Cortisone Injections
What a cortisone shot actually does, when it helps, and what to expect.
What It Is
A cortisone shot is a small injection of a steroid medicine — a strong anti-inflammatory — usually mixed with a numbing medicine like lidocaine, placed directly into an inflamed joint, bursa, or tendon. The steroid calms the inflammation for weeks to months; the numbing medicine gives short-term relief and helps confirm we injected the right spot.
Cortisone injection is the most commonly used non-surgical treatment in orthopedics and has been in use, in essentially its current form, since the 1950s.
How It Works
Cortisone is a strong anti-inflammatory medicine. When injected directly into an inflamed area, it quiets down swelling and pain at the source. It does not reverse arthritis, regrow cartilage, or repair a torn tendon — it simply turns down the inflammation around the problem so you can move and feel better.
Conditions We Commonly Use It For
Knee arthritis
Short-to-medium term relief while we work on weight, activity, and physical therapy.
Hip arthritis
Done with ultrasound or X-ray guidance; useful both to treat and to confirm the hip is the pain source.
Shoulder arthritis
Targeted relief for stiffness and pain before considering a joint replacement.
Shoulder impingement & bursitis
Injection into the space above the rotator cuff, paired with rotator-cuff rehab.
Rotator cuff irritation
Adds to physical therapy for shoulder pain that isn’t a full tear.
Frozen shoulder
A cortisone shot into the joint can shorten the painful phase.
Tennis elbow
Short-term relief; repeating the shot over and over isn’t supported by the evidence.
Carpal tunnel syndrome
Both treats the symptoms and helps predict who will do well with release surgery.
Trigger finger
Usually the first thing we try — often solves it without surgery.
De Quervain’s wrist tendonitis
Injection into the affected thumb-side tendon sheath; high success rate.
Thumb-base arthritis
Relieves joint pain before a thumb-base reconstruction is considered.
Outer-hip bursitis
Injection into the inflamed pocket on the outside of the hip.
Plantar fasciitis (heel pain)
Used selectively when stretching and orthotics haven’t helped. Repeated shots can weaken the plantar fascia.
Morton’s neuroma
Injection around the irritated nerve between the toes.
Facet joint back pain
Image-guided injection of the small joints at the back of the spine.
What to Expect
- The shot itself takes a few minutes. Some joints go in by feel; deeper ones (hip, occasional shoulder) use ultrasound or X-ray guidance for accuracy.
- A small group of patients (about 1 in 20) get a brief “steroid flare” — increased pain for 24–48 hours. Ice and an over-the-counter anti-inflammatory usually settle it.
- Relief usually starts 2–5 days after the injection and peaks at 1–2 weeks.
- How long it lasts varies widely — weeks to several months. Some patients get long, durable relief; others need a repeat down the road.
Risks and Limitations
- It’s temporary. Cortisone calms inflammation; it doesn’t cure the underlying problem.
- How often we’ll do it. We generally limit repeat injections in the same joint to about every 3–4 months, and we avoid repeat shots directly around weight-bearing tendons.
- Blood sugar. If you have diabetes, expect a short rise in blood sugar for 3–7 days after the shot.
- Skin changes. A small chance of lightening of the skin or thinning of the fat at the injection site, especially with shots that are close to the skin.
- Infection. Very rare (less than 1 in 10,000) when done with sterile technique.
- Tendon concerns. Repeated shots right next to a weight-bearing tendon (Achilles, patellar) can weaken it, so we generally avoid those.
- Cartilage. Long-term studies show repeated cortisone in an arthritic knee over many years may contribute to a small extra amount of cartilage loss, so we tailor how often we repeat it.
Next Steps
If you and your provider decide a cortisone shot is the right next step, it can often be done at the same clinic visit. Request an appointment or call (830) 625-0009 to schedule.