Mommy Medicine: Cortisone shots — just what the doctor ordered?

Mommy Medicine: Cortisone shots — just what the doctor ordered?


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SALT LAKE CITY — Have you ever had a friend or family member suggest getting a cortisone shot to ease a nagging pain? While the shots can be very effective, there are some side effects you should be aware of.

Question:

Do cortisone injections for joint and bone pain really work?

Answer:

The simple answer is yes … and no, depending on the person and the problem. Dr. Jonathan Cluett, a practicing orthopedic surgeon in Massachusetts, wrote a very informative article about the subject, and I’ll include some of his words in my answer.

Cortisone is a steroid produced naturally by a person’s adrenal glands. Injectible cortisone, according Cluett, is “synthetically produced and has many different names (i.e. solucortef, cortisone, prednisone) but is a close derivative of the natural cortisone your body makes.”

The most significant difference between natural and synthetic cortisone is that that the synthetic steroid is not injected into the blood stream, where the natural cortisone goes, but rather into a particular area of inflammation. Synthetic cortisone also works more quickly at reliving pain than does natural cortisone.

What a cortisone shot does

When you have an inflamed joint, it is common practice to inject the area with cortisone to reduce the pain and inflammation. Some problems often treated by cortisone shots include: shoulder bursitis, arthritis, and spinal pain.

Ask Nurse Suzy

According to Cluett, injecting cortisone into a particular area of inflammation, even at very high concentrations, can be done while keeping potential side effects to a minimum. “Cortisone injections usually work within a few days, and effects can last up to several weeks,” he adds.

Cortisone injections are prescribed, in most cases, to delay a surgical intervention. Still, some patients never find relief from the injection.

Side effects of the shot

When considering the treatment, it’s important to remember that anything you inject into your body that is not normally there will create scaring of some kind. Cortisone injections can also cause weakening of tendons and softening of cartilage, with multiple injections.

Repetitious injections are not recommended, but they may be the only solution if surgery is not possible.

Possible side effects of cortisone injections
  • Weakened tendons
  • Softened cartilage
  • Pain
  • Infection
  • Decrease in blood sugar level
  • Allergic reactions

A cortisone injection can range from slightly painful to extremely painful. Often, cortisone injections can be performed with a very small needle that causes little discomfort. Some patients state "it is the best thing I ever did," while I’ve heard others say "it was so painful I will never have that done again."

Some rare side effects can be quite serious.

“The most concerning is infection, especially if the injection is given into a joint,” Cluett says. “The best prevention is careful injection technique, with sterilization of the skin using iodine and/or alcohol."

Cluett also notes that patients with diabetes may see an increase in their blood sugar.

Allergic reactions are also rare but not unheard of.

If you are considering a cortisone injection due to pain, please educate yourself of the effects, risks and benefits before doing so.


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About the Author: Suzanne Carlile ---------------------------------

Suzanne Carlile, "Nurse Suzy," has been a nurse since 1982. Her main focus is critical care and nursing education. She holds a master's degree in nursing, is a Certified Emergency Nurse, and a member of NNSDO Intermountain West Chapter.

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