About Cortisone (Steroid) Injections
Cortisone is a corticosteroid, a lab-made relative of a hormone your body already produces to control inflammation. Injected into an irritated joint, bursa, or tendon sheath, it settles swelling and pain far more directly than a pill can, because the medicine stays concentrated where it is needed.
We use cortisone for flares of shoulder, hip, knee, and thumb arthritis, for subacromial bursitis and outer hip pain, and for carpal tunnel syndrome, trigger finger, and plantar fascia pain. Every injection is placed under live ultrasound so the medicine reaches the inflamed structure and stays away from nerves and tendons that should not be exposed to it.
Cortisone treats inflammation, not the underlying wear or overload. We pair it with a strength and activity plan, and we do not inject it into the Achilles or patellar tendon, where steroid can weaken a tendon that carries heavy loads. When repeated shots would be needed, we talk through options such as PRP or a procedure.
Where we use Cortisone Injection
What happens during treatment
- 1.
Your physician examines you and scans the area with ultrasound to confirm that inflammation is the main driver of your pain.
- 2.
The skin is cleaned, and a small amount of numbing medicine is usually placed first.
- 3.
Watching on ultrasound, your physician guides a thin needle to the target and injects the cortisone with a local anesthetic.
- 4.
You rest for a few minutes and leave with guidance on activity, what to expect, and when to start or resume rehab.
Who may be a good candidate
- People with an arthritis flare in the shoulder, hip, knee, or base of the thumb that limits sleep or daily activity.
- People with bursitis or outer hip pain that has not settled with rehab and load changes.
- People with carpal tunnel syndrome or trigger finger who want to try an injection before a release procedure.
- People with plantar fascia pain that persists despite footwear changes, stretching, and strengthening.
Recovery
The numbing medicine wears off within hours, and the cortisone itself usually starts to work over two to seven days. Some people have a short flare of soreness the first day or two. We suggest easier use of the area for a few days, then a gradual return to exercise guided by your rehab plan.
Risks and limits
Possible side effects include a brief pain flare, facial flushing, a temporary rise in blood sugar for people with diabetes, lightening or thinning of the skin at the injection site, and, rarely, infection. Repeated cortisone in the same spot can weaken nearby tendon and other tissue, so we limit how often it is given and never inject it into the Achilles or patellar tendon.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Clinical evidence
Published studies our physicians draw on. Results in studies do not predict any one person's outcome.
Questions about Cortisone Injection
- How long does a cortisone shot last?
- Relief varies from a few weeks to several months, depending on the problem and how well rehab addresses the cause. The goal is to calm pain enough to strengthen the area, so the benefit lasts beyond the medicine itself.
- How many cortisone shots can I have?
- We space injections in the same area by at least a few months and limit how many are given over a year. If you need frequent shots, that is a sign to look at other options, such as PRP, a release procedure, or a different rehab approach.
- Why won't you inject cortisone into my Achilles or patellar tendon?
- These tendons carry very heavy loads, and steroid placed in or around them can weaken the tendon and raise the risk of a tear. For these tendons we use loading programs, shockwave, PRP, or percutaneous tenotomy (Tenex) instead.
- Is a cortisone shot the same as a steroid injection?
- Yes. Cortisone is the common name for the corticosteroid medicines used in joint and soft tissue injections. They are different from the anabolic steroids some athletes misuse and do not build muscle.