Cortisone shots are a common medical intervention used to alleviate pain and inflammation. These injections deliver a synthetic corticosteroid directly to the affected area, mimicking hormones that reduce swelling and discomfort. Often recommended for conditions like arthritis, tendinitis, and bursitis, cortisone shots are generally effective. However, some individuals may not experience the expected relief.
Understanding Cortisone Shots and Expected Outcomes
Cortisone shots suppress the immune system’s inflammatory response, decreasing swelling and pain. The medication does not heal; instead, it creates an environment for the body to recover.
The timeframe for a cortisone shot to take effect can vary. Anti-inflammatory effects typically begin within 3 to 7 days, with full benefits potentially taking up to two weeks. Relief from a successful injection can last from several weeks to several months, or even up to a year. A shot “not working” generally means there’s no improvement, symptoms worsen, or relief is very short-lived.
Common Reasons for Lack of Relief
Several factors can contribute to a cortisone shot not providing anticipated relief. An incorrect diagnosis is one reason; the pain may not stem from inflammation or an issue cortisone cannot address, such as a torn ligament.
Improper injection technique or placement is another factor. If the medication is not delivered precisely to the inflamed site, it may not effectively reach the target area. This can occur if imaging guidance is not used, particularly for deeper joints. The severity of the underlying condition can also influence the outcome; advanced inflammation or structural damage might be too extensive for a single shot.
Underlying structural issues, such as severe arthritis, torn ligaments, or nerve compression, are often beyond cortisone’s action. Cortisone reduces inflammation but does not repair physical damage. Individual variations in how people respond to corticosteroids also play a role. Diminished effectiveness can occur with repeated injections, as frequent use can lead to reduced responsiveness over time.
Next Steps When a Shot Doesn’t Work
When a cortisone shot does not provide the expected relief, communicating this clearly with your doctor is a crucial next step. Provide detailed feedback on your symptoms, noting if they persist, have changed, or if relief was minimal and brief. This information helps your healthcare provider understand the situation comprehensively.
Your doctor might then review the initial expectations for the injection, clarifying if the anticipated outcome was realistic for your specific condition. They may also consider further diagnostic evaluations, such as additional imaging like X-rays or MRI, to re-evaluate the underlying cause of your pain. This helps to confirm or refine the diagnosis, ensuring that subsequent treatments are appropriately targeted. In some situations, seeking a second opinion from another specialist can offer additional perspectives and alternative treatment considerations.
Alternative Treatment Approaches
When a cortisone shot proves ineffective, a range of alternative treatment options can be explored to manage pain and improve function. Physical therapy is often a primary recommendation, focusing on strengthening muscles, improving flexibility, correcting posture, and restoring normal movement patterns. This approach addresses mechanical issues that cortisone cannot fix.
Oral medications can also be considered, including nonsteroidal anti-inflammatory drugs (NSAIDs) for general pain and inflammation, or other pain relievers. For specific inflammatory conditions, disease-modifying antirheumatic drugs (DMARDs) may be prescribed. Beyond cortisone, other injectable therapies exist, such as hyaluronic acid injections for joint lubrication, or regenerative options like platelet-rich plasma (PRP) and prolotherapy, which aim to stimulate healing.
Lifestyle modifications can significantly contribute to pain management. These include maintaining a healthy weight to reduce stress on joints, modifying activities to avoid aggravating pain, and using assistive devices if needed. If conservative measures consistently fail and the pain severely impacts daily life due to structural problems, surgical consultation may become an option. Surgical procedures can range from minimally invasive arthroscopy to joint replacement, depending on the nature and severity of the underlying issue.