Cortisone injections – most people know at least someone who has had a cortisone injection to numb the pain of a shoulder, a knee, or one of many musculoskeletal problems and pains. It promises quick pain relief – one injection and it’s all fixed, right?
Unfortunately, no. As Podiatrists we see a lot of patients for who cortisone either didn’t work, didn’t last very long, or who are now in greater pain after cortisone than they were before. If you look for it, you’ll find tonnes of information about the risks, side-effects and dangerous of cortisone, also referred to as corticosteroid injections. Despite the risks, cortisone is still widely used for it’s anti-inflammatory and pain relieving properties.
Because at the heart of what we do here at Sole Motion Podiatry is providing the best treatment and outcomes for our patients that is in their best interest both short and long-term, we thought we’d give you the down-low on the risks cortisone so you can be fully informed before making the decision of whether to use this drug in your body. Here are four things you should know:
One of the main ways that cortisone works is by decreasing inflammation. Injury causes swelling and inflammation, which causes pain. By reducing inflammation, cortisone reduces and relieves your pain. However, it doesn’t do anything to repair the injury. In fact, by restricting blood flow to the area to reduce inflammation, it restricts the rate at which the body repairs the injury. This means it can take significantly longer for the tissues to repair and your injury to heal. In these cases, you’re risking short-term, temporary pain relief for a much longer recovery period.
We have many patients come to see us with the complaint that they’re in more pain now than before having their cortisone injection. This can be very much true – and this is why. Because cortisone masks your pain, you start feeling good and moving around as if you would if you were uninjured. The problem is, you are still injured, but you don’t feel the pain that’d otherwise tell you you’re further straining and damaging the injured area. The injury can progress and worsen without you even realising. Once the effects of cortisone wears off, the pain comes back and is worse than it was previously because your injury is now worse.
The body is a well-built machine for repairing itself. The body carries out the repair process and then removes any excess material, to leave the area looking clean and with as little scar tissue as possible. However, when the repair process is delayed and interrupted because of the effects of cortisone, it’s not only the repair process that is impaired but the process or removing that excess material. This means that more scar tissue is permanently left at the site of the injury.
Cortisone injected repeatedly has been shown to weaken your connective tissues – and even bones. Firstly, cortisone weakens collagen, the main protein in your connective tissues, thereby weakening them. Because scar tissue is less flexible than healthy tissue and you have more scar tissue left with cortisone, the strength of your tendons and ligaments decreases. This means they cannot sustain as much force before injury, which is why the re-injury rate after cortisone is higher. With bones, cortisone limits the calcium absorption by the body and its uptake by bone. It also inhibits the release of the growth hormone, which further impairs bone and soft tissue repair.
All in all, while cortisone does offer short-term pain relief, and we understand that’s what you may need at times, it carries with it a series of dangerous risks that can have significant negative long-term effects. The decision to have a cortisone injection must be weighed up with your injury, the symptoms you’re experiencing and the short versus long-term benefits, along with numerous other factors. You should definitely discuss these with your GP.
We do work with patients after cortisone to successfully rehabilitate their injuries and get them back to their fullest capacity. We use non-invasive and effective therapies such as low level laser therapy (LLLT) which has no side effects and instead promotes healing and tissue repair.
If you’re in this position, or you’ve yet to start your treatment for your injury, get in touch with our expert team here at Sole Motion Podiatry. We’re all about delivering the best outcomes for you
So you can keep doing the things you love! If you have any questions about cortisone or the safe alternatives to cortisone we offer, please don’t hesitate to get in touch on 1300-FX-FEET.