Cortisone is an anti-inflammatory hormone naturally produced in our body. It is produced by the adrenal gland and released into the blood stream when our body is under stress. Natural cortisone effects are short-lasting compared to the synthetically-produced counterparts. Unlike natural cortisone, synthetic cortisone is not injected into the blood stream. It is injected into the inflamed area and has a long-lasting effect. Cortisone shots are administered to patients complaining of joint pain, mainly caused by inflammation.
Cortisone is not a painkiller but an anti-inflammatory substance, and the knee, elbow, spine, and shoulder joints are some of the common joints where these shots are given. People suffering from bursitis, arthritis, tendonitis, and carpal tunnel syndrome are the ones requiring a cortisone shot. These shots are injections made up of a mixture of corticosteroids and a local anesthetic. In some cases, other medications are added for long-term pain relief. Cortisone effectively suppresses inflammation, helps dissolve scar tissue, and speeds up the healing process.
The Side Effects
There are 2 types of steroids: local and systemic. Local steroids are injected in just one area of the body and their effects are limited to that area. Systemic steroid pills go through the entire system of the body and have an overall effect. The side effects are minimal as these shots fall under the local steroid category. Mentioned below are some side effects that people generally experience:
► Discoloration of skin is one of the side effects of a cortisone shot, and patients with a dark skin should be aware of this. However, this is only a cosmetic adverse effect - it is not harmful.
► Another drawback is the 'steroid flare', a condition in which the injected cortisone crystallizes and causes severe pain. This pain is much worse than the pain experienced by the patient before the shot. Physicians suggest the use of ice packs for relief after a shot. The pain lasts for about 24 - 48 hours, but the patients feel greater relief after the pain subsides.
► Facial flushing is the most common adverse effect in women, and it occurs in almost 15% of them. A visible redness can be noticed in female patients after a shot, which lasts for a couple of days. They might also experience other side effects, like acne and menstrual disturbances.
► Fat atrophy can occur at the spot where the injection was inserted. It causes the loss of fatty tissue, and the injected area looks recessed. Although this is not permanent, the effects last for several months.
► Infection is also a rare possibility, especially if the injection is given in the joint. If not given correctly, side effects in the knee, elbow, and other joints can lead to infection and damage of the nerves. The best prevention is consulting a good physician and the use of an antiseptic before the shot to clean the area. However, some people are allergic to antiseptics like betadine and need to be extra careful.
► Diabetics have to monitor their blood sugar level, as cortisone can cause a temporary rise in sugar levels. Patients on insulin need to monitor their sugar levels as well as adjust their doses accordingly.
► If cortisone is injected directly in an inflamed or weakened tendon, it suffers the risk of a rupture. Doctors try to limit the dose of cortisone injections as they are known to weaken the tendons.
Some of the other adverse effects are hypertension in patients with blood pressure problems and bleeding due to the breakage of blood vessels. Overuse of cortisone may cause avascular necrosis of the bone. The most important thing to remember is that if it doesn't work the first time, it should not be repeated. Cortisone is a natural hormone and hence does not have any allergic reactions, but you should be aware of the other medicines that might be used with the cortisone shot.
Disclaimer: This HealthHearty article is for informative purposes only and should not be used as a replacement for expert medical advice.