Michael Huang, MD
One of the most frequent topics that come up in office visits involve cortisone injections, aka steroid injections. Cortisone is the term we use to describe a group of medications called corticosteroids. Some examples include prednisone, methylprednisolone, betamethason, triamcinolone, etc.
In orthopaedics, we use these medications frequently in joint injections and bursa injections. The typical purpose is to decrease the inflammation in a local area. Occasionally, an oral corticosteroid may be prescribed to address systemwide inflammation.
In my practice, we encounter patients with significant joint related pain. Common diagnosis include osteoarthritis, rheumatoid arthritis, bursitis of the hip/knee/shoulder, tendonitis. Once a diagnosis has been made, we often have a long discussion with the patient regarding their treatment options. Many patients are not interested and frankly, not ready for any type of surgical intervention so we often focus on conservative or non-surgical treatments. These include anti-inflammatories (non-steroidal anti-inflammatory medications, physical therapy, activity modification, physical therapy, and injections.
Injections can include cortisone, visco-supplementation (hyaluronic acid), biologic injections (i.e. platelet rich plasma). Each of these types of injections brings something unique to the patient. Cortisone is one of the most effective ways to combat inflammation. A painful, swollen joint is, by definition, inflamed and if one can administer cortisone to that area, the patient will usually receive significant pain relief for some period of time. It is important to understand that a cortisone injection is often not a “cure” for the problem. For instance, if the underlying diagnosis is arthritis, the cortisone injection will help reduce the inflammation in the joint but does not change the arthritis itself. That means that eventually, the cortisone that was injected will be consumed and the inflammation may come back. So, it is not unusual to have patients come back and request repeat injections. I will address the safety of repeated cortisone injections in another post.