Are Cortisone Injections Effective for Shoulder Pain?

If you have been experiencing shoulder pain for some time, you may be wondering what options are available other than medication. Cortisone shots may be an effective alternative to manage pain or inflammation.

What are cortisone injections?

The injections use a medication to target both pain and inflammation in joints. Many have found that cortisone injections provide relief for shoulder pain even when the pain is not a new symptom. 

The injections contain both a corticosteroid medication and a local anesthetic. The injections are given outpatient at the clinic but are limited in the number provided yearly due to potential side effects. If you are considering asking about a steroid shot for your shoulder from an Orthopedic provider, there are some important things to consider. 

How does a cortisone shot work

Cortisone shots work by decreasing inflammation in the shoulder. Once the inflammation subsides, then patients feel relief from the pain. 

Decrease in inflammation can take time, and some patients may even need more than one injection before they find relief. However, this is not common, and most patients do well on their first cortisone shot. If you have not had relief of symptoms within a few weeks of the first injection, speak with your provider to see if a second injection may be beneficial. 

Why would I need a cortisone shot for shoulder pain?

Often cortisone shots are effective for patients who are experiencing arthritis in their joints. This can include osteoarthritis, Rheumatoid arthritis, or psoriatic arthritis. 

The injections can also provide short-term pain relief for shoulder pain related to injury and other shoulder conditions. 

How long does it take for a cortisone shot to work?

Generally, cortisone shots work very quickly. Often full effects of the injection are felt within 5 days of the injection. The time varies as to how quickly relief is felt, but many people feel a difference within a day of the injection. 

Relief varies based on how fast inflammation decreases in the area of the injection. Following a decrease in inflammation, pain relief then occurs. 

How is a cortisone shot administered?

Cortisone shots are injected into a specific area of the body, such as the shoulder. The provider may use different types of cortisone medications. The medication is mixed with a local anesthetic before it is injected into the affected area. 

The local anesthetic works by providing some pain relief from the initial injection and pain at the injection site. 

The provider thoroughly sterilizes the area before the injection to eliminate the risk of a secondary infection after the procedure. A needle containing the medication is then placed into the joint or tendon sheath, and once in the proper position, the shot is given. Usually, the doctor uses radiographic guidance to ensure the injection is given in the right location.

Once the injection is given, a simple band-aid or small piece of gauze is usually placed over the injection site. There is generally very minimal bleeding. 

Are there side effects to cortisone shots?

As with any procedure, there are always possible side effects. Rarely patients experience what is known as a cortisone flare. What is a cortisone flare? It is a rare side effect where the injected cortisone medication crystallizes. 

If this happens, patients can experience more pain than before they had the injection. It usually only lasts for one to two days and can be managed by rest and icing the affected area. 

Other potential side effects to a cortisone shot for shoulder pain can include:

• Facial Flushing
• Elevated blood sugar
• Pain at the injection site
• Bleeding at the injection site. This is usually only a risk if you are currently taking blood thinners. 
• Cartilage damage
• Nerve damage
• Joint infection

It’s important to understand that most side effects are very rare as corticosteroid injections are generally a very safe procedure. However, if you experience any of the above side effects or have any other unusual symptoms, be sure to speak with your orthopedic specialist as soon as possible. It is also important to be aware that the risk of side effects increases each time you have a steroid injection or if large amounts of cortisone are used for treatment. 

How many injections are safe to have? The general rule is that you do not have an injection sooner than six weeks from your last injection and limit it to 3 to 4 injections per year. This helps to eliminate the side effect of damaging the cartilage in the joint. 

What can you expect after your cortisone shot?

Some people experience facial flushing or a feeling of warmth when they have a cortisone shot. This is just a temporary side effect and isn’t unusual or concerning. 

Your doctor will instruct you to be mindful of the area around the injection site for 1-2 days after the injection. It is important to avoid any heavy lifting for a few days after the injection. 

You can apply ice to the area to help with any pain that you experience after the shot. It’s best to avoid heat which includes heating pads and baths. It is ok to shower after having a cortisone shot. 

Your doctor will give you additional instructions, which will likely include looking for any signs of infection around the injection site, report any abnormal pain or inflammation that is not improving, as well as any redness noted around the injection site. 

If you have mild pain after, you can take over-the-counter pain medication, including acetaminophen, to help minimize the pain. 

The best news is generally, after a few days, you will feel relief from both pain and inflammation, and the effects usually last for a few months. Many patients opt for corticosteroid injections to manage their pain and maintain normal, functioning lives. 

Where Can I Learn More About Shoulder Orthopedics Options?

If you have shoulder pain, several options are available to you, which may include steroid injections. Only an Orthopedic Specialist can evaluate and make the best recommendation for your specific needs. 

If you need a consultation for your shoulder pain, contact us today at Sports and Orthopedics Center. We are here to help you find relief so you can live your best life!