SPORTS TIP Cortisone Injections EXPERT CONSULTANT: Matthew J. Matava, MD

What is cortisone? treatment as they may turn off the body’s do not last long and resolve with icing Injectable corticosteroid medications, “alarm system,” ultimately leading to after 12 to 48 hours. a more significant injury later on. commonly called “cortisone,” have been Whitening of the skin around the used by orthopaedic professionals since injection site is also a common side Who shouldn’t have a cortisone the early 1950s for a variety of conditions, effect in dark-skinned individuals. injection? including tendonitis, arthritis, tennis This discoloration is not harmful. elbow, and carpal tunnel syndrome. There are very few contraindications in Cortisone is naturally produced in the the use of cortisone injections. However, Additional side effects include softening body through the adrenal gland and the following conditions should be fully of cartilage and weakening of tendons at released when the body is under stress. discussed with an orthopaedic professional the injection site. This usually occurs in Injectable cortisone is synthetically before seeking a cortisone injection: patients who receive shots on a weekly- to-monthly basis, during a period of produced and is similar to the body’s Ⅲ Infection of a joint (septic arthritis) own product. By minimizing inflammation, months to years. Most surgeons currently Ⅲ Skin infection at the site injectable cortisone can provide significant recommend having injections at least of the injection pain relief and allow for an earlier three months apart and avoiding repeat injections within a short-time period. return to activity, whether to complete Ⅲ Allergic reaction to previous a weekend home repair effort or to win cortisone injections Diabetic patients may experience

a football game. Cortisone injections Ⅲ Usage of blood thinners, a temporary, but significant, elevation are completely legal and different from such as Coumadin ® in blood sugar due to absorption of the the illegal anabolic steroids used to cortisone into the bloodstream. Diabetic Ⅲ Acute injury (head trauma, increase athletic strength and speed. patients should therefore carefully monitor broken bones) blood sugar levels for 24 to 48 hours How does cortisone work? Finally, athletes should not receive following an injection. Cortisone is not a pain-relieving cortisone injections into a joint or bursa Although rare, infection at the injection medication, but rather works by sac immediately before competition, site is another side effect. This can be minimizing the body’s reaction to as the athletic activity may cause the avoided with proper skin sterilization inflammation. When the inflammation injury to resurface, resulting in pain, using iodine and/or alcohol. is lessened, the pain is also. By injecting swelling, and stiffness. the medicine directly into the inflamed area, such as a wrist or shoulder joint, What are the side effects high concentrations of cortisone can be of cortisone injections? administered with minimal side effects. As with nearly any procedure where Discomfort usually improves within medications are injected into the body, a few days and lasts for several weeks adverse reactions may occur. The or permanently. If cortisone injections are so-called “cortisone flare” reaction has used, they must be combined with the been reported to occur in approximately appropriate rest period and rehabilitation two percent of patients. This occurs to gain the best results. Medical when the injected cortisone crystallizes professionals are often hesitant to use and causes pain worse than before the these injections routinely for injury shot. Fortunately, these “flares” usually

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