Cortisone injections are anti-inflammatory local injections that have the following benefits:
 | Pain relief from inflammation associated with tendons and surrounding bursae (swollen sheaths of tendons) |
| Reduction of swelling |
| Reduction of the symptom of 'impingement' (two structures causing pain by excessively rubbing against each other) |
The three environments in which I feel cortisone injections offer the most benefit are the following:
- Impingement lesions, such as ITB friction syndrome of the knee, trochanteric bursitis of the hip, and rotator cuff impingement of the shoulder (without major tendon damage).
- Conditions where the prognosis for long-term improvement is very good due to removal of overuse trigger for injury.
- Situations where short-term pain relief is by far the major priority for management.
The possible negative effects of cortisone injections are:
| Weakening of tendons if further excessive load is continued soon after the injection, possibly leading to tendon rupture (this is THE most significant side effect). |
| Infection (can happen but very rare in my hands - over 2000 injections given, no known infections) |
| Skin reaction (can happen but usually mild) |
| Cost if the treatment doesn't work (although usually less than other treatments such as physiotherapy or surgery) |
| Pain of injection (usually only bad in the sole of the foot as cortisone can be given through thin guage needles) but varies from person-to-person |
Some research papers which compare cortisone injections to other treatments are linked below:
Shoulder tendonitis and cortisone injections versus physiotherapy Comment
Cortisone injections and tennis elbow Comment
Review of use of cortisone injections (this review is quite negative regarding the use of cortisone injections for overuse tendon disorders. It doesn't cover the use of cortisone for impingement lesions like ITB friction syndrome or trochanteric bursitis).