How Many Cortisone Shots Can I Have?

And Are They Effective Over Time?

cortisone injection given by nurse
Cortisone injections are powerful anti-inflammatory treatments. Hero Images/Getty

Cortisone injections are commonly used by orthopedic surgeons and other doctors as a treatment for inflammation.  While cortisone can be an effective treatment, many doctors will advise against too many cortisone shots.  So why do physicians recommend against too many shots, and just how many is too much?

Cortisone Injections

First, a bit about cortisone injections: They are used in treating many common orthopedic conditions, and they work by decreasing inflammation of irritated tissues.

By limiting the inflammation, pain from these conditions is often relieved. Cortisone injections are used for many orthopedic problems, including: bursitistendonitis, trigger fingercarpal tunnel syndrometennis elbowknee arthritis and many other overuse conditions.

Patients often hear that they can only have a limited number of cortisone injections. Sometimes they are told only three injections, or perhaps three injections in one year, or perhaps something else. So what is the limit for the number of cortisone injections?  And why do doctors place limits on the number of injections they will give for a treatment that seems to be effective?

How Effective Are Cortisone Shots?

A 2013 study found that 83 percent of people who got a cortisone shot for tennis elbow recovered or improved within a year. But in that same study, 96 percent who got placebo shots recovered, too. The study involved 165 people in Australia.

Half of the people in that study who got cortisone shots had their symptoms return within a year. So the jury is still out on how effective cortisone shots can be over time. 

Cortisone shots do not cure every type of orthopedic problem, and despite their broad use in orthopedics, they are probably much more effective a treatment of some conditions than others.

For example, problems that cause acute inflammation and swelling are more likely to respond effectively to the powerful anti-inflammatory effects of cortisone, than a condition that causes more chronic discomfort.

How Many Cortisone Shots Can You Have?

There is no rule about the number of cortisone injections a person can have, but there are some concerns with repeated cortisone injections to one area of the body. 

If one or two cortisone injections into one region do not help a problem for a sustained period of time, then it is unlikely that more cortisone injections will be of any benefit.

And repeated cortisone injections are not healthy for tissues. Small amounts of cortisone in the body are probably reasonable, but repeated injections can cause damage to tissues over time. Sometimes this is of little concern. For example, if a patient has severe knee arthritis, and a cortisone injection every 6 months helps significantly, then the number of injections probably does not matter too much.

On the other hand, if a patient has shoulder tendonitis, but an otherwise healthy shoulder, the number of injections should probably be limited to prevent further damage to these tendons.

A Word From Verywell

There is no hard and fast rule that says how many cortisone injections can be given over time.

However, cortisone injections can have side effects, and repeated use of cortisone injections should be done with caution. Patients should understand that there are reasons not to use cortisone injections, even if they may help some symptoms. Because of this, most orthopedic surgeons will limit the number of cortisone injections they will offer to a patient.


Brooke K. Coombes, PhD; Leanne Bisset, PhD; Peter Brooks, MD, FRACP; Asad Khan, PhD; Bill Vicenzino, PhD. "Effect of Corticosteroid Injection, Physiotherapy" Journal of the American Medical Association, Feb. 2013

Hepper CT, at al. The efficacy and duration of intra-articular corticosteroid injection for knee osteoarthritis: a systematic review of level I studies.

 J Am Acad Orthop Surg. 2009 Oct;17(10):638-46.

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