Cortisone shot

Cortisone was discovered in 1935 by the group of researchers led by Edward C. Kendall.

What is cortisone?

Cortisone is a natural hormone produced by our adrenal glands. It is involved in metabolizing sugars, immune defense and inflammation.

Inflammation is a set of phenomena produced by our body in reaction to an aggression (infection, trauma).

It is characterized by heat, swelling, redness and pain. These signs are not always noticeable to the naked eye. Some degree of inflammation is necessary to repair and rebuild our tissues.

However, when the pain associated with the inflammation is too great, it can be impossible to use the injured limb, which compromises rehabilitation and recovery. The vicious cycle of disuse is usually worse than the effects of the treatment itself.

Osteoarthritis or inflammation of the shoulder, knee or hip: when should you consider cortisone infiltration?

Cortisone infiltration is mainly used to treat the pain related to an acute localized inflammatory crisis. It is often used on the knee, hips or shoulders in cases of arthritis or inflammation.

Reducing the pain will help to resume activities such as therapeutic exercises.

Cortisone alone rarely cures the condition; rather, it is part of a series of interventions that aim to relieve pain and allow patients to go back to their activities.

Cortisone shots often help reduce the use of anti-inflammatory pain medications, which have significant side effects and complication rates.

Cortisone infiltration should not be considered as a maintenance treatment, i.e., a continuous treatment to be repeated on a regular basis.

Rather, it is a short-term treatment that allows you to get out of the inflammatory crisis triggered by an injury, decompensated osteoarthritis or an inflammatory disease.

What should you expect during a cortisone injection?

After a simple local disinfection, the physician will insert the needle where needed to inject the product. In some cases, the physician will use ultrasound to determine the exact location where the medication should be injected. This procedure is usually not painful and does not require local anesthesia.

What happens after the injection? How much rest time and why?

After 24 to 48 hours, the patient usually begins to feel relief. In some types of treatments, this period can be much longer, up to one to two weeks.

How long does cortisone stay in your body?

Even if the product is eliminated after four to six weeks, the relief can be much more lasting, if not permanent.

Should you fear cortisone shots?

Quite wrongly, cortisone infiltrations have a bad reputation…

If taken in large amounts, cortisone can cause osteoporosis, joint degeneration and muscle loss.

These side effects are rarely seen with localized injections and are mainly seen when cortisone is taken systemically for a long time.

Over time, however, repeated infiltrations in the same area may result in thinning of the tissue and some degeneration.

It is recommended to limit the number of cortisone shots to three per area per year. Depending on the context, your doctor may suggest that you exceed this limit. There should be a minimum of six weeks between two injections.

Cortisone injections remain one of the most effective and safest ways to control localized inflammation.

What are the side effects and are there actually any?

Cortisone may cause a slight increase in blood sugar during the first two weeks. If you are diabetic, you should check your blood sugar more carefully.

Injecting cortisone into the subcutaneous tissues can cause a thinning of the skin called skin atrophy. This complication is usually reversible.

Allergic reactions, post-injection infections and nerve damage are very rare.

Contraindications

Patients who are taking anticoagulants must stop taking them a few days before the procedure.

Patients with a fever or who have had a fever in the last week should avoid cortisone shots.

Cortisone injections are generally not recommended for immunosuppressed patients, pregnant or nursing women, or patients who have just received a vaccine.

As with other types of injections, a skin condition at the injection site is another contraindication.

What is the difference between cortisone infiltration and viscosupplementation?

Cortisone is a medication that reduces inflammation. Viscosupplementation is a supplement of hyaluronic acid (already present in the joint) to nourish the cartilage and thus slow down its degeneration (osteoarthritis).

How much does a cortisone infiltration cost?

The infiltration technique is covered by the RAMQ. The cortisone is provided free of charge by CMI Clinics.

The costs of a cortisone injection are covered by the RAMQ.

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