Common Cortisone Shot Questions Answered

One of the most utilized treatments in the medical field for orthopedic conditions is a cortisone injection. As an orthopedic surgeon and sports medicine physician at Advocate Sherman Hospital, I am often asked questions about cortisone shots by my patients and their family members. Below are the top five questions I typically get asked.

What is cortisone?

Cortisone is a naturally produced hormone released by the adrenal gland in your body during times of stress. A synthetic, injectable version of cortisone is available as a medication that can reduce inflammation, taking away pain and swelling in muscles, joints, and soft tissue.

Who is a candidate for cortisone injections?

Cortisone injections are given to patients with a variety of medical conditions including shoulder and knee arthritis, rotator cuff tendonitis, tennis elbow, and bursitis. These are the primary inflammatory conditions where an injection of cortisone would be used and are commonly performed in the physician’s office setting.

Does the injection help right away and last for a long time?

A cortisone injection can take between 2-7 days to begin reducing the inflamed area. Depending on the severity of the condition, an injection may last anywhere between one month to ten years. Although cortisone can be administered to more than one area of the body, the general recommendation is that these injections are spaced out every four months per injection location.

Are cortisone injections safe?

Overall, cortisone injections are very safe. Occasionally, the steroid injection can be known to temporarily increase a patient’s blood sugar. For those patients with diabetes, we recommend 24-hour blood sugar checks after an injection. Too much cortisone may also damage tissue, which is why injections are spaced out every four months.

Does the injection hurt?

Usually, a cortisone injection completed by an experienced professional is no different than a needle stick for a blood draw. Each injection takes under 5 seconds to administer, and it is only one needle stick. Less painful areas for injections are the shoulder and knee, while more sensitive areas like the bottom of the foot have higher pain potential.

In my profession, I have found cortisone injections to be a safe and effective way to decrease inflammation and reduce pain associated with common orthopedic conditions. Ask your primary physician if a cortisone injection would be an appropriate treatment plan for your condition.

The use of Platelet-Rich Plasma in Orthopedic Surgery and Sports Medicine

Platelet-Rich Plasma (PRP) therapy is a new, minimally invasive injectable therapy used to treat many common orthopedic conditions. The injection is composed of a specially prepared sample of a patient’s own blood, which is then injected into damaged or surgically treated tissue. It is used to decrease pain associated with overuse conditions such as tendinitis, stimulate muscle recovery after a new injury and promote healing after surgery.

This therapy consists of a high concentration of a patient’s own platelets, which are a normal component of blood. Platelets play a significant role in accelerating the normal healing response by helping recruit cells that repair tissue and speed the rate of recovery. Some studies show that PRP therapy can help rebuild joint cartilage and strengthen injured ligaments and tendons.

How is PRP created?

PRP is created by taking a sample of a patient’s own blood (similar to when blood is drawn for routine blood work). The blood is then placed into a machine and filtered to separate out a high concentration of platelets. This “platelet-rich plasma” is then injected into a specific area to treat muscle or tendon injuries and enhance healing. The entire process takes about 15 minutes and can be performed in an office or operating room setting.

Does PRP therapy work?

PRP has been used and proven effective in multiple medical specialties including cosmetic surgery, maxillofacial surgery, urology, and ophthalmology. The use of PRP in orthopedics, especially sports medicine, is growing given its potential to enhance muscle and tendon healing.

Laboratory testing has supported the beneficial effects of PRP therapy in new muscle, tendon and ligaments injuries, as well as in the treatment of more chronic overuse conditions such as tendinitis. Multiple promising studies suggest PRP to be beneficial in shortening recovery and rehabilitation after orthopedic surgical procedures.

What sports injuries respond best to PRP therapy?

Early orthopedic studies have shown good results when giving PRP to patients with tennis elbow (lateral epicondylitis), golfer’s elbow (medial epicondylitis), Achilles tendonitis, rotator cuff tendinitis, plantar fasciitis and patellar tendonitis.

PRP therapy is now being used as a treatment option during surgery to enhance healing and speed the rate of recovery after anterior cruciate ligament (ACL) reconstruction, Achilles tendon repair, and rotator cuff repair.

In addition to using PRP to treat chronic debilitating overuse conditions, many professional athletes have used PRP injections to get back on the field faster and safer after muscle or tendon injury. The use of PRP in sports medicine has the potential to lead to higher rates of healing, a faster rehabilitation after injury, and a quicker return to activity for athletes of all levels.

How many treatments will I need to experience results?

The number of treatments can vary and depends on the severity of the problem or injury. Some people respond within four weeks and only require one treatment. Other times a response can take up to six months and require multiple injections.

Is PRP therapy safe?

Because the injection is simply a platelet-rich version of a patient’s own blood cells, the therapy is very safe. The risk of allergic reaction or disease transmission is effectively zero. Patients with a known blood disorder or infection should avoid PRP injections.

What does PRP therapy cost?

he price of a PRP injection is an important consideration, as the cost varies. As PRP therapy may be able to prevent an expensive surgical procedure or possibly enhance the speed of healing after surgery, some insurance providers will reimburse for PRP injections.

Given PRP therapy’s excellent safety profile and ease of preparation, its use in sports medicine will likely continue to grow. The procedure is minimally invasive, virtually painless and far less expensive than surgery. In addition, the potential to improve tissue healing and get patients back to their activities quickly and safely make this procedure attractive to both patients and physicians. Consult an experienced health care provider or orthopedic surgeon to see if a PRP injection is right for you.

Joshua Alpert, M.D. is a board certified orthopedic surgeon, fellowship trained in sports medicine and arthroscopy at Massachusetts General Hospital/Harvard. As an active member of the American Orthopedic Society for Sports Medicine, Dr. Alpert treats individuals of all ages. He is a physician with the Midwest Bone & Joint Institute, which has served the Chicago area for over 30 years. He may be reached at 847-931-5300.