Joint pain from years of use, arthritis and other conditions is exceedingly common and often sends people to seek relief from an orthopaedic physician. While surgery may be the solution for some, injections can provide real and relatively lasting relief for many.
Cortisone shots are simple, in-office procedures where a steroid combined with an anesthetic is injected into the joint to reduce inflammation and associated pain. Injections may be recommended after less invasive treatments, including oral medications and physical therapy, have failed to significantly reduce pain.
“It does vary from person to person, but most people typically get months to sometimes even years of relief following a cortisone injection,” said Endeavor Health orthopaedic sports medicine specialist Kirsten Geary, MD.
What type of injections are available? Dr. Geary weighs in:
- Cortisone shots are frequently used to reduce pain associated with bursitis, rotator cuff injuries and lateral hip pain as well as arthritis. While cortisone shots are effective treatment options for many, they do carry some risk of deteriorating cartilage or increasing risk of a tendon rupture. For that reason, Dr. Geary said steroid injections are never advised to treat Achilles tendonitis and must be administered with extra caution around some tendon injuries. Steroid injections can also cause a temporary rise in blood sugars for people with diabetes. Because cortisone injections can degrade tendons and cartilage, most physicians will caution patients to limit the number and frequency of injections.
- Hyaluronic acid (gel injections) are increasingly used to treat knee pain caused by arthritis, and are typically given in a series once a week for three weeks. These injections are designed to help lubricate the joint, and have almost no associated risks. “Gel injections are a great option and most people get at least some relief from them,” said Dr. Geary. There is some early industry sponsored research that shows these injections may even provide some protective effects on cartilage, she added.
- Platelet rich plasma (PRP) injections are another promising treatment option for many, but they are often not covered by insurance, which can make them prohibitively expensive.
One of the most important points Dr. Geary emphasizes for her patients is that any kind of injections are only part of a whole treatment program.
“This isn’t a cure for most issues, you need to follow recommendations for physical therapy and continue with home exercises to maximize mechanics and help reduce risks for further injuries,” she said.
In some cases, injections coupled with physical therapy and rehabilitative exercises may provide enough relief to allow people to remain comfortably active with no further treatment. But that’s certainly not always the case.
“Once you are not able to do what you want to do, whether that’s your fitness routine or even daily activities then it’s definitely time to consider surgery,” said Dr. Geary.
