A cortisone shot delivers a potent anti-inflammatory medication directly into a specific area of the body. The medication is a corticosteroid, a synthetic version of the naturally occurring hormone cortisol. This injection reduces localized swelling, redness, and pain caused by inflammation in joints, tendons, or soft tissues. The corticosteroid is often combined with a local anesthetic, which provides immediate, short-lived pain relief while the anti-inflammatory medication begins to work.
Key Medical Specialists Administering Cortisone Shots
The medical professional who administers a cortisone injection depends on the injection site and the underlying condition. Orthopedic physicians and surgeons frequently provide these injections for problems affecting the musculoskeletal system, such as joint pain in the knee, shoulder, and hip. Their practice focuses on injuries and degenerative conditions like osteoarthritis, bursitis, and various forms of tendonitis.
Rheumatologists are specialists who focus on systemic inflammatory and autoimmune conditions, such as rheumatoid arthritis or psoriatic arthritis. These doctors administer cortisone shots directly into joints affected by this widespread inflammation to help quiet disease activity in a localized area. Their expertise lies in determining whether the joint pain is due to a systemic condition or a mechanical issue.
For complex pain involving the spine or chronic nerve issues, a Pain Management Specialist is the most appropriate provider. These doctors, often anesthesiologists or physiatrists, perform specific injections like epidural steroid injections or facet joint injections in the back or neck. They utilize advanced imaging techniques to ensure the medication is delivered precisely to the affected nerve root or spinal structure.
Sports Medicine Physicians regularly administer cortisone shots, primarily targeting soft tissue injuries and joint issues related to athletics and exercise. These specialists often treat problems like golfer’s elbow, tennis elbow, and various tendon sheath inflammations. For superficial procedures, such as trigger finger or small skin lesions, a Primary Care Physician or a Dermatologist may perform the injection. They generally refer patients to a specialist for deeper or more complex intra-articular injections.
Understanding the Types of Cortisone Injections
The delivery method often dictates the type of medical specialist required for the procedure. Injections into superficial soft tissue structures, such as a tendon sheath or bursa, can be performed using landmark guidance. This method relies on the physician’s anatomical knowledge and palpation to identify the correct injection site.
For injections into deeper or more intricate structures, such as the hip joint or the spine, image guidance is necessary to ensure accuracy and reduce the risk of tissue damage. Fluoroscopy (real-time X-ray) is commonly used for spinal procedures like epidural injections to confirm needle placement near the nerve roots. Ultrasound guidance is frequently used for joint, tendon, and soft tissue injections, allowing the physician to visualize the needle tip entering the target area.
Cortisone injections are categorized by their location. Intra-articular injections place the steroid directly into a joint space like the knee or shoulder. Peri-articular or soft tissue injections target areas immediately surrounding the joint, such as tendons and bursae. Spinal injections, like epidurals, target the area surrounding the spinal cord and nerve roots to address pain originating from disc issues or nerve compression.
The medication involves a corticosteroid compound, such as triamcinolone or methylprednisolone, selected based on the desired duration of effect and the specific area being treated. These compounds are mixed with a local anesthetic like lidocaine or bupivacaine. The anesthetic also helps confirm the injection is in the correct location if it immediately relieves the patient’s pain.
Preparation and Post-Injection Expectations
Before receiving a cortisone shot, patients must inform their doctor about any medications, particularly blood thinners, which may need to be temporarily paused to lower the risk of bleeding. For procedures requiring deep access or sedation, a period of fasting may be required. The physician will also discuss allergies and review the patient’s current blood sugar levels if they have diabetes, as corticosteroids can cause a temporary elevation.
Immediately following the injection, the local anesthetic provides initial numbness and pain relief lasting several hours. This relief fades, and some patients may experience a temporary increase in pain and swelling, often called a “steroid flare,” which can last up to 72 hours. Patients are advised to rest the treated area for 24 to 48 hours and avoid strenuous activity to allow the medication to settle. Applying ice can help manage post-injection soreness. The therapeutic anti-inflammatory effects typically begin within two to seven days, with pain relief potentially lasting for several weeks to months.