Many of our clients will be referred for a cortisone injection or will try to organise a cortisone injection to achieve the “instant relief” we all seek.
What is cortisone?
Cortisone is the grand-daddy of all anti-inflammatory agents. We all produce our own cortisone in our adrenal glands. The injections are generally a synthesised version of this chemical which has a very strong and systemic anti- inflammatory effect.
Why do we have inflammation?
This is actually quite a complex question. When our tissues are damaged they react by releasing chemicals and proliferating certain types of cells into the area of injury. These cells and chemicals react to bind the damaged tissues back together which over time help the tissues differentiate back into their original form i.e. bone muscle or tendon. Thus, in most cases inflammation is the bodies basic repair mechanism for musculoskeletal injury and our frontline protection against infection.
In some disease states like rheumatoid disease or chronic synovitis, the bodies inflammatory system goes haywire leading to chronic inflammation which usually entails heat, redness, swelling and pain.
What happens when I have a cortisone injection?
If you have a musculoskeletal-skeletal injury the cortisone injection will often stop the pain. “Great!” I hear you cry, but the problem is that the injection will also stop, or at best delay, the healing process for the same length of time that it alleviates pain. Additionally, because you feel no pain you are quite likely to engage in activity that aggravates the tissue damage, eventually resulting in the problem returning worse. We see this often! We also know that repeated cortisone injections weaken tissues making tendon rupture or bone breakdown more likely. In those much rarer conditions where chronic inflammation is the primary problem cortisone can be a very useful part of the treatment.
Take home message: Cortisone is a powerful chemical and some care needs to be taken in its use. Whilst it will nearly always make you feel better initially, it will delay full-strength recovery for most musculoskeletal injuries. Sadly there are no magic cures not based on thorough assessment and a well thought out graded program.
If you have any problems or questions about this or any other related issues come and talk to us at Back To Health Physiotherapy. We would love to assist you back to your full potential!