Cortisone injections are usually given no more than four times a year per affected joint. Most physicians recommend a space of at least three months between injections. If the injections are not providing significant relief from the pain in the joint, they are generally discontinued as a treatment option. Injections of cortisone are not given prior to surgery, as they can cause a decrease in the immune response and increase the length of the recovery period.
Cortisone treatments are prescribed to reduce the amount of inflammation in the joint. Cortisone is not a painkiller; the pain relieving benefits of the steroidal medication are related to its ability to reduce inflammation in the joint. The inflammation is what irritates the surrounding tissue and causes the joint pain to occur. The cortisone in the shot is usually mixed with a numbing agent to decrease the pain felt when the medication is injected into the body. There are many types of cortisone used for the treatment of joint pain, and physicians will choose which cortisone to use based on the joint being treated.
Cortisone injections can cause a decrease the immune response, so people with lowered immune systems are not typically good candidates for the treatment. Physicians are not likely to prescribe injections of cortisone for long-term therapy, as repeated use of the steroid may cause damage to the cartilage of the joint. The steroid shots are most often given for conditions such as osteoarthritis, carpel tunnel syndrome, and tennis elbow. Patients with rheumatoid arthritis and lupus have reported benefits from cortisone injections, noting a decrease in the pain felt in their joints.
Side effects of frequent cortisone shots may include a thinning of the soft tissue around the joint being treated. The skin around the injection site may become a lighter color, and a thinning of the skin may become noticeable. If the cortisone shot is given too close to a nerve, the nerve may lose the ability to function properly; there also may be a non-stop tingling for a few days or even a lasting pain emanating from the nerve.
When the cortisone injections are given too often, there have been reported cases of bone death near the joint being treated. A thinning of the nearby bone, tissue, and tendons are another known risk of cortisone shots. Diabetics receiving injections of cortisone may notice an increase in their blood sugar levels because the cortisone delays the natural absorption of the sugars into their tissues. The increase is not usually enough to discourage the treatment of joint pain with cortisone injections, however.