Cortisone Effects - How It Works and What Can Go Wrong

When Can You Expect To See Results After A Steroid Shot

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A cortisone shot starts to work very quickly once injected, although the time when you feel relief from your symptoms can vary. Most people find that relief begins within a few days after the injection.

How It Works

Cortisone shots work by decreasing inflammation. Many patients mistakenly think that cortisone only serves to mask pain; that's not really true. Cortisone can be a very effective method to reduce the inflammation caused by a variety of common orthopedic conditions including tendonitis, bursitis, and arthritis.

Once the inflammation subsides, pain relief follows. Cortisone starts to work immediately following the injection, and inflammation usually begins to subside within a few days. Depending on how quickly the inflammation subsides, the timing of pain relief can vary from a few days to a few weeks.

If the inflammation is severe, or if the inflammation has been around a long time (chronic), the cortisone injection may take longer to take effect and may require more than one injection. Not every patient will respond to a cortisone injection, but the good news is that most people find this to be an excellent treatment for many common inflammatory conditions.

Immediate Relief

While the effects of cortisone typically take a few days or longer to begin to take effect, many patients will report almost immediate relief of pain following an injection. There are two possible reasons why pain relief is sometimes more immediate.

The most common reason for immediate pain relief is that most physicians will mix an anesthetic medication, such as lidocaine or marcaine, with the cortisone injection.  These local anesthetics can take their effects more immediately, and provide dramatic relief soon after the injection. In fact, many doctors will use this effect as a test to ensure the medication was injected to the located problem.

If the problem was numbed by the injection, then your doctor can be confident the cortisone was delivered to the proper location.

The other reason why some people find immediate relief is that sometimes your doctor will remove accumulated fluid at the same time they inject a swollen joint. For example, many patients with a swollen knee may have the fluid drained from the joint just prior to the injection. Having the accumulated fluid removed from the joint can lead to dramatic relief of pain.

What Can Go Wrong?

Some patients may react to the cortisone injection with what is called a 'cortisone flare.' A cortisone flare is a condition where the injected cortisone crystallizes and can cause a brief period of pain, worse than before the shot. This usually lasts a day or two and is best treated by icing and resting the injected area.  There are also other possible side-effects of cortisone. While these problems are uncommon, they sometimes do occur. Most patients find cortisone to be a helpful treatment for a variety of orthopedic conditions.

Unfortunately, not every patient finds the relief they hope for with this medication.

Sources:

Mayo Clinic. Cortisone Shots. http://www.mayoclinic.org/tests-procedures/cortisone-shots/home/ovc-20206814

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