WHAT IS CORTISONE?
Cortisone is the name used for a group of drugs called corticosteroids. Cortisone is used to treat painful musculoskeletal disorders where inflammation is felt to be the cause of pain. Cortisone is used where alternative methods of treatment have been unsuccessful or deemed inappropriate. Cortisone is effective in treating this type of pain as it is a powerful anti-inflammatory. Cortisone is often combined with a local anaesthetic drug which gives immediate relief of symptoms. The cortisone part of the injection takes a week to two weeks to have its full effect and give pain relief.
Cortisone can be helpful for Arthritis, Bursitis, Tendinosis and Tenosynovitis, some nerve entrapment conditions and other soft tissue complaints such as Frozen Shoulder, Trigger Finger and Dupuytren’s contracture.
We do not do spinal injections as these types of injections are performed in theatre by a surgeon under ultrasound or x-ray guidance.
BENEFITS AND POSSIBLE SIDE EFFECTS/RISKS OF CORTISONE
The decision to give a cortisone injection is a carefully considered one based on your signs, symptoms, response to other treatment, your medical history and diagnosis. The procedure can give significant benefits by reducing pain and inflammation which help restore normal movement and function but there are a few potential side-effects you should be aware of.
-If you have local anaesthetic it should produce almost instant relief from pain. The local anaesthetic wears off fairly quickly and you may have a brief increase in pain. The cortisone takes longer to produce pain relief – from 1-2 days to 2 weeks. Relief from a successful injection can last for an average of 3 months but may be more or less. Usually a maximum of three injections is allowed in a joint in a year period.
-A few patients may notice their pain flare up after injection but this usually settles within a day or two once the cortisone medication starts taking effect.
-The skin at the injection site may change colour (depigmentation). This may take a while to fade or may even be permanent.
-Cortisone may cause palpitations, skin flushing and mild mood disturbance. These usually resolve in 24-48 hours.
-Female patients occasionally experience a change in their menstrual cycle following injection. If this doesn’t settle within a couple of months please see your G.P.
-The procedure is performed with a sterile technique so the risk of infection is very low (1 in 20,000). Infection would present with a high temperature, the joint would become hot, red, swollen and more painful. If you suspect infection following your injection, contact your G.P. immediately or go to Accident & Emergency.
-Very rarely people are allergic to the Local Anaesthetic or to the Cortisone medication. This could present as a rash, facial swelling or difficulty breathing. If this happens you will be treated immediately. Should you experience any of these symptoms when you go home, you must go to Accident & Emergency.