What is the difference between a steroid shot and a cortisone shot

Q: Is a cortisone shot the same as a steroid shot?

Also called corticosteroid,” steroid shot,” and a human-made version of the hormone cortisol, these shots arent pain relievers. Cortisone is a type of steroid, a drug that lowers inflammation, which is something that can lead to less pain.

Painful joint inflammation may be treated with a cortisone injection. Cortisone, a type of corticosteroid, reduces the inflammation associated with conditions such as osteoarthritis, tendonitis, bursitis, rheumatoid arthritis, and gout.

Table of Contents Show

Treating Joint Pain with a Cortisone Injection
Setting Expectations with the Physician
In This Article:
Recognizing Cortisone’s Limitations
Why it's done
From Mayo Clinic to your inbox
Limits on the number of cortisone shots
How you prepare
What you can expect
During the cortisone shot
After the cortisone shot
Is a cortisone shot the same as a steroid shot?
Is a cortisone injection a steroid?
How long will it take for a steroid shot to work?
How long does a cortisone shot last?

Cortisone injections are a common treatment for knee osteoarthritis. See Knee Osteoarthritis Treatment

By reducing inflammation, a cortisone injection can alleviate pain, swelling, skin redness, and warmth over the joint. A cortisone injection will not necessarily treat the underlying condition. For example, osteoarthritis and rheumatoid arthritis can be treated, but not cured.

Treating Joint Pain with a Cortisone Injection

A cortisone injection typically relieves inflammation and pain between 6 weeks and 6 months, but results vary widely. The pain may not be relieved at all, return after a few days or longer, or may not recur. It is unclear why results vary and who will respond best.

Temporary pain relief allows the patient to:

Treat an arthritic flare-up. Cortisone can help treat bouts of severe arthritis pain and symptoms, such as joint pain caused by a gout flare. Similarly, cortisone may be used when rheumatoid arthritis causes persistent swelling in a joint.
Participate in physical therapy. Pain relief from a cortisone injection can give the patient an opportunity to participate in physical therapy. Prescribed stretching and exercise can improve the affected joint's biomechanics. The hope is that by the time the effects of the cortisone wear off, the joint is healthier and pain is tolerable or even eliminated.
Postpone surgery. In moderate to severe cases of arthritis, a joint replacement or another surgical treatment may be recommended. For patients who want to postpone or avoid surgery, cortisone injections may allow them to live with less pain.

Patients should have close follow up with an orthopedist or other musculoskeletal specialist for periodic reevaluation. Almost all types of arthritis are chronic, and a cortisone injection is just one part of a larger treatment plan.

Read more about Arthritis Treatment Specialists

Setting Expectations with the Physician

An injection meant to aid in diagnosis can be useful for treating pain, and vice versa. A doctor and patient should take time to discuss the primary purpose of the cortisone injection before it is administered. During this conversation a doctor should let the patient know:

What part of the joint is being targeted (for example, a joint capsule, bursa, or tendon)
What are reasonable expectations regarding pain relief
If follow-up treatment will involve medications, physical therapy, or lifestyle changes

Clear communication and expectations increase the likelihood of successful treatment.

Recognizing Cortisone’s Limitations

While cortisone injections are a valuable treatment, they are not a cure-all and may not work well for everyone. In addition, cortisone, like all medications, can have side effects.

Most notably, cortisone is known to break down tissues, such as articular cartilage in the joint.1-3 Cartilage is crucial to joint health, acting as a shock absorber and reducing friction between bones when a person moves. Therefore, most physicians will refuse to administer repeated cortisone injections into the same joint over a short period of time, simply because too much cortisone may cause more harm than good.

See What Is Cortisone?

Patients are encouraged to learn about cortisone’s potential risks, benefits, and alternatives and to talk to their health care provider about their concerns.

References

1.Dragoo JL. Chondrotoxicity of commonly used single injection corticosteroids. Presented at the 2010 Annual Meeting of the American Orthopaedic Society for Sports Medicine. July 15-18. Providence, R.I. Cited by Orthopedics Today. Preservative noted as possible key to intra-articular injection corticosteroid chondrotoxicity. Helio Orthopedics. www.healio.com. Published September 2010. Accessed February 18, 2014.
2.Papacrhistou G, Anagnostou S, Katsorhis T. The effect of intraarticular hydrocortisone injection on the articular cartilage of rabbits. Acta Orthop Scand Suppl. 1997 Oct;275:132-4. PubMed PMID: 9385288.
3.McAlindon TE, LaValley MP, Harvey WF, et al. Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. JAMA. 2017;317(19):1967–1975. doi:10.1001/jama.2017.5283

Overview

Cortisone shots are injections that can help relieve pain and inflammation in a specific area of your body. They're most commonly injected into joints — such as your ankle, elbow, hip, knee, shoulder, spine or wrist. Even the small joints in your hands or feet might benefit from cortisone shots.

The injections usually contain a corticosteroid medication and a local anesthetic. Often, you can receive one at your doctor's office. Because of potential side effects, the number of shots you can get in a year generally is limited.

Why it's done

Cortisone shots might be most effective in treating inflammatory arthritis, such as rheumatoid arthritis. They can also be part of treatment for other conditions, including:

Back pain
Bursitis
Gout
Osteoarthritis
Psoriatic arthritis
Reactive arthritis
Rheumatoid arthritis
Tendinitis

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Risks

Potential side effects of cortisone shots increase with larger doses and repeated use. 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

Limits on the number of cortisone shots

There's concern that repeated cortisone shots might damage the cartilage within a joint. So doctors typically limit the number of cortisone shots into a joint.

In general, you shouldn't get cortisone injections more often than every six weeks and usually not more than three or four times a year.

How you prepare

If you take blood thinners, you might need to stop taking them for several days before your cortisone shot to reduce bleeding or bruising risk. Some dietary supplements also have a blood-thinning effect. Ask your doctor what medications and supplements you should avoid before your cortisone shot.

Tell your doctor if you've had a temperature of 100.4 F (38 C) or greater in the previous two weeks.

What you can expect

During the cortisone shot

Your doctor might ask you to change into a gown. You'll then be positioned so that your doctor can easily insert the needle.

The area around the injection site is cleaned. Your doctor might also apply an anesthetic spray to numb the area where the needle will be inserted. In some cases, your doctor might use ultrasound or a type of X-ray called fluoroscopy to watch the needle's progress inside your body — so as to place it in the right spot.

You'll likely feel some pressure when the needle is inserted. Let your doctor know if you have a lot of discomfort.

The medication is then released into the injection site. Typically, cortisone shots include a corticosteroid medication to relieve pain and inflammation over time and an anesthetic to provide immediate pain relief.

After the cortisone shot

Some people have redness and a feeling of warmth of the chest and face after a cortisone shot. If you have diabetes, a cortisone shot might temporarily increase your blood sugar levels.

After your cortisone shot, your doctor might ask that you:

Protect the injection area for a day or two. For instance, if you received a cortisone shot in your shoulder, avoid heavy lifting. If you received a cortisone shot in your knee, stay off your feet when you can.
Apply ice to the injection site as needed to relieve pain. Don't use heating pads.
Not use a bathtub, hot tub or whirlpool for two days. It's OK to shower.
Watch for signs of infection, including increasing pain, redness and swelling that last more than 48 hours.

Results

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 a cortisone shot the same as a steroid shot?

Also called “corticosteroid,” “steroid shot,” and a human-made version of the hormone cortisol, these shots aren't pain relievers. Cortisone is a type of steroid, a drug that lowers inflammation, which is something that can lead to less pain.

Is a cortisone injection a steroid?

Steroid injections, also called corticosteroid injections, are anti-inflammatory medicines used to treat a range of conditions. They can be used to treat problems such as joint pain, arthritis, sciatica and inflammatory bowel disease.

How long will it take for a steroid shot to work?

A corticosteroid injection will usually take 3 to 7 days to begin to have a positive effect. It may take up to two weeks for the medicine to decrease the inflammation to a point where pain is improved. The full benefit of the corticosteroid may not be felt until 6 weeks after injection.

How long does a cortisone shot last?

Generally, a cortisone shot can suppress pain for anywhere from six weeks to six months.” Cortisone provides pain relief by reducing inflammation. If you have pain caused by inflammation, cortisone can make you feel really good.