I think it’s time we set the record straight regarding cortisone injections for joint pain, including sciatica.
Cortisone Injections are injected into:
- The epidural space. It is called an epidural injection. This injection targets the area around the spinal cord where nerve roots exit and extend to our muscles and organs systems. The area near the nerve roots may be the source of low back pain, such as sciatica.
- Tendons and bursae to treat tendinitis and bursitis. Cortisone shots reduce inflammation of a tendon and/or bursa sac.
- Our joints to calm inflammation related to arthritis. Common targets are the knee and the facet joints in the spine.
According to the Harvard Health Publishing in association with HARVARD MEDICAL SCHOOL when “used appropriately, cortisone shots can calm inflamed joints and tissues but do not speed healing or prevent future problems. “
In their article, a paragraph subtitled “What to expect from a cortisone injection” the author goes onto say “If the cortisone shot works, you’ll certainly be grateful for the relief, but success is not guaranteed. In studies of large groups of back pain sufferers, the benefit is small to none on average. It’s hard to predict what you, individually, will experience. Corticosteroid injections do not change the course of a chronic back pain condition. Months down the road, you will generally end up in the same condition as if you never got the shot. In the meantime, the shot could ease your discomfort.”
In the study, Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials by Coombes et al., published October 22nd 2010 revealed that “over all, people who received cortisone shots had a much lower rate of full recovery than those who did nothing or who underwent physical therapy. They also had a 63 percent higher risk of relapse than people who adopted the time-honored wait-and-see approach.” – GRETCHEN REYNOLDS
I would like to ask a question to all of those who have received cortisone injections… Did your physician discuss with you the success rate and complications associated with a cortisone injection?
This is my father’s wrist after 3 or more (I am afraid to ask) cortisone injections for carpal tunnel syndrome. (Dad I LOVE YOU!). The cortisone damaged and weakened his wrist bones so badly, he had to eventually have the bones removed. Now he has screws and bolts with a pulley system for his thumb to function. Thank goodness the docs who did this were able to perform a surgery to restore full function of his hand so he can continue to play pickelball! 😱
Let review the risks of complications with cortisone injections per the Mayo Clinic:
- Joint infection
- Nerve damage
- Thinning of skin and soft tissue around the injection site
- Temporary flare of pain and inflammation in the joint
- Tendon weakening or rupture
- Thinning of nearby bone (osteoporosis)
- Whitening or lightening of the skin around the injection site
- Death of nearby bone (osteonecrosis)
- Temporary increase in blood sugar
The Mayo Clinic goes on to add that there are limitations on the number of cortisone shot because repeated cortisone shots might cause the cartilage within a joint to deteriorate. Doctors typically limit the number of cortisone shots into a joint to more than every six weeks and no more than three or four times per year.
PLEASE NOTE: It is not uncommon for doctors do give cortisone injections blindly. Meaning, they do not have an X-Ray orMRI to show where the source of the pain is coming from.
It is also important to note that pain may not actually be coming from an area that is suggestive on X-Ray or MRI. The whole body is connected through our fascia. Our nevous system lives within our fascia, therefore, pain can be referred. This means that carpal tunnel pain could be referred pain from your elbow, shoulder or even the neck and the actual cause could be your poor posture. For example, Back pain, and more specifically sciatica pain, can come anywhere from L1-2, L2-3, L3-4, L4-5, L5-S1, S1-2, S2-3, S3-4 or the piriformis sac. Even if the MRI is suggestive of a specific location, the pain may still be coming from another location.
The moral of the story…. THERE IS NO QUICK FIX TO JOINT PAIN! Instead of seeking pain relief from outside your body, seek to find why your body has pain in the first place. What did YOU DO that got yourself into this mess in the first place. I will give you some hints.
- Was it your poor posture?
- Was it your poor form while parking in your sport?
- Was the musculosketel imbalances including strength and flexibility between the front and back body?
This isn’t rocket science, it is basic human anatomy and physiology that A.T. Still, MD, DO preached since the 1800s and Socrates spoke about before CHRIST!
To reiterate… THERE IS NO QUICK FIX! You will need osteopathic manual therapy, a strengthening and myofascial stretching program and an ELDOA™️ practice to fix your broken body part. It will require hard work, dedication and courage to face you weaknesses. It will be HUMBLING and worth every second. The risk of complications and side effects of healing your own body:
- Improvement of pain
- Improvement in the function of affected organs systems
- Increase joint awareness & proprioception
- A balanced body
- A happier demeanor and/or mood due to lack of pain
- Increase in ones ability to partake in exercise or enjoyable activities including those involving human connection👨❤️💋👨💏👨❤️👨
PLEASE NOTE: ELDOA™️ postures are specific to each level of the spine and joint space potentially isolating the culprit of your pain.
PLEASE NOTE: Osteopathic manual therapy, strength training, myofascial stretching and ELDOA™️ pose must be practiced at your own risk as the benefit : risk ratio may far exceed cortisone injections.