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Risks
By Mayo Clinic staffCortisone shots carry a risk of complications, such as:
- Death of nearby bone (osteonecrosis)
- Joint infection
- Nerve damage
- Skin and soft tissue thinning around 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 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 in a joint. The limit varies depending on the joint and the reason for treatment. In general, people with osteoarthritis or other noninflammatory conditions may be limited to four total cortisone shots per joint. People with rheumatoid arthritis may be limited to three or four cortisone shot per joint per year.
References
- Intraarticular and soft tissue injections: What agent(s) to inject and how frequently? http://www.uptodate.com/home/index.html. Accessed Sept. 9, 2010.
- Wise CM. Arthrocentesis and injection of joints and soft tissue. In: Firestein GS, et al. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa.: W.B. Saunders; 2008. http://www.mdconsult.com/das/book/body/217997889-3/1050729258/1807/345.html. Accessed Sept. 9, 2010.
- Schumacher HR, et al. Joint injection/aspiration. American College of Rheumatology. http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/jointinjection.asp. Accessed Sept. 9, 2010.
- Roberts WN, et al. Joint aspiration or injection in adults: Complications. http://www.uptodate.com/home/index.html. Accessed Sept. 9, 2010.
- Baker RM. Epidural steroid injections. North American Spine Society. http://www.knowyourback.org/Pages/Treatments/InjectionTreatments/ES_Injections.aspx. Accessed Sept. 9, 2010.
- DiMicco R. Lumbar zygapophysial (facet) joint injections. North American Spine Association. http://www.knowyourback.org/Pages/Treatments/InjectionTreatments/LZJ_Injections.aspx. Accessed Sept. 9, 2010.
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