Cortisone injections have been used for decades to treat joint inflammation and pain, and for good reason. When used properly, they can provide rapid relief and help patients move and function better. But they’re not a cure-all. In fact, repeated or poorly placed cortisone injections can sometimes do more harm than good.
Here’s what you should know before saying “yes” to another shot.
What Is a Cortisone Injection?
Cortisone (a type of corticosteroid) is a powerful anti-inflammatory medication.
When injected directly into a painful or swollen joint or tendon sheath, it can:
- Reduce inflammation.
- Decrease pain.
- Improve range of motion.
This makes cortisone a useful tool for conditions like:
- Shoulder bursitis.
- Tendinitis.
- Knee or hip osteoarthritis.
- Trigger finger or plantar fasciitis.
Why Some Injections Work and Others Don’t
Many patients tell me, “I had a cortisone shot but it didn’t help.”
The truth is, it’s not just about the medication—it’s about the precision. If the injection is done “blind” (without imaging), there’s a chance the medication doesn’t reach the inflamed area. That’s why we perform every injection under ultrasound guidance, ensuring the medication goes exactly where it’s needed.
This simple step makes a huge difference in how well the injection works — and how long the relief lasts.
The Limits of Cortisone
While cortisone is helpful, it’s not without risks:
- It doesn’t fix structural damage, like torn tendons or cartilage.
- Too many injections in the same area may weaken tendons or cartilage over time.
- Temporary relief — the effects often last weeks to months, but may wear off.
- May delay proper treatment if used without proper diagnosis.
For these reasons, use cortisone strategically — and only when I’m confident it will benefit the patient as part of a larger plan.
Who Should Avoid It?
Avoid cortisone injections in:
- Young, active patients with tendinitis (we use PRP instead).
- Patients with poorly controlled diabetes (cortisone can raise blood sugar).
- Those who’ve already had several injections in the same area.
What Are the Alternatives?
If you’re looking for a longer-term or more natural approach, we may recommend:
- Platelet-Rich Plasma (PRP) — to stimulate healing.
- Ultrasound-guided needling for calcific tendinitis.
- Minimally invasive surgery — when structural damage is confirmed.
- Rehabilitation with my expert physio team — to restore strength and function.
Final Thought
Cortisone is a valuable tool, but it’s not always the right one.
The key is not just the injection—it’s the diagnosis, technique, and overall plan behind it.
If you’ve tried cortisone without lasting results, it might be time to explore other solutions.