One of the most commonly used medical treatments for arthritis joint pain is the cortisone injection. Whether or not a cortisone injection is right for you depends on many factors. For example, is inflammation causing your joint pain? Which joint is affected? Are you in need of short-term relief?
Is your pain caused by inflammation?
Physicians typically recommend cortisone injections when inflammation causes joint pain, swelling, and warmth. Painful joint inflammation is associated with several conditions, including but not limited to osteoarthritis, rheumatoid arthritis, gout, and tendonitis.
Not all of these conditions produce enough inflammation to cause visible joint swelling or skin redness. For example, a joint affected by osteoarthritis has lost protective cartilage, which results in joint friction and can lead to painful inflammation, but the affected joint may not look much different than it normally does. Cortisone can still be an effective treatment in these cases.
Which joint is affected?
Cortisone injections are generally used to treat just one painful joint at a time. Injections can deliver cortisone into the knee, hip, shoulder, spine, and other joints, including small joints in the hands.
Cortisone injections are not considered a safe treatment for:
- Achilles tendonitis at the back of the ankle
- Plantar fasciitis 1 Kim C, Cashdollar MR, Mendicino RW, Catanzariti AR, Fuge L. Incidence of plantar fascia ruptures following corticosteroid injection. Foot Ankle Spec. 2010;3(6):335-7. doi:10.1177/1938640010378530 at the bottom of the foot
Injected cortisone can make these tissues more susceptible to damage and tearing.
Do you need fast, short-term relief?
Unlike treatments such as physical therapy, dietary changes, or weight loss, a cortisone injection can be given and take effect as soon as 24 hours.
The temporary pain relief may allow a person to:
- Engage in physical therapy
- Attend to an important life event, such as a long-planned wedding or vacation
- Postpone knee replacement surgery
The fast-acting nature of cortisone makes it an option for people who need quick, temporary relief from arthritis joint pain.
Treatment results vary
If successful, an injection can relieve pain for several weeks or even several months, but keep in mind that results vary widely. Your pain may not be relieved at all, or it may go away and never come back. Doctors are not sure why results vary and who will respond best.
Are you aware of the potential side effects?
While cortisone shots are generally considered safe, they do carry risks for side effects and longer-term negative effects. It’s a good idea to learn about these risks before making your decision to have an injection.
One concern is that cortisone shots, particularly multiple shots to the same area, might accelerate the degeneration of soft tissue. 2 Wernecke C, Braun HJ, Dragoo JL. The Effect of Intra-articular Corticosteroids on Articular Cartilage: A Systematic Review. Orthop J Sports Med. 2015;3(5):2325967115581163. doi:10.1177/2325967115581163 , 3 McAlindon TE, LaValley MP, Harvey WF, et al. Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. JAMA. 2017;317(19):1967–1975. doi:10.1001/jama.2017.5283 , 4 Dragoo JL, Danial CM, Braun HJ, Pouliot MA, Kim HJ. The chondrotoxicity of single-dose corticosteroids. Knee Surg Sports Traumatol Arthrosc. 2012;20(9):1809‐1814. doi:10.1007/s00167-011-1820-6 , 5 Papacrhistou G, Anagnostou S, Katsorhis T. The effect of intraarticular hydrocortisone injection on the articular cartilage of rabbits. Acta Orthop Scand Suppl. 1997 Oct;275:132-4. PubMed PMID: 9385288. , 6 McAlindon TE, LaValley MP, Harvey WF, et al. Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. JAMA. 2017;317(19):1967–1975. doi:10.1001/jama.2017.5283 This effect may make joint degeneration worse in the long term, which may be a particular concern for younger patients who already have mild to moderate arthritis.
Another concern with cortisone shots is that they can temporarily increase blood sugar levels, which is important for patients with diabetes to be aware of.
Read more about Cortisone Injection Risks and Side Effects
Cortisone shots are an elective treatment, meaning it's up to you to decide whether or not to get one. If arthritis pain is preventing you from doing everyday activities, going to work, or exercising, a cortisone shot may be worth considering. Keep in mind that a cortisone shot should just be one part of a larger treatment plan that helps you maintain long-term joint pain relief.