A cortisone shot, also referred to as a corticosteroid injection, delivers a powerful anti-inflammatory medication directly into a specific area of the body. This approach targets the precise source of pain and swelling, providing localized relief. The medication, a synthetic version of the naturally occurring cortisol hormone, works by reducing the immune response in the injected area. This article covers the conditions treatable by these injections, the specialists qualified to administer them, and the steps involved in securing the procedure.
Conditions Treated by Cortisone Injections
Cortisone injections primarily manage localized pain caused by inflammation in musculoskeletal structures. The anti-inflammatory effect of the corticosteroid treats conditions resulting in painful swelling of joints, tendons, or surrounding soft tissues. By suppressing the immune system’s inflammatory pathways, the injection reduces pain and helps restore mobility.
One common application is treating acute flares of osteoarthritis, particularly in large, weight-bearing joints like the knee or hip, where inflammation has exacerbated the underlying joint degeneration. Injections are also frequently used for various forms of tendonitis, which is the inflammation of a tendon, such as Achilles tendonitis, rotator cuff tendonitis in the shoulder, or lateral epicondylitis (tennis elbow). Bursitis, the painful swelling of the small fluid-filled sacs that cushion the joints, is another condition that responds well to targeted cortisone delivery.
Nerve-entrapment syndromes, such as carpal tunnel syndrome in the wrist, can be treated to reduce inflammation around the compressed nerve. For patients with systemic inflammatory conditions like rheumatoid arthritis, localized cortisone shots can provide temporary relief to a single, severely affected joint during a disease flare. The injection often contains a local anesthetic combined with the corticosteroid to provide immediate, short-term numbness while the anti-inflammatory medication takes several days to become fully effective.
Specialists Who Administer Cortisone Injections
The medical professional you consult often depends on the specific location and nature of your pain. Orthopedic surgeons and specialists are sought out for joint-specific issues, such as pain in the shoulder, knee, or ankle, especially when the condition relates to injury or structural wear. These specialists are experts in musculoskeletal anatomy and perform injections for conditions like osteoarthritis and specific sports-related joint injuries.
Rheumatologists specialize in pain related to systemic or autoimmune inflammatory diseases, such as rheumatoid arthritis or psoriatic arthritis. They use cortisone shots as part of a broader treatment plan to manage widespread inflammation and joint-specific symptoms caused by these conditions. Their expertise lies in understanding how the injection fits into the overall management of an immune-mediated disorder.
Physiatrists, or physical medicine and rehabilitation specialists, focus on functional restoration and non-surgical treatments for nerve, muscle, and bone conditions. They frequently use cortisone injections, including complex spinal injections, as an integral part of a comprehensive rehabilitation program. Consulting a physiatrist is beneficial if your pain is impacting your daily function and requires a coordinated approach involving physical therapy alongside the injection.
Sports medicine physicians specialize in the diagnosis and non-surgical treatment of athletic injuries and are skilled in targeted soft-tissue injections. For basic, easily accessible injections into common sites like the knee or shoulder, some primary care physicians (PCPs) or family doctors may also administer the shot directly in their office. However, more complex or deep-tissue injections, particularly those in the spine, typically require a specialist with the capability to use imaging guidance like fluoroscopy or ultrasound.
Locating a Provider and Scheduling the Procedure
The first step in securing a cortisone injection is determining the most appropriate specialist, which is often guided by your primary care physician who can issue a referral. Before scheduling with a specialist, contact your insurance provider to confirm coverage. Most plans require the injection to be deemed “medically necessary” for a diagnosed condition. Some insurance carriers may also require a prior authorization from the specialist before they will cover the cost of the procedure.
Cortisone injections are typically performed in a specialist’s outpatient clinic, an interventional pain management center, or a hospital’s outpatient facility. While some urgent care centers may offer basic, superficial injections, a specialist’s office is preferred for deeper or more complex joint injections where imaging guidance, like ultrasound or fluoroscopy, is necessary to ensure precise placement of the medication. The specialist will almost always require an initial consultation to confirm the diagnosis and ensure the injection is the correct course of action, which may involve reviewing recent X-rays or MRI scans.
When you schedule the procedure, you should ask logistical questions regarding preparation. This includes whether you need to temporarily stop taking any blood-thinning medications, which is a common requirement to prevent bleeding at the injection site. It is also helpful to clarify the expected recovery time and whether you will need someone to drive you home, especially if a local anesthetic is used. Be aware that some patients experience a temporary increase in pain for one to two days following the shot before the anti-inflammatory effects begin to take hold.