Cortisone shots are injections that may help relieve pain and inflammation in a specific area of your body. Cortisone shots are most commonly given into joints — such as your ankle, elbow, hip, knee, shoulder, spine and wrist. Even the small joints in your hands and feet may benefit from cortisone shots.

Cortisone shots usually include a corticosteroid medication and a local anesthetic. In many cases, cortisone shots can be administered in your doctor's office. However, the number of cortisone shots you can receive in one year generally is limited because of potential side effects from the medication.

Cortisone shots may be part of treatment for a number of diseases and conditions, including:

  • Baker's cyst
  • Bursitis
  • Carpal tunnel syndrome
  • Chondromalacia patella
  • De Quervain's tenosynovitis
  • Frozen shoulder
  • Gout
  • Juvenile rheumatoid arthritis
  • Lupus
  • Morton's neuroma
  • Myofascial pain syndrome
  • Osteoarthritis
  • Plantar fasciitis
  • Psoriatic arthritis
  • Reactive arthritis
  • Rheumatoid arthritis
  • Rotator cuff injury
  • Sarcoidosis
  • Tendinitis
  • Tennis elbow

Cortisone shots carry a risk of complications, such as:

  • Death of nearby bone (osteonecrosis)
  • Joint infection
  • Nerve damage
  • Thinning of skin and soft tissue around the injection site
  • Temporary flare of pain and inflammation in the joint
  • Tendon weakening or rupture
  • Thinning of nearby bone (osteoporosis)
  • Whitening or lightening of the skin around the injection site

Limits on the number of cortisone shots

There's some concern that repeated use of cortisone shots may cause deterioration of the cartilage within a joint. For this reason, doctors typically limit the number of cortisone shots into a joint. In general, cortisone injections should not be given more often than every six weeks and usually not more than three or four times a year.

If you take blood thinners, you may need to stop taking these medications for several days before your cortisone shot, to reduce your risk of bleeding or bruising. Some dietary supplements also have a blood-thinning effect. Your family doctor can help coordinate what medications and supplements you should avoid before your cortisone shot.

Your doctor may ask you to remove your clothing and change into a gown. You'll then be positioned in a way that allows your doctor to most easily insert the needle.

The area around the injection site is cleaned. Your doctor may also apply an anesthetic spray to numb the area where the needle will be inserted. In some cases, your doctor may use ultrasound or a type of X-ray called fluoroscopy to watch the needle's progress inside your body — so it will be placed in exactly the right spot.

You'll likely feel some pressure when the needle is inserted. Let your doctor know if you're uncomfortable.

The medication is then released into the injection site. Typically, cortisone shots include a corticosteroid medication to relieve pain and inflammation over time and an anesthetic to provide immediate pain relief.

After the cortisone shot

Some people experience redness and a feeling of warmth of the chest and face after receiving a cortisone shot. If you have diabetes, a cortisone shot might temporarily increase your blood sugar levels.

After your cortisone shot, your doctor may ask that you:

  • Protect the injection area for a day or two. For instance, if you received a cortisone shot in your shoulder, avoid heavy lifting. If you received a cortisone shot in your knee, stay off your feet when you can.
  • Apply ice to the injection site as needed to relieve pain.
  • Watch for signs of infection, including increasing pain, redness and swelling that last more than 48 hours.

Results of cortisone shots typically depend on the reason for the treatment. Cortisone shots commonly cause a temporary flare in pain and inflammation for up to 48 hours after the injection. After that, you should experience decreased pain and inflammation at the injection site.

Aug. 13, 2013