When to use cortisone injections to manage joint pain

Joint pain affects millions of Australians. It is commonly caused by inflammatory conditions such as arthritis, but can also happen as a result of injury or a virus. Whatever the cause, it is a miserable thing to deal with and can significantly impact your quality of life. Learning how to manage it with the best treatment options can provide relief.

Cortisone injections for joint pain are a treatment option for some people with conditions such as arthritis, bursitis and tendonitis. Learn more about what’s involved, if it’s right for you and the alternatives if it’s not.

Cortisone injections contain a corticosteroid medication that can provide relief from pain and discomfort in the joints. The injection can be put into joints including the ankle, knee, wrist, shoulder, hip and spine.¹

Cortisone injections are a type of anti-inflammatory medication and can only be accessed via prescription. The injection may also contain a local anaesthetic to provide immediate pain relief.² They are usually administered by a doctor.

Note: While cortisone injections should help to reduce inflammation in the affected joint, they do not cure the underlying condition that causes the pain.

If you are experiencing ongoing and persistent pain and/or loss of mobility in a joint, cortisone injections could help to reduce pain and reinstate movement².

Cortisone injections can be used to treat inflammatory or autoimmune conditions including:

• multiple sclerosis
• osteoarthritis
• bursitis
• sciatica
• tendonitis
• carpal tunnel syndrome.

“For something like arthritis, cortisone injections can help reduce the inflammation in the joints that causes loss of movement and pain,” says Bupa GP Janice Tan. “But it is usually only one part of the treatment plan and will be used in conjunction with other therapies such as physiotherapy.”

“One of the main benefits of cortisone injections is that they can be delivered straight to the joint and provide immediate relief, as opposed to pain relief or anti-inflammatory medications such as paracetamol and ibuprofen that need to make their way around the body,” says Tan.

Another potential benefit, she adds, is the window of opportunity the results from the injection give medical professionals to work on the root cause of the pain.

“With less pain and more range of movement thanks to the injection, you may be able to achieve more with a physiotherapist to help support the joints even after the results have worn off,” she explains.

As with any injection, there are risks of mild or severe side effects. Mild side effects can include pain, bruising or swelling at the injection site. This should ease after one or 2 days.

Usually lasting a few days, other side effects from corticosteroids can include:

• a rise in blood sugar, particularly if you have diabetes
• flushing of the face
• sleep problems

More serious and less common risks include joint infection and loss of joint cartilage. These tend to be caused by frequent use of corticosteroids.

You will get the opportunity to discuss any possible side effects with your doctor before deciding if cortisone injections are right for you.

Pain relief from cortisone shots can last anywhere from a few weeks to months.¹ If the joint pain is a result of injury, you may well only need one shot. While there is no scientifically proven limit for cortisone injections, they are generally limited to a few per year when treating the same joint, because of concern that repeated shots may damage the tissues within a joint⁴. Discuss your treatment plan with your doctor to ask how often you can safely have cortisone shots.

Most healthy adults may be suitable for cortisone injections³, although they are not always right for children. You may not be suitable for cortisone injections if you:

• have an infection
• have a blood-thinning disease.

While cortisone shots can be very beneficial in some cases, it’s worth noting that they aren’t a magic solution, and should be part of a whole treatment approach. “It’s a common misconception that you can either do physio or have the injections, when actually it's both,” says Tan.

“The corticosteroid could allow you to start building up strength again and getting mobility back through movement and exercise. With something like back pain, for example, you don’t move as much, and that very quickly leads to a deconditioning of the muscles, which makes it harder and more painful to move when you want to. It can be like a self-fulfilling prophecy. The injections can help remove that barrier.”

If cortisone injections aren’t suitable for you, or they simply don’t appeal, there are other ways² you can try to reduce pain and inflammation relating to joint pain.

• Losing any excess weight and regular exercise can help.
• Using a walking aid or applying hot and cold treatments to the joints can help to improve mobility and reduce stiffness.
• Medication can provide pain relief and help reduce inflammation.

Talk to your healthcare provider about the best options that suit your needs and health status.

Arthritis Australia has a printable information sheet on Medicines and Arthritis, including corticosteroids.

The Arthritis Movement publishes a comprehensive list of the Pros and Cons of Cortisone Injections.