Cortisone injections, formally known as corticosteroid injections, are a common medical procedure designed to provide localized, temporary relief from pain and inflammation. The medication is a synthetic version of cortisol, a hormone naturally produced by the adrenal glands, which acts as a powerful anti-inflammatory agent. The purpose of a cortisone injection is to deliver this potent anti-inflammatory directly to a specific site, such as a joint, tendon sheath, or bursa. They must be administered by a licensed healthcare professional, as they involve a prescription drug and a precise medical procedure.
Why Cortisone Injections Require Medical Administration
Cortisone injections require medical oversight due to the inherent risks and technical nature of the procedure. Introducing a needle and medication carries a risk of infection, making a strict sterile technique non-negotiable. The joint space, bursa, or tendon sheath has limited blood flow, meaning introduced bacteria can grow easily and lead to a serious joint infection.
Delivering the drug effectively requires high anatomical precision, as the medication must reach the exact source of inflammation for the treatment to work. For deep or complex structures, a medical professional often uses real-time imaging guidance, like ultrasound or fluoroscopy, to steer the needle to the target. Without this precision, the injection may miss the intended site entirely, rendering the treatment ineffective and risking damage to surrounding structures.
Improper placement or excessive dosage can lead to localized complications, including the weakening or rupture of a tendon or ligament. This risk is pronounced when cortisone is injected directly into a tendon, as the steroid can inhibit the body’s natural collagen repair processes. Incorrect administration can also cause nerve damage, skin atrophy, or depigmentation (whitening) at the injection site.
Medical Professionals Who Provide Cortisone Injections
A range of specialists commonly perform cortisone injections. Orthopedic surgeons and sports medicine specialists are frequent providers, as they specialize in joint, bone, and soft tissue conditions. Rheumatologists, who focus on inflammatory and autoimmune conditions like arthritis, also regularly administer these injections to treat flare-ups in affected joints.
Pain management specialists operate dedicated clinics where injections are a central part of their treatment for chronic pain conditions. Primary care physicians may also administer more superficial injections in their offices, such as those into the shoulder or knee. When the targeted structure is difficult to access or requires advanced imaging, interventional radiologists frequently perform the procedure using ultrasound or fluoroscopy for accuracy.
Conditions Commonly Treated and Patient Expectations
Cortisone injections treat a variety of inflammatory and painful musculoskeletal conditions that have not responded adequately to conservative therapies. Common targets for treatment include bursitis (inflammation of fluid-filled sacs that cushion joints), tendinitis (inflammation of a tendon), osteoarthritis flares, carpal tunnel syndrome, and chronic plantar fasciitis.
When you arrive for the procedure, the medical professional will first ensure the injection site is thoroughly cleaned with an antiseptic solution to maintain sterility. A local anesthetic is often injected first or mixed with the cortisone to numb the area, reducing discomfort. For deeper joints or spine injections, the provider may use imaging guidance to visualize the needle’s path and confirm the medication is delivered to the exact target.
Following the injection, patients are advised to rest the treated area for a day or two and apply ice as needed to minimize soreness. The immediate pain relief is due to the local anesthetic and wears off within a few hours. The anti-inflammatory effect of the cortisone usually takes two to seven days to become noticeable as the medication begins to reduce the inflammation. A temporary increase in pain, known as a “cortisone flare,” can occur in the first 48 hours. Due to the potential for long-term tissue damage, such as cartilage breakdown or tendon weakening, most medical professionals limit injections to no more than three or four per joint per year.