While cortisone injections have been shown to be effective in treating inflammation and pain in joints, they have some limitations. These limitations are discussed here.

Within a broader treatment plan, cortisone injections are given

With these injections, you can get temporary relief. However, if long-term relief is desired, patients are typically advised:

  1. Physical therapy should include exercise. Muscles and soft tissues can be strengthened to alleviate pain and other symptoms of arthritis. In one study1, physical therapy was more effective than cortisone injections over the long term.
  2. You should lose weight. Your joints will be more comfortable when you lose weight. The likelihood of cortisone injections helping patients with knee osteoarthritis may be reduced when patients are obese.
  3. Take on a new way of life. Changing your footwear every day can help reduce the amount of microtraumas your joints suffer.

This will result in improved joint biomechanics and will decrease or eliminate cortisone shots.

Without other treatments, joint pain may worsen over time

Repeated cortisone treatments may cause chronic pain relief to become shorter and shorter over time. It may not be the medication causing the joint to degrade, but the patient’s tolerance to it. With physical therapy and a change in lifestyle, joint degradation can be stopped or slowed.

Activity should be gradually increased

A Cortisone injection might take up to a few days to become fully effective. In general, patients during this time are told to rest and reduce their normal activities.

After joint pain has been relieved, a patient may be tempted to start exercising immediately.
In general, doctors recommend patients gradually resume normal activities and gradually increase intensity over time to avoid causing injuries or making their condition worse.

When repeated too often, injections can cause soft tissue damage

When you use too many injections within a short period, the tendons, ligaments, and cartilage at the injection site may be damaged. Here are some reasons why:

  • Injections should be spaced several weeks apart when more than one is required at the same time. Some doctors would rather wait up to four months before administering multiple injections at the same time.
  • Ideally, you should not inject more than three or four times in the same place per year.
  • After receiving a cortisone injection, a surgeon typically needs to wait 3 months before operating on an affected joint.

Tendons are especially prone to degeneration and injury from cortisone injections. Since cortisone is associated with this risk, doctors will avoid injecting it directly into a tendon even if a tendon appears to be the source of discomfort. Even if cortisone is injected near a tendon, it can reduce inflammation because cortisone works locally.

Despite whether an injection was administered in or near the Achilles or patella tendons, these tendons are particularly vulnerable to injury post-injection. Therefore, Achilles tendinopathies and patellar tendinopathies are rarely treated with cortisone injections.