depo-medrol.jpgWhat is cortisone?

Corticosteroids are medications that are commonly injected into the body to help relieve pain and inflammation.  Examples of corticosteroids include: Depo-Medrol(Methylprednisolone), Kenalog(Triamcinolone), and Celestone(Betamethasone). Many people refer to these corticosteroid injections as “Cortisone” injections.  The injections usually contain a corticosteroid medication and a local anesthetic.  They're most commonly injected into joints such as the ankle, elbow, hip, knee, shoulder, spine or wrist.  At Central Alberta Orthopedics patients may receive injections with Depo-Medrol mixed with a local anaesthetic such as Lidocaine. 

How do cortisone injections work?

The medications are synthetically formulated to mimic the steroid hormone cortisone, which is produced by the adrenal gland and released in response to stress. Intra-articular corticosteroids reduce synovial blood flow and alter local collagen synthesis. They have also been shown to decrease the local inflammatory modulator response by mechanisms such as interfering with inflammatory cell adhesion, interrupting cytokines like IL-1, and impairing leukotriene and prostaglandin synthesis.

What are the risks associated with corticosteroid injection?
Side effects can include:
  • Cartilage damage
  • Death of nearby bone
  • Joint infection
  • Nerve damage
  • Temporary facial flushing
  • Temporary flare of pain and inflammation in the joint
  • Temporary increase in blood sugar
  • Tendon weakening or rupture
  • Thinning of nearby bone (osteoporosis)
  • Thinning of skin and soft tissue around the injection site
  • Whitening or lightening of the skin around the injection site

There's concern that repeated cortisone shots might damage the cartilage within a joint. Cortisone injections are usually limited to less than once every 3 months and in certain areas then may be an upper limit as to how many total injections will be allowed.

What to expect after the injection?
Results of cortisone shots typically depend on the reason for the treatment. Cortisone shots commonly cause a temporary flare in pain and inflammation for up to 48 hours after the injection. After that, your pain and inflammation of the affected joint should decrease, and can last up to several months.
Is there a cost associated with a Cortisone injection?
The Alberta Health Care Insurance Plan pays for many of the services you receive from your doctor.  However, the government plan does not cover certain uninsured services. Any fee requested will be discussed with you before providing an uninsured service.  Payment will be expected when you receive this service.
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