A cortisone shot delivers a dose of medication directly to a localized area of the body to reduce swelling and irritation. These shots contain a synthetic version of cortisol, which acts as a powerful anti-inflammatory agent. The primary purpose of this targeted treatment is to provide temporary relief from pain by calming the inflammatory response in a specific joint or soft tissue structure. This localized approach is distinct from oral steroids and serves as an intermediate step when basic treatments have not provided adequate relief.
Conditions That Warrant Treatment
Cortisone injections are generally reserved for specific inflammatory conditions that cause localized pain in the musculoskeletal system. Common joint-related problems that respond well to this treatment include osteoarthritis flare-ups in the knee, hip, or shoulder, as well as inflammatory arthritis such as rheumatoid arthritis or gout. The anti-inflammatory effect can lessen pain and stiffness, creating a window for physical therapy and rehabilitation.
Soft tissue conditions also frequently benefit from a cortisone shot when inflammation is the root cause of discomfort. These include bursitis, tendinitis (such as rotator cuff tendinitis or tennis elbow), plantar fasciitis, and trigger finger. These localized issues are often successfully managed with targeted injections.
Types of Medical Specialists Who Administer Shots
The medical professional who administers the shot depends heavily on the location and complexity of the injection site. Orthopedic surgeons are frequent providers, often delivering injections for joint-specific issues like knee or shoulder arthritis, as their practice focuses on the musculoskeletal system. Rheumatologists, who specialize in inflammatory and autoimmune conditions, routinely perform injections for patients suffering from conditions like rheumatoid arthritis.
Specialists in Physical Medicine and Rehabilitation (physiatrists) are also highly trained in administering these injections, particularly for spine-related pain and peripheral joint issues. For complex injections requiring advanced imaging guidance, a pain management specialist (often an anesthesiologist or neurologist) is typically consulted. Less complex joint injections, such as those into the knee or shoulder, may sometimes be performed by a primary care physician or a sports medicine physician.
For injections in deep or intricate areas, such as the hip joint or the spine, a radiologist may also be involved to guide the needle with precision imaging. The specialist’s training ensures the injection technique matches the anatomical complexity of the target area, often requiring advanced tools like ultrasound or fluoroscopy for accurate placement.
Clinical Settings Where Shots Are Provided
The physical location for a cortisone injection is usually determined by the type of guidance required for the procedure. Many routine joint and soft tissue injections can be performed directly in a specialist’s private practice office or a dedicated orthopedic or rheumatology clinic. These settings are appropriate for non-guided injections where the target area is easily accessible and the provider can use anatomical landmarks for placement.
If the injection requires imaging technology to ensure precise needle placement, the procedure must be performed in a setting equipped with that machinery. Image-guided injections are commonly performed in hospital outpatient departments or specialized imaging centers that have fluoroscopy or ultrasound equipment. Ambulatory Surgery Centers (ASCs) also serve as locations for more involved procedures, particularly those requiring sterile conditions for injections into deep structures or the spinal area.
The Consultation and Procedure Process
The process begins with an initial consultation where the provider confirms the diagnosis, reviews the patient’s medical history, and discusses alternative treatment options. This is a chance to address concerns regarding medications like blood thinners or conditions like diabetes, which may require temporary management changes before the injection. The provider will also discuss the potential for a temporary increase in blood sugar levels for diabetic patients due to the corticosteroid.
During the procedure, the injection site is thoroughly cleaned with an antiseptic solution, and a local anesthetic is often administered to numb the skin and underlying tissue. The cortisone, which is frequently mixed with an anesthetic for immediate relief, is then injected into the target area, sometimes with the assistance of ultrasound or fluoroscopic guidance to confirm accurate placement. The entire injection process is usually quick, taking only a few minutes from start to finish.
Following the injection, immediate post-procedure care involves resting the treated area for 24 to 48 hours and avoiding strenuous activity to allow the medication to settle. Some patients may experience a temporary increase in pain and swelling within the first 48 hours, known as a “cortisone flare,” which occurs before the anti-inflammatory effect begins. Due to the potential for side effects like cartilage damage or tendon weakening, providers typically limit injections to the same joint to no more than three or four times per year, with a minimum of 12 weeks between treatments.