A cortisone shot is a powerful anti-inflammatory treatment designed to reduce localized pain and swelling in a targeted area of the body. Because these injections treat a wide variety of musculoskeletal and inflammatory conditions, many different types of doctors administer them. The medical professional who administers the shot depends on the location of the injury and the complexity of the underlying issue.
What Exactly is a Cortisone Shot
Cortisone is a synthetic version of cortisol, a corticosteroid hormone naturally produced by the adrenal glands. The medication used in the injection, often a compound like triamcinolone or methylprednisolone, acts as a potent anti-inflammatory agent. This substance is injected directly into an inflamed joint, tendon sheath, or bursa to suppress the local immune response.
The injection mixture typically combines the corticosteroid with a fast-acting local anesthetic, such as lidocaine or bupivacaine. The anesthetic provides immediate, temporary pain relief. The cortisone begins interacting with the cells over the next two to seven days, calming irritated tissue and reducing swelling. This provides pain relief lasting several weeks to months. While a cortisone shot manages symptoms effectively, it is not a cure for the underlying cause of the inflammation.
Key Medical Specialists Who Administer Injections
The most common specialists involved focus on conditions affecting the body’s support structure and movement. Orthopedic surgeons and specialists frequently perform injections for localized issues involving major joints, bone, and significant tendons. They treat acute injuries such as shoulder impingement, knee osteoarthritis, or hip bursitis. Their focus is primarily mechanical, treating specific areas of damage or wear.
Rheumatologists focus on systemic inflammatory conditions that manifest as joint and muscle pain. Patients with chronic autoimmune diseases, such as rheumatoid arthritis or gout, may receive injections to manage disease flares in smaller joints like the hands or wrists. The rheumatologist’s approach considers the body-wide inflammatory process, using injections as part of a broader, long-term treatment plan.
Physical Medicine and Rehabilitation (PM&R) physicians, or physiatrists, specialize in restoring function and managing pain related to musculoskeletal and nervous system disorders. Physiatrists often utilize cortisone shots for non-surgical spine pain, such as nerve root inflammation, or for complex soft tissue injuries. They frequently employ advanced imaging techniques, like ultrasound guidance, to ensure precise placement for rehabilitation.
Additional Providers and Treatment Settings
Cortisone injections are administered by a wider range of medical professionals, particularly for less complex or specialized anatomical areas. Primary care physicians (PCPs) may provide injections for straightforward, common conditions like simple knee bursitis or muscle trigger points. They typically refer patients to a specialist when the inflammation is deep, the case is complicated, or the injection requires fluoroscopic guidance.
Sports medicine physicians, often fellowship-trained in non-surgical orthopedics, routinely use cortisone injections to help athletes recover from injuries like tendinitis or plantar fasciitis. These specialists are skilled in ultrasound-guided injections for soft tissue problems. Podiatrists, who specialize in the foot and ankle, administer cortisone shots for localized foot conditions, such as heel spurs or Morton’s neuroma.
For pain originating from the spine and nerves, patients are directed toward pain management specialists, who may be anesthesiologists or neurologists. These doctors frequently use cortisone in the form of epidural steroid injections or nerve blocks to target inflamed spinal nerves. These procedures almost always require fluoroscopy (a type of real-time X-ray) to accurately guide the needle into sensitive areas near the spine.
The Cortisone Injection Procedure and Aftercare
The procedure is typically quick and performed in an outpatient setting. Before the injection, the site is thoroughly cleaned, and the doctor may apply a topical numbing agent. For shots into deep joints or near nerves, the physician uses real-time imaging, such as ultrasound or fluoroscopy, to visualize internal structures. This confirms the medication is delivered to the exact target location. Patients generally feel pressure as the needle is inserted.
Following the injection, patients are advised to rest the treated area and avoid strenuous activity for 24 to 48 hours. Applying ice to the injection site can help minimize post-procedure soreness. It is common to experience a temporary increase in pain, known as a “cortisone flare,” which usually subsides within one to two days. Relief from the cortisone typically begins to be noticeable after a few days, as the anti-inflammatory effects take hold.