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Cortisone Shots: Panacea for Pain?

What are the side effects of a cortisone injection?

Answer (Published 5/24/2002)

Updated on 6/22/2005

A cortisone shot may be recommended when more conservative measures - anti-inflammatory drugs and physical therapy - fail to relieve localized pain, usually in the joints or tendons. It can produce dramatic results and is believed to work by blocking the body's natural inflammatory response. However, the effects are temporary and do nothing for the underlying cause. Pain relief from the shot begins within a few days and may last for a few days or up to a month, but unless you address the cause, it will recur.

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The shots are most often used to relieve pain due to tennis elbow and other sports-related injuries, joint pain from osteoarthritis, bursitis, plantar fasciitis, carpal tunnel syndrome and back pain due to a herniated disk. Sometimes, pain can be from muscular trigger points that refer pain into a joint, without the joint itself being a problem. If that's the case, a cortisone shot won't help.

A single shot is unlikely to prove harmful - the only side effect may be some pain due to the injection itself. However, repeated shots can lead to a number of serious side effects including weight gain, high blood pressure, cataracts, diabetes, osteoporosis, reduced immunity, increased risk of infection and long-term damage to an inflamed joint or tendon. These risks, coupled with the fact that the shots don't have any curative effect on the underlying problem, make them a poor choice for long-term treatment.

If your pain is due to a sports-related injury, your best bet is to consider whether you may have hurt yourself as a result of a weakness or improper training and do what you can to address these possibilities. Among the alternatives you can explore are acupuncture, osteopathic manipulation, various forms of body work, and the use of natural anti-inflammatory agents such as ginger and turmeric.

Andrew Weil, M.D.

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