injected cortisone crystallizes and causes a brief period of pain worse than before the shot. This usually lasts a day or two and is best treated by icing the injected area. Another common side effect is whitening of the skin at the point of injection. This is only a concern in people with darker skin and is not harmful, but patients should be aware of this so as not to be alarmed if it happens.
Other side effects of cortisone injections, although rare, can be quite serious. The most worrisome is infection, especially if the injection is given into a joint. The best prevention is careful injection technique, with sterilization of the skin using iodine and/or alcohol. Also, diabetic patients may have an increase in their blood sugar, which they should monitor.