Written by: Matias Malkamaki, OMS II
Medically reviewed by: Dr. Nicholas Cheney
Around 1949, cortisone was synthesized for medical use for the first time. It is a lab-made drug that is similar in structure and action to the natural hormone cortisol. Cortisol is made in our adrenal glands and is transported throughout one’s body through the bloodstream.
Cortisol has many regulatory functions, including but not limited to energy regulation, modulating the immune system, and combating inflammation. The anti-inflammatory role of cortisone is where we get the primary benefit as a medication.
It can be used to help assist in treatment by decreasing a patient’s pain for countless different conditions. Some examples include bursitis, tendinitis, rheumatoid arthritis, etc.
Another term used to describe cortisol is a glucocorticoid (a specific kind of steroid). More specifically, cortisone is known as a synthetic glucocorticoid. You might also hear this drug prescribed as prednisolone and prednisone.
Pharmaceutically, cortisol is used for the anti-inflammatory properties mentioned above. The way these drugs work is that the cortisone molecules bind to immune cells and stop them from producing inflammatory molecules. This blocking of the natural inflammatory process can help reduce pain depending on the root cause.
If you have joint pain and want to know if you are a candidate for cortisone, then schedule a consultation with our expert team at OrthoNeuro. Our physicians will provide an accurate diagnosis and a specialized treatment plan for you. Call or book an appointment online with us today!
Cortisone can be administered in a couple of ways. It can be given as a tablet or taken orally. By taking it orally, the cortisone spreads diffusely throughout the body to get to places like internal organs. However, the most common way to administer it is via injection.
The benefit of injecting cortisone as a local anesthetic rather than taking it orally is that a physician can target the medication to a specific location in the body. These joint injections are also convenient due to their possible longer-acting effects and not needing daily administration. It is recommended that you wait several months between doses as repeated injections can, over time, cause tissue damage and even tendon rupture in extreme cases and even cause a risk of infection at the injection site.
Even though a person can get cortisone shots a few times each year, long-term use of steroid injections is not recommended. While corticosteroid injections can provide pain relief, they do not contribute much to the body’s natural healing process.
Masking the pain and reducing the inflammation can be just what a patient needs to get through rehab. However, due to the masking of pain, cortisone can also disincentivize people from doing the rehab and physical therapy their anatomy needs to recover. Thus, it can sometimes be a double-edged sword.
Cortisone is also an immunosuppressant, meaning that long-term usage could leave someone with a weakened immune system. There can also be medication issues for people with diabetes, as cortisone can raise a person’s blood sugar.
Cortisone injections are both diagnostic and therapeutic. Nowadays, cortisone is used more as a diagnostic tool than an actual treatment. The way this works is that a physician who suspects pain is coming from a specific joint, tendon, or another part of one’s anatomy, can inject that location with cortisone and figure out if the patient’s pain was relieved by the injection and for how long.
The job is done if the pain goes away for good after the injection and some physical therapy or lifestyle modification. If the pain is alleviated for a while and then comes back as the medicine wears off, then the physician knows they have correctly identified the pain generator/issue and can move on to the next stage of treatment.
As a rule-of-thumb, surgeons will choose to start with non-operative/conservative treatments. Non-surgical treatments can range from physical therapy to immobilization, lifestyle changes, and medicines such as cortisone injections.
The way to know if you need surgery is if your pain is incompatible with normal activities of life, non-surgical options are not helping, and/or your physician recommends it. All these signs together should help to understand where the management of one’s issue is headed.
Whether you need a cortisone injection, physical therapy, or surgery, OrthoNeuro has a deeply caring and extensive team of physicians ready to help you. Our physicians are skilled in many types of orthopedic surgery, including hip replacement surgery, knee replacement surgery, and other joint replacement surgeries.
Our team can help you with your hip, shoulder, spine, foot, ankle, hand, and knee pain. Do not let pain rule your life. Get evaluated by one of our excellent physicians so you can better understand the root cause of your pain and how it should be handled. Do not hesitate to check us out at https://orthoneuro.com.
