Do Cortisone Shots Work Immediately for Osteoarthritis?

Cortisone shots are used to help treat some health conditions such as osteoarthritis (OA), a very common arthritis (joint disease). The goal of this treatment is to relieve inflammation and pain in a specific joint such as knee (the most commonly joint affected by OA), hips, spine, or even small joints of fingers. What you can expect and does the effect work immediately?

Understanding the use of cortisone shots in general

Actually, cortisone itself is a natural anti-inflammatory hormone in the body that exists all the time. Mostly, the treatment works locally. It is less likely to cause generalized side effects, unlike oral cortisone.

There are usually two major procedures in this treatment; making a local anesthetic and injecting a corticosteroid. The good news, the treatment can be done in a doctor’s office.

The bad news, there is a limited number of cortisone shots you can take per year. The reason is due to too much shots may become counterproductive because can increase the risk of worsening joint damage such as deterioration of the cartilage within the affected joint.

image_illustration214Furthermore, it can be potential to cause some of the following complications:

  1. Infection.
  2. The risk of damage to the nerve.
  3. Changes in the skin around the injection. These may include lightening or thinning of the skin.
  4. Osteonecrosis, a condition of when the blood flow to the bone doesn’t run as well as it should, affecting the life cycle of bone cells. It may make the bone easier to break down.
  5. Weakening or rupturing tendon.
  6. Osteoporosis (a weakening nearby bone).
  7. Inflammation and pain in the joint, these flare-ups are usually temporary.

So, again the use of cortisone shots is limited. Typically, it is maximally given about 3-4 times /year with the minimum interval by every 6 weeks.

Any medicines or supplements that can cause a blood-thinning effect can worsen the complications because they increase the risk of bruising /bleeding. If you are taking some of these medicines /supplements, make sure to tell your doctor before taking a cortisone shot.

How to do it?

You may be asked to use a comfortable cloth so thus you and your doctor can do the procedure of injection as well. If necessary, you may need to change your clothing by a gown.

Then the area of the injection will be cleaned. To reduce the pain during treatment, anesthetic spray can be applied to locally numb the area of injection.

It’s important to ensure that the medicine is injected to the right spot. Fluoroscopy can be used to help guide your doctor in injecting the medicine to the exactly right site. Then the medicine is released through injection to the joint.

Does the effect of the treatment work immediately?

During and after the treatment, the area of injection will initially be numb. This numbness can last about 2 to 8 hours, depending on the type of anesthetic used in the treatment.

After numbness, the area of injection may get increased soreness. Typically, it will maximally last about a day (24 hours). Getting plenty of rest and sleep, and applying an ice pack to the area of soreness in the evening are some common recommendations for coping!

How long it takes for the medicine to work effectively?

The cortisone shot generally start working within t 3-4 days. But typically it begins working effectively (full effect) about 7-10 days after the treatment.

The following are major checklist you need to follow after the treatment:

  1. To make sure the medicine work optimally, avoid a significant use of the joint with cortisone shot about a week or follow the direction from your doctor!
  2. The use of ice pack is also recommended to help relieve the pain.
  3. Keep monitoring the symptoms that you feel! If you experience unusual symptoms such as infection or increasing soreness, redness, and pain that last more than 2 days – see your doctor promptly!

Depending on the reason of why you need to take it, the prognosis of the effect with this treatment can vary. While some can have long-term pain /inflammation relief, others even get permanent relief.

Cortisone shot is one of surgical options for osteoarthritis. If it doesn’t help enough, your doctor may recommend other treatment options such as lubricant injection (with Hyalgan, Synvisc) or even a joint replacement.

References:

  1. http://www.mayoclinic.org/tests-procedures/cortisone-shots/basics/results/prc-20014455
  2. http://www.nlm.nih.gov/medlineplus/osteonecrosis.html
  3. https://uhs.berkeley.edu/home/healthtopics/PDF%20Handouts/Cortisone%20Injections.pdf