Pros and Cons of Cortisone Injections

By: Shruti Jani

Patients will often times ask the therapist their opinion on cortisone injections. Cortisone injections can be very helpful and significantly reduce inflammation, however, some therapists feel this can mask the pain not treating the true root cause of the problem. This is often debated among therapists. A short synopsis of the pros and cons of cortisone injections will be provided.

Cortisone injections are a type of steroid that has been used in orthopedic conditions to
reduce inflammatory response and pain. Cortisone mimics our body’s natural corticosteroid
hormones (cortisol) produced by the adrenal glands. Cortisone is mainly an anti-inflammatory
medicine, not a painkiller. However, pain is often diminished once the inflammation goes down.
Cortisone is effective in conditions such as arthritis, tendonitis, bursitis, frozen shoulder, plantar
fasciitis, carpal tunnel syndrome, herniated disc, rotator cuff injuries, and more.
Cortisone injections are often recommended if the pain is localized and not controlled by
first-line anti-analgesics. It works directly at the site of inflammation leading to a direct target
effect, and this, in turn, also leads to a reduction in pain. However, some side effects and
disadvantages should be considered for cortisone treatment.


  • Small dosages can prove effective for some patients
  • Cortisone is a naturally occurring substance in the body, so most patient tolerates the
  • A patient may only feel minimal discomfort
  • Cortisone injections have few but usually tolerable side effects, i.e., palpitations, tremors,
    skin site erythema, and facial flushing.
  • Drug’s effect is limited to a specific area.


  • High concentration or repetitive use of medication can damage tissue in the body. This
    may also lead to the weakening of the tendons or softening of the cartilage.
  • Repetitive cortisone may cause damage to the joints of healthy tendons of young people.
    Oral anti-inflammatory medications, ice and heat applications, and physical/occupational
    therapy should be attempted first in the case of young individuals.
  • Certain tendons (E.g., Achilles tendon) are prone to rupture when treated with cortisone
  • Other serious but rare adverse events include bone necrosis, joint infection, nerve
    damage, a serious increase in blood sugar, and a weakening of the immune response.

Cortisone injections are an excellent treatment option for many inflammatory conditions
with various advantages. Caution should always be undertaken to reduce the possibility of adverse


Jonathan Cluett, M. D. (2022, January 28). Are cortisone injections bad for you? Verywell

Health. Retrieved October 29, 2022, from

Mayo Foundation for Medical Education and Research. (2021, May 20). Cortisone shots. Mayo

Clinic. Retrieved October 29, 2022, from

Urgent Care Omaha. (2019, September 16). Cortisone Shots Pros & Cons: Urgent Care Omaha
& Bellevue, NE. Urgent Care Omaha. Retrieved October 29, 2022, from


  1. Laura Coleman on May 30, 2023 at 12:52 am

    Good information. As a hand therapist I often am at a loss as to whether I should encourage patients to get an injection. Every doctor has a different opinion and I don’t like to contradict them. This provides basic objective info. No opinions. Thank you

  2. Maria on May 30, 2023 at 8:32 am

    You mentioned repetitive cortisone injections – Can you clarify what the risk scale is for repetitive use?
    I am not an injecting therapist but have been led to understand the following:
    – that if a steroid’s beneficial effect wears off within 3 months then it is not advised to have another and to seek alternative treatments,
    – that people can have more than one injection, up to approx 3/year, (if needed) ? in the same location

    How many is too many? (some people have more than 3 over a couple years).

    I don’t know if you can answer these questions but I am just curious to get some clarity because these are also questions people ask.

Leave a Comment

More To Read

Splinting and Stretch Protocol for Pediatric Trigger Thumb

May 10, 2020

Tan, A. C., Lam, K. S., & Lee, E. H. (2002). The Treatment Outcome of Trigger Thumb in Children. Journal of Pediatric Orthopaedics B, 11(3), 256-259. The Skinny:Pediatric trigger thumb is a “relatively uncommon” condition of unknown origins. Studies have indicated that spontaneous recovery of trigger thumb is around 25-40%, and chances increase with age.…

Read More

The Utilization of CBD Hand Therapy for Pain Treament

October 3, 2021

Patients frequently ask for advice on how to alleviate their pain symptoms.  It is common for them to ask about the benefits of CBD Therapy. With the expanding holistic treatment market, Cannabis and CBD is at the forefront of holistic pain treatment.   This article aims to give an overview of the utilization of CBD…

Read More

Hand Pain in Pregnancy and the New Parent

September 27, 2020

By: Rachel Reed The transition to parenting can be difficult on a mother or parent’s body, especially when considering the increase in repetitive hand use required to care for a baby. The most common upper extremity conditions that develop during pregnancy and postpartum are carpal tunnel syndrome and de Quervain’s tenosynovitis (Wagner, 2019). Frequently, new…

Read More

Sign-up to Get Updates Straight to Your Inbox!

Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.