A cortisone shot, or corticosteroid injection, is a powerful anti-inflammatory medication delivered directly into a specific area to alleviate localized pain and swelling. Corticosteroids are manufactured drugs resembling cortisol, a natural hormone, designed to temporarily reduce inflammation. Whether a Primary Care Physician (PCP) can administer this injection depends on their training, experience, and the specific injection site. A PCP’s ability to provide this treatment relies heavily on their individual competency and the complexity of the procedure.
Training and Ability of Primary Care Physicians
Primary Care Physicians (PCPs), including Family Medicine and Internal Medicine doctors, are often the first contact for patients with musculoskeletal pain. During residency training, PCPs receive instruction on evaluating and managing common musculoskeletal disorders. This frequently includes hands-on training for joint and soft tissue injections.
The decision to administer a cortisone shot rests with the individual doctor’s comfort level and procedural competency. Many PCPs participate in continuing medical education courses to enhance their ability to assess injuries and perform injections. Physicians often expand this skill set to manage common conditions in their office, aiming to reduce unnecessary specialist referrals.
A PCP’s ability to perform injections is governed by state medical board guidelines, but the most significant factor is the physician’s self-assessed experience. Doctors who perform these procedures regularly are more likely to offer them. For simple, easily accessible injection sites, the PCP is often fully capable and can provide the treatment during a standard office visit.
Typical Injection Sites and Conditions Treated
PCPs commonly perform injections for conditions involving superficial joints and soft tissues that do not require advanced imaging for accurate placement. These typically target bursae, tendon sheaths, or larger, easily palpable joints. Common conditions treated include bursitis in the shoulder or hip, and tendinitis in the elbow (such as “tennis elbow” or “golfer’s elbow”).
The knee joint is a frequent site for PCP-administered injections, especially for managing osteoarthritis pain. PCPs also treat peripheral locations in the wrist, such as those for carpal tunnel syndrome or trigger finger. These injections are performed using anatomical landmarks and palpation to guide needle placement. The low-risk profile and ease of access at these sites make them appropriate for primary care, offering immediate, localized anti-inflammatory relief.
When Referral to a Specialist is Mandatory
The complexity of the injection site dictates when a referral to a specialist, such as an Orthopedist, Rheumatologist, or Pain Management physician, becomes necessary. Procedures targeting deep joints, including the hip, ankle, or sacroiliac joint, require specialist expertise. These deeper structures are not easily accessible through palpation and carry a higher risk of damaging nearby nerves and blood vessels.
Any injection requiring imaging guidance mandates a specialist referral. This guidance typically uses fluoroscopy (real-time X-ray) or ultrasound. These techniques allow the provider to visualize the needle’s path, ensuring the medication is delivered precisely into the intended space, such as a small facet joint in the spine. PCPs rarely have this specialized equipment or the extensive training required to operate it in a standard clinic setting.
Referral is also warranted when the cause of the pain is uncertain, involves a systemic disease, or if a patient has received two or more injections without achieving adequate pain relief.