Cortisone (a type of corticosteroids) is a type of steroid that is naturally produced by the adrenal gland. Natural cortisone is released from the adrenal gland into the blood stream when the body is under stress. Cortisone injections are synthetically produced but it is a close derivative of your body’s natural cortisone. Cortisone injections (synthetic cortisone) are more potently designed and tend to last longer than natural cortisone.
A great misconception about corticosteroids is that it is a pain reliever when in fact it is not. It is simply an anti-inflammatory. The pain reduction experienced is generally due to a reduction of inflammation. High concentrations of corticosteroids can be given with little apparent side effects if medication is injected into the area of inflammation. Some experience relief from cortisone injections within a few days and the relief have been known to last up to several weeks.
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Cortisone injections can be used to treat injections that are widespread throughout the body, known as systemic injections (used for conditions affecting many joints like asthma, allergic reactions and rheumatoid arthritis), or they can be used as local injections (including tendonitis, arthritis, bursitis) treating small areas or the body.
Cortisone shots can be especially painful when given in the joint but there are cases when the injections can be performed with a small needle causing little discomfort. There is a slightly larger needle is used, generally if your physician is attempting to remove fluid through the needle before injecting cortisone. There are topical anesthetics that help numb the skin of the area to be injected and other numbing medications such as Marcaine or Lidocaine are often injected into site with the cortisone to provide temporary relief.
Some advantages of cortisone injections include the removal of joint fluid which can be helpful in analyzing what caused the joint to swell. This tends to be a more accurate diagnostic test. Another advantage would be the relief from inflammation that is more powerful than over the counter anti-inflammatory drugs like Advil or Mortin. Cortisone Injections have a reputation of being dependable with rapid action and little side effects. Many also enjoy the convenience of having a cortisone injection procedure done at the doctor’s office.
A few disadvantages of cortisone injections include increased pain after the injection typically due to allergic reaction to the cortisone often referred to as “cortisone flare”. This happens when the cortisone crystallizes causing pain worse than the discomfort of inflammation. Facial flushing may occur in about 40% of cases but this effect only last briefly. Tendons can be weakened, sometimes resulting in tendon ruptures, by cortisone injections near or in tendons. With high frequency and doses of injections there is a risk of weight gain, thinning of the skin, injury of joint tissue, weakening of ligaments of the joint, bruising, cataract formation, osteoporosis, avascular necrosis, facial swelling and a rise in blood pressure.
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