Whether it’s caused by injury, age or something else, chronic joint pain is — well — a pain in the neck (or knee, or wherever). You may have heard of using cortisone shots to treat the issue, but Physician Assistant Kevin Casey with OrthoCarolina says there are a few things you need to know before going under the needle.
• A cortisone shot’s main purpose is to reduce inflammation and pain, eventually helping to restore function.
• The shot usually contains a numbing agent like Lidocaine, and is often injected directly into the painful joint. It’s not a conservative treatment, and often is only introduced after the patient has tried heat, ice, rest, etc.
• Kevin says the easiest way to describe what happens after the shot is to imagine injecting a basketball with cortisone and then swirling it around. After a few moments, the entire inside of the basketball will be coated with medicine. It works the same way inside a joint, and that medicine will (ideally) bring down inflammation and get you back to living your life pain-free.
Kevin said it’s important to understand that cortisone injections aren’t a cure — they’re like a Band-Aid.
“Injections of themselves shouldn’t be your sole treatment. If you’re having pain, it’s for a reason,” Kevin says. “That’s why it’s important to use other means to minimize pain: lose some weight, get stronger, stop smoking, stretch the area, etc. Things like that are what cure conditions and injuries.”
If you and your treatment professional agree that cortisone is the way to go, here’s what you can expect:
Q: Will it hurt?
A: That depends on who’s giving it and where the shot is. Some people say the pain is among the worst they’ve felt in their life. But Kevin said when he does it, patients often ask “are you about to do it?” after he’s already finished. He also said some injections hurt worse than others. For example, the knee is a huge joint. It’s easy to put a small needle into an open space in a knee joint and get the fluid in there. However, the thumb joint is small and thin, so it takes some skill for the doctor or PA to slide it in there smoothly so the patient won’t feel any pain.
Q: Are there any side effects?
A: Kevin says there’s always the possibility of infection, but the risk is incredibly low — less than one-tenth of a percent. Some people will go through a “hot flash” where they get warm and red in the face. That may last up to a day. Some people with diabetes may have an increase in their blood sugar, but that will usually go away in 24 to 48 hours. You also might be sore at the injection site.
Q: What’s the most common place for people to get cortisone shots?
A: Cortisone is a very, very common treatment for knee arthritis. Kevin did adult reconstruction for many years and had lots of patients who went through the process of mild but worsening arthritis. Kevin said those folks would get injected every three or four months, and eventually they would undergo knee replacement.
Want more information on this and other related topics? Visit OrthoCarolina online here.
OrthoCarolina is one of the nation’s leading independent academic orthopedics practices serving North Carolina and the Southeast since 1922. They provide comprehensive musculoskeletal care including operative and non-operative care, diagnostic imaging and rehabilitative therapy. Widely known for musculoskeletal research and training, OrthoCarolina’s physicians have specialized expertise in foot & ankle, hip & knee, shoulder & elbow, spine, sports medicine, hand, pediatric orthopedics and physical medicine and rehabilitation. They have more than 130 surgeons amongst 25 plus locations.