Cortisone shots are a common medical treatment used to address pain and inflammation in various joints, including the shoulder. These injections deliver a powerful medication directly to the affected area. They are often considered when more conservative treatments, such as rest, ice, or oral medications, have not provided sufficient relief for shoulder discomfort. The primary goal of a cortisone shot in the shoulder is to reduce localized inflammation, which in turn helps alleviate pain.
How Cortisone Alleviates Pain
A cortisone shot works by delivering a corticosteroid, a type of steroid that resembles cortisol. When injected into the shoulder, this medication acts as an anti-inflammatory agent. It functions by reducing the inflammatory response. This helps to block the release of chemicals that contribute to swelling, redness, and pain.
The reduction in inflammation directly lessens the pain experienced in the shoulder joint. While cortisone shots are highly effective at managing symptoms, they do not repair any underlying structural damage or cure the chronic condition causing the pain. Instead, they provide temporary relief, which can facilitate other treatments like physical therapy by making movement less painful.
Shoulder Conditions Treated
Cortisone injections are used to treat a variety of inflammatory conditions affecting the shoulder. One common condition is rotator cuff tendinopathy, which involves inflammation or degeneration of the tendons surrounding the shoulder joint. Bursitis, an inflammation of the fluid-filled sacs (bursae) that cushion the shoulder joint, is another condition often targeted by these injections.
Frozen shoulder, also known as adhesive capsulitis, characterized by significant stiffness and pain, can also benefit from cortisone shots, especially in the early inflammatory stages. Additionally, osteoarthritis, a degenerative joint disease where cartilage breaks down, can cause inflammation and pain in the shoulder; cortisone injections can help manage these symptoms.
What to Expect After the Shot
Following a cortisone injection in the shoulder, it is common to experience some initial discomfort or a temporary increase in pain at the injection site. This “cortisone flare” can last for up to 24 to 48 hours after the procedure. Healthcare providers often combine the corticosteroid with a local anesthetic, which can provide immediate, but short-lived, numbing relief.
Significant pain relief from the cortisone itself typically begins within a few days to a week after the injection. The duration of this relief can vary widely among individuals and depends on the specific condition being treated, but it commonly lasts for several weeks to a few months. Protecting the treated area for a day or two by avoiding heavy lifting or strenuous activity is often recommended.
Important Considerations
While generally safe, cortisone shots in the shoulder come with potential side effects and important considerations. Locally, there can be temporary skin thinning or discoloration at the injection site. Although rare, there is a small risk of infection, and a temporary increase in blood sugar levels can occur, particularly in individuals with diabetes. Repeated injections into the same joint can also potentially weaken tendons over time.
Due to these potential effects, there are limitations on how many injections a person can receive in a specific joint. Most healthcare providers recommend a maximum of three to four injections per year in any single joint to minimize risks. Cortisone shots are not always the best option; for example, they are typically avoided if there is an active infection in the joint or if severe joint damage requires surgical intervention. The decision to use a cortisone shot is made after a thorough diagnosis.