In many cases cortisone works to suppress inflammation for limited periods of time, and of course this often provides a degree of pain relief. But it doesn't really help to deal with the root cause of the problem. The end result is that the discomfort will return once the effects of the injection have worn off. There is also a limit to the number of shots you can get within a particular time period. Research on animals has indicated that cortisone can actually weaken tendons, fascia and cartilage in joints if it is over-prescribed and injected into local sites.
This potential (but frequent) adverse effect is more of a problem with younger people, because younger joints, tendons and fascia are still comparatively healthy. Patients in their mid-twenties or younger should definitely try other types of treatment before opting for cortisone injections. But with patients who are older, and whose joints usually have already experienced some fairly significant damage, this is not as much of a concern. There are also certain tendons and fascia that have a high tendency to tear even if the injections themselves are given as carefully as possible.
The physiological process of inflammation is generally a useful reaction. But it can end up impeding the healing process when it is present to an excessive degree. A cortisone shot is supposed to suppress unnecessary inflammation, which will then help the body to heal itself. But recent medical studies are increasingly starting to show that long-term fascia conditions like plantar fasciitis are, despite the name, not actually the result of inflammation but of some different mechanism. (The most likely suspect is thought to be direct damage to the primary fascia tissue.) Of course, this means that the whole rationale for the shots is decidedly iffy.
So why is it that patients often report a decrease in pain when they get a cortisone injection? Well, not all of them do - the injections are only effective about 50% of the time. But some people do experience some relief; for them, the most likely reason is that the analgesic that is put into the shots is temporarily masking the pain. And, of course, the possibility of a placebo effect should never be ignored.
This potential (but frequent) adverse effect is more of a problem with younger people, because younger joints, tendons and fascia are still comparatively healthy. Patients in their mid-twenties or younger should definitely try other types of treatment before opting for cortisone injections. But with patients who are older, and whose joints usually have already experienced some fairly significant damage, this is not as much of a concern. There are also certain tendons and fascia that have a high tendency to tear even if the injections themselves are given as carefully as possible.
The physiological process of inflammation is generally a useful reaction. But it can end up impeding the healing process when it is present to an excessive degree. A cortisone shot is supposed to suppress unnecessary inflammation, which will then help the body to heal itself. But recent medical studies are increasingly starting to show that long-term fascia conditions like plantar fasciitis are, despite the name, not actually the result of inflammation but of some different mechanism. (The most likely suspect is thought to be direct damage to the primary fascia tissue.) Of course, this means that the whole rationale for the shots is decidedly iffy.
So why is it that patients often report a decrease in pain when they get a cortisone injection? Well, not all of them do - the injections are only effective about 50% of the time. But some people do experience some relief; for them, the most likely reason is that the analgesic that is put into the shots is temporarily masking the pain. And, of course, the possibility of a placebo effect should never be ignored.
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