A cortisone injection can usually be administered in a doctor's office and takes less than 5 minutes. Like any injection, it may be mildly to moderately painful. Patients typically feel a pinching followed by a burning sensation that dissipates quickly.
During the procedure, imaging technology such as ultrasound may be used. Whether or not imaging technology is used depends on the doctor's preference, the patient's anatomy, and the joint being injected. For example, imaging technology must be used for injections into the lumbar spine's facet joints to avoid injury to vertebral discs or nerve roots. Imaging technology is also often used for hip joint injections.
Local anesthetics are often mixed with the cortisone, so the injected area may feel numb immediately after the procedure. The anesthetic usually wears off within a few hours at which time the patient may notice an increase in joint pain. This aching sensation is usually gone within 24 hours but can last up to 3 days.
Cortisone Injection Step-by-Step
Below is a step-by-step description of a typical cortisone injection procedure. An injection may be administered so that medication is delivered directly into the joint capsule or near the joint capsule, depending on the condition being treated.
- The patient will be asked to sit or lay down in a position that gives the doctor easy access to the joint. For example, if an injection is being administered to the knee, the patient may be told to recline on his or her back with the knee either straight or bent at a 20- or 30-degree angle with a rolled-up towel to support it.
- The injection site will be cleaned with disinfectant, such as alcohol or iodine.
- The patient will be encouraged to relax. Relaxing the joint's muscles will make the injection process easier and more comfortable.
- If ultrasound is being used, a gel will be applied to small area of skin near the injection site, and a technician will gently press a hand-held ultrasound transducer against the gel-covered skin. An image of the joint space will be projected onscreen for the doctor to see.
- The doctor may administer a topical anesthetic to numb the area receiving the injection.
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- If the affected joint or bursa contains excess fluid, the doctor may draw out this fluid with a needle and syringe. This procedure is known as joint aspiration or arthrocentesis.
- The doctor will inject a small amount of cortisone into the targeted area. The cortisone may be mixed with an anesthetic, such as lidocaine or bupivacaine. The patient may notice a pinching or burning sensation.
- The injection area is cleaned and bandaged.
- The patient may be asked to flex and straighten the joint several times to help spread the cortisone.
The patient may be asked to stay in the medical office or waiting room for observation for 30 minutes following the injection. This precaution is taken to make sure that the patient does not have unusually severe pain or an allergic reaction to any material in the injection.
Who can administer injections for arthritis? See Arthritis Treatment Specialists