As a physical therapist, my patients regularly ask me if I think they should get a steroid injection.  This is a great question because even though the shot promises relief to a flared up joint or tissue, it can also have some negative side effects on someone depending on their medical history.  Today I want to discuss what the pro’s and con’s are of getting a steroid injection.

Let’s start with the Pro’s.  For anyone with a bursitis or an inflamed knee who has received a cortisone injection, they know just how awesome it feels to get that shot.  For some, it can literally be the difference between being able to walk or being stuck on the couch indefinitely.  I have spoken to countless people who had been dealing with some form of pain whether it was in the shoulder, the neck, low back or even their foot.  They were feeling hopeless and discouraged and depressed because of what they had been going through.  Once they got that shot, it turned their lives around.  Now they were able to walk, or reach over head or bend over or get a good night’s rest.  These are things most of us take for granted but not someone who has been dealing with pain for a long period of time.  It is no understatement when I say cortisone shots can be life changing and transformative.

The con’s to getting a steroid shot are real and need to be taken very seriously.  The first con to getting a steroid shot is knowing whether you are diabetic or not.  No, a cortisone shot is not going to give you diabetes, but if you already have it, a cortisone shot can make your blood sugar shoot through the roof for several days.  This can be problematic for certain diabetics.  Another con is the risk of tendon rupture or bones becoming more brittle and susceptible to fracture.  Now, the good news is, this usually only happens with chronic steroid use and it is something your physician is watching out for anyways but it can and sometimes does happen to people.  Something else people don’t realize is how painful the steroid injection can be.  While there is usually some discomfort associated with a syringe penetrating skin, joint, muscle, etc there can also be flare ups that come with said injections.  How will you know if you are going to be one of those people?  You won’t, at least not until it happens.  Like so many things in medicine, outcomes vary from patient to patient.  Having this adverse event happen can be very frustrating to anyone seeking relief.  Instead of decreasing pain, it has increased.  This can happen.  The last con that I wanted to speak about today that can occur from a cortisone injection is nothing.  Yes, nothing.  You go in, you get your injection and nothing happens.  This can be at times just as frustrating as getting a flare up from the injection.

So why wouldn’t an injection help?  Well they work just like anything else that requires precision.  If the injection doesn’t go into the body part that is causing the pain, it won’t help. And this, believe it or not, it where medicine becomes tricky.  Knowing what causes pain, in the case of low back pain, is very difficult.  Medicine has all sorts of images and tests to try to determine what is causing that pain and sometimes we actually get it right.  But there are plenty of other times when we miss the mark.  Figuring out what is causing pain, isn’t always that cut and dry.

In short, Cortisone shots can be a tremendous help.  There are hundreds if not thousands of people a day who receive them and feel better.  However, there are certainly those who also receive the injection and either feel no different or in some rare instances worse.  If you have more questions about this article, feel free to reach out to me via phone at 479-402-9400 or you can email me at [email protected].

Dr. Christian Robertozzi

Author Dr. Christian Robertozzi

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