Question: Why Are Cortisone Shots Variable in Effectiveness?
Injecting steroids (sometimes called "local" cortisone shots) into one or two specific areas of inflammation allows the doctor to deliver a high dose of medication directly to the bothersome area. When doctors give steroids orally or intravenously, they can not be certain that enough steroid medication will reach the problem area.
Answer: Doctors often inject cortisone-type medications into painful damaged joints. Single injections can relieve pain and swelling and appear to be safe, but papers from a scientific study in Greece, show that repeated injections can damage joints and delay healing. In light of these findings, you would think that doctors would stop injecting joints. However, since people can be crippled by arthritis, and a single cortisone injection into a damaged knee joint can allow an arthritic to walk without pain for many weeks, cortisone-type drugs continue to be used to reduce swelling, lessen pain, and allow patients to return to normal daily activities.
Cortisone injections vary, and both short and long acting preparations are used, depending on the patient's needs. The duration of effectiveness depends on the type of cortisone injected, and how long the patient rests the joint after injection. A good general rule to follow is to give no more that 2-3 injections into the same joint in any given year, and ideally, rest the joint for 1 week after each injection.
Answer provided by the late Dr. Raymond Federman, aka Dr. Bones, who passed away on September 2, 2003. The care of his patients even in retirement was always his joy.)
