Injections…nobody I have met actually enjoys getting an injection. Some patients flat out refuse to go there while other patients see it as a first point of call. So the low down on injections and their benefits is based solely on the individual presentation. I can’t tell you that cortisones are a blanket cure-all modality, but I can give a little information about them so you can make an informed decision should you be advised to get one.

So what is a corticosteroid injection? well it is an injection of cortisone medication usually alongside some sort of anaesthetic creating an anti-inflammatory effect. In presentations where there is an inflammatory component.

What conditions is it used in? we commonly see these injections used in cases of shoulder pain eg. frozen shoulder; also lateral epicondylitis, hip bursitis, knee pain, elbow pain, and the wrist eg. De Quervains, and sometimes the foot. Note that in cases of chronic pain this is not a modality of choice.

So I’m going to address the most commonly asked questions regarding cortisone injections in my clinical practice:

1) Is it curative?

I have had patients who said it fixed the pain for a few years then it came back, or other cases where it relieve it momentarily, and others who didn’t have any improvement and others where the pain didn’t persist. So the answer is it is very very dependent on you and your condition.

2) Will it hurt?

Like any needle there will be discomfort, but an anaesthetic is used. Sometimes patients will have a residual ache in the area for a few days after the injection.

3) Is it bad for me?

Cortisones are an anti-inflammatory, a bit like taking an oral anti-inflammatory but it is more targeted at the site of tissue irritation. But there are limits to the amount of cortisones you should have in one area, and many surgeons I have worked with will have limits on how many they give and over what period of time. The low down is, every time you have one, the effects on the tissue apart from reducing inflammation, is that it makes tissue a bit more fragile each time and the durability of the tissue wains overtime.

4) Should I get one?

Making an informed decision about your health is just that, informed. Get as much information from your treating specialist, general practitioner and physiotherapist about the pros and cons of this procedure. In the end, no one can make you have this intervention.

5) When can I start physio again? do I need to?

We advise patients wait up to 10 days post injection before starting therapy again, this includes avoiding irritating the area at home as well. It’s important to begin therapy as the cortisone gives us the opportunity to rehabilitate the shoulder effectively without irritating it.

6) How long will it last?

Again this depends on the area being treated, for example, usually in the shoulder we get a 2 week window where the effects are the best. The lower back, again the initial weeks are where you get the best indication if it’s going to work for you, if you’ve gone a few months without pain post lower back injection then usually you don’t need anymore injections.

If you’d like to enquire about cortisones for your condition book in to see one of us at The Edge Physiotherapy.

Sam and Andy