Are You Considering Cortisone Injections?

Corticosteroid therapy are among the most commonly used treatment modality in the orthopaedic world. They are powerful anti-inflammatory drugs that provide strong and quick effects to conditions such as osteoarthritis, tennis elbow, plantar fasciitis, gout, tendonitis and trigger finger. Research has shown that cortisone injections provide short-term pain relief for chronic and severe conditions. Hence, the general population are more inclined to select corticosteroids therapy as a treatment for their condition.

However, there are several serious side effects of corticosteroids and it is important for clients to be aware of these before resorting to cortisone injections. Here are a few of the known side effects that you should be aware of:

  1. Weakening of Tendons: High concentrations of cortisone (hence we call it ‘cortisone shots’) are usually injected into the specific joint space. Studies found that repetitive use of cortisone injections (as multiple can be required) can result in softening of the cartilages and damages of the surrounding tissues, therefore effecting the healthy tissue in the injured area along with the damaged structures. Subsequently effecting the joint more than the previous injury.
  2. Chondrotoxicity: There is evidence found that a single dose of cortisone injection is associated with consistent and significant chondrotoxicity (toxication of cartilages). It is to be seriously considered before allowing young healthy athletes this injury treatment. The drug loses its effect over time, meaning subsequent injections are required and co- currently worsening the joint that causes more damage.
  3. Increased bone fragility: Oral corticosteroids or consumed through IV, the drug enters through the bloodstream and inhibits osteoblast replenishment. Subsequently affecting the formation of new bone collagen that decreases bone density and therefore increase rick of serious injury.

    Aside from the side effects mentioned above, other side effects include: elevated blood sugar, risk of infection, thinning of skin and osteonecrosis are to be considered before opting for corticosteroid therapy.

Here are some recommendations/ alternatives when dealing with joint inflammation:

  1. Supplementation/ Herbs: Using natural occurring anti-inflammatories such as; curcumin, fish oil, ginger, white willow, glucosamine, black catechu, baical skullcap, boswellia, bromelain, devil’s claw. Ensure to ask your health practitioner on what’s best for you!
  2. Diet: Consuming fresh food including leafy green vegetables, nuts, omega 3 rich fish, fruits, monosaturated fats like olive oil, avocado and almonds. AVOID: Refined starches, sugar, saturated fats and trans fats.
  3. Chiropractic Adjustment: Poor biomechanics and aberrant joint function can cause inflammation, chiropractors aim to realign the joints and vertebrae in your spine to reduce pressure on the nerves and promote a healthy nervous system.
  1. Physiotherapy: Physiotherapy treatment includes various modality such as joint mobilisation, dry needling, progressive exercises, biomechanical and postural corrections. Physiotherapy can assist to speed up the healing process and ensure an optimal outcome with inflammatory pain due to a musculoskeletal injury.
  2. Occupational Therapy: Soft Tissue Therapy can help to de-load joints from taut muscles and soft tissue structures along with correcting postural faults that cause or contribute to inflammation. Our OTs are able to provide a holistic approach to injury management through by analysing occupations and basing recommendations from this including: ergonomics, lifestyle advice, activity modification, stress management and mental health.
  3. Exercise: Physical exercises promote good circulation for the healing process to reduce inflammation. It is encouraged to practise gentle exercises every day as recommended by your health practitioner.
  4. Sleep & De-loading: We cannot stress enough how important sleep and de-loading is for our body to repair and heal. Stress is also part of the inflammation process, learning and teaching yourself strategies. For example; mindful walking, eating, breathing and being in the moment rather than thinking of the 35 other things on your mind.

Plan for the future – not just from injury to injury.