The administration of a cortisone injection is an advanced skill that requires extensive post-graduate training and as a result very few private physiotherapy clinics throughout the UK are able to offer this service.
Cortisone is a very powerful anti-inflammatory injection. It helps to settle pain, swelling and inflammation. It does not have the same side-effects as anabolic steroids and does not help to build muscles. Anabolic steroids are synthetic substances related to testosterone. They have a muscle building effect. They have quite marked side effects with repeated use.
The cortisone is combined with local anaesthetic (LA), therefore the patient often experiences immediate relief of symptoms due to the effect of the LA. The LA wears off in a couple of hours and as a result the patient often experiences a return of the pain or even a slight worsening, known as 'post-injection flare-up'. An increase in pain can last for a few days and is best treated with icing of the area. The pain relief associated with the cortisone part of the injection can take from a couple of days to a couple of weeks. The timing of the pain relief depends on how long the inflammation takes to settle down following the injection.
This is also dependent on the condition being treated. It is common to need repeat injections for chronic conditions such as knee arthritis. For many conditions, one injection will be enough to resolve the problem or reduce the pain to a manageable level, so that the patient is able to perform exercises to further reduce pain and disability.
There is no hard and fast rule that says how many cortisone injections can be given over time. However, cortisone injections can have side effects (see below), and repeated use of cortisone injections should be done with caution. Most doctors / physiotherapists use the rule of no more than 3 injections in one area within one year. It is common to try a second injection, even if the first provided only partial or short-term relief. If there is only short-term relief following the second injection, a third is unlikely to help and therefore the doctor or physiotherapist would advise against it and would discuss alternative treatment options.
There is no universal agreement regarding the minimum period between injections in the same area, but 6 weeks is used as a general rule of thumb.
Cortisone injections are widely used in the treatment of joint and soft tissue conditions. They are very safe to perform. Side effects tend to be very rare or very minor. Our physiotherapist will discuss all of the potential side effects with you prior to administering the injection. There are certain conditions that would increase the risk of side effects, so our physiotherapists will discuss your medical history in detail before performing an injection. If it is not appropriate to offer you a cortisone injection, other treatment options will be discussed.
No, we do not offer spinal joint injections. It is recommended that these are performed by spinal surgeons under x-ray / ultrasound guidance.
No, cortisone injections are anti inflammatory. They have no muscle building / anabolic effect. They do not have the same side effects associated with anabolic steroids.
Our physiotherapists are happy to discuss any further questions / concerns you have regarding a cortisone injection before you book an appointment. Please call our booking line on 02920 547 210 to speak to a chartered physiotherapist.
The Independent General Practice