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Cortisone shots
By Mayo Clinic staffMayo Clinic Health Manager
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Definition
Cortisone shots are injections that may help relieve pain and inflammation in a specific area of your body. Cortisone shots are most commonly given in joints, such as your ankle, elbow, hip, knee, shoulder, spine and wrist, as well as the small joints in the hands and feet. Joint injections are commonly referred to as cortisone shots, but what medication or combination of medications is injected varies. Cortisone shots typically include a corticosteroid medication and a local anesthetic. Cortisone shots are typically given in a doctor's office. The results you can expect from cortisone shots depend on the reason for your treatment.
Why it's done
Cortisone shots may be part of treatment for a number of diseases and conditions, including:
- Baker's cyst
- Bursitis
- Carpal tunnel syndrome
- De Quervain's tenosynovitis
- Frozen shoulder
- Gout
- Hip (trochanteric) bursitis
- Juvenile rheumatoid arthritis
- Lupus
- Morton's neuroma
- Myofascial pain syndrome
- Osteoarthritis
- Plantar fasciitis
- Pseudogout
- Psoriatic arthritis
- Reactive arthritis
- Rheumatoid arthritis
- Rotator cuff injury
- Sarcoidosis
- Tendonitis
- Tennis elbow
Risks
Cortisone shots carry a risk of complications, such as:
- Death of nearby bone (osteonecrosis)
- Joint infection
- Nerve damage
- Skin 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 cortisone shots per joint. People with rheumatoid arthritis may be limited to one cortisone shot per joint per month.
How you prepare
Cortisone shots don't require any preparation. However, if you're allergic to any corticosteroids or other medications, tell your doctor. Allergic reactions to the injected medication are possible.
What you can expect
During the cortisone shot
Your doctor may ask you to remove clothing in order to access your joint. You may be asked to 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.
The needle is then inserted into the injection site. If you're receiving a cortisone shot in a joint, the doctor inserts the needle inside the joint. 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. What medication you receive is up to your doctor. 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
After your cortisone shot you can go about your day. You may have some mild pain or stiffness at the injection site. 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
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.
- Joint injection/aspiration. American College of Rheumatology. http://www.rheumatology.org/public/factsheet/jointinjection.asp?aud=pat. Accessed Sept. 23, 2008.
- Wise C. Arthrocentesis and injections of joints and soft tissues. In: Harris ED, et al. Kelley's Textbook of Rheumatology. 7th ed. Philadelphia, Pa.: Elsevier Saunders; 2005. http://www.mdconsult.com/das/book/body/105473152-4/0/1257/0.html. Accessed Sept. 23, 2008.
- Roberts WN. Joint aspiration or injection in adults: Technique and indications. http://www.uptodate.com. Accessed Sept. 24, 2008.
- Roberts WN. Intraarticular and soft tissue injection: What agent(s) to inject and how frequently? http://www.uptodate.com. Accessed Sept. 24, 2008.
- Roberts WN, et al. Joint aspiration or injection in adults: Complications. http://www.uptodate.com. Accessed Sept. 24, 2008.
- Anderson CF (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 13, 2008.
