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September 2011
Why Surgery ?
Cortisone Injections are the new thing
Dr. Naveen Reddy
Cortisone injections are nothing but the introduction of cortisol or corticosteroid (hormone naturally produced by the body and secreted by the adrenal glands) in an affected area of an individual's body in order to reduce pain and inflammation.

Cortisol also affects the metabolism of sugar or glucose and proteins in the body. There are various types of corticosteroids that are used and they differ in potency, side effects and the duration for which they can last.

Are they harmful?
A cortisone injection is not exactly designed to be a painkiller. However, it does reduce pain by reducing the inflammation and is commonly used for osteoarthritis of knee and rheumatoid arthritis conditions.

Short-term side effects
  • Shrinking and discolouration around the skin injected
  • Bacterial infection at the site
  • Weakening of the tendons
  • Temporary rise in blood pressure and sugar levels in diabetics
Long-term side effects
  • Thinning of the skin
  • Body begins to bruise easily
  • Thinning of the bones or osteoporosis
  • Rare but serious damage can be caused to the bones of large joints
  • Increase in blood pressure
Why is it an alternative to surgery?
Cortisone injections help in treating many conditions. In some patients, who suffer from already damaged joints, such as severe knee arthritis, it is unlikely that a cortisone injection can cause further joint damage. In such patients, an occasional administration of cortisone injection may delay the need for joint replacement surgery.

People always look for non-surgical means to alleviate their discomfort. For instance, patients suffering from severe arthritis of the hipbut with not much interruption in the function of the hip, can opt for physical therapy such as walking aids, cortisone injections, anti-inflammatory medications and joint supplements. This may avoid the need for a total hip replacement.

However, a patient ideally begins to get relief within two to five days from the day of taking the cortisone injection. If there is no sign of relief for the next 10 days, further diagnostic tests maybe required to analyse the pain. The injections can be repeated within a gap of three weeks; a maximum of three injections can be given.

Why cortisone injections?
A cortisone injection for orthopaedic problems is generally for reducing the inflammation that can lead to pain and loss of function in:
  • Many kinds of arthritis such as osteoarthritis (wear and tear kind of arthritis), rheumatoid arthritis, gout and pseudogout.
  • Inflammatory conditions in the tendons of the forearm, hand and wrist can be helped with cortisone injections, such as ‘tennis elbow’, ‘trigger finger’, Dequervains disease and plantar fascitis.
  • Inflamed bursas, the fluid-filled cushioning sacs present in joints, especially in the hip and shoulder.
  • Chronic back pain (epidural steroid for disc prolapse)
  • Hip pain that lasts for a week after engaging in extensive activity or exercise(bursitis) and post-traumatic bursitis.
  • Pain in the elbows on using the arm or hand (tennis elbow)
  • Shoulder pain (supraspinatus tendinitis) causing sleepless nights.
  • Conditions affecting many joints such as asthma, allergic reactions or rheumatoid arthritis (chronic inflammation of the joints or other parts of the body)
Dr.Naveen Reddy Consultant Orthopaedic Surgeon
Apollo Hospitals,Secundrabad

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