Cortisone Injection (cont.)

What are the advantages of cortisone injections?

When a joint is swollen, sometimes joint fluid is removed before cortisone is injected. If fluid is removed, it can be analyzed with laboratory testing to determine what caused the joint to swell. This is a big advantage as it is a powerful and accurate diagnostic test.

A distinct benefit of a corticosteroid injection is that the relief of localized inflammation in a particular body area is more rapid and powerful than with traditional anti-inflammatory medications given by mouth, such as aspirin. A single injection also can avoid certain side effects that can accompany many oral anti-inflammatory medications, notably irritation of the stomach. Cortisone injections can be administered easily in the doctor's office. Other advantages include the rapid onset of the medication's action, dependability, and minimal side effects.

What are the disadvantages and side effects of cortisone injections?

Disadvantages of cortisone injections are the necessity of piercing the skin with a needle as well as potential short- and long-term side effects. It should be emphasized that though each of these side effects is possible, they usually do not occur.

Short-term complications are uncommon but include shrinkage (atrophy) and lightening of the color (depigmentation) of the skin at the injection site, introduction of bacterial infection into the body, local bleeding from broken blood vessels in the skin or muscle, soreness at the injection site, and aggravation of inflammation in the area injected because of reactions to the corticosteroid medication (postinjection flare). Increased pain after the injection is typically due to a postinjection flare as a true allergic reaction to cortisone is very rare. Tendons can be weakened by corticosteroid injections in or near tendons. Tendon ruptures as a result have been reported. Facial flushing may occur in up to 40% of cases but lasts only briefly. Sweating and insomnia are uncommon.

In people who have diabetes, cortisone injections can elevate the blood sugar. In patients with underlying infections, cortisone injections can suppress somewhat the body's ability to fight the infection and possibly worsen the infection or may mask the infection by suppressing the symptoms and signs of inflammation. Generally, cortisone injections are used with caution in people with diabetes and avoided in people with active infections. Cortisone injections are used cautiously in people with a bleeding disorder.

Long-term risks of corticosteroid injections depend on the dose and frequency of the injections. With higher doses and frequent administration, potential side effects include thinning of the skin, easy bruising, weight gain, puffiness of the face, acne (steroid acne), elevation of blood pressure, cataract formation, thinning of the bones (osteoporosis), and a rare but serious type of damage to the bones of the large joints (avascular necrosis).

Source: MedicineNet.com
http://www.medicinenet.com/cortisone_injection/article.htm