Cortisone and Healing - An overview of the science
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 Published On Feb 26, 2015

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This week we pose this question- Does Cortisone Actually make things worse? See below for the complete transcript. We would like to thank Dr. Nady Hamid and Blair Primis over at OrthoCarolina for helping get this set up. I highly recommend these guys, the facilities and staff are really top notch. You can find out more about them here: http://www.orthocarolina.com/physicia...

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Here is the transcript of the animation

There is no denying that cortisone reduces pain and swelling. Because of that a lot of cortisone shots have been given to help people healing from joint injuries. But just because you get immediate pain relief doesn’t mean it’s helps your joint heal.

A recent analysis of studies on thousands of individuals with joint pain, particularly tennis elbow, showed that cortisone shots, did in fact reduce pain immediately. However, when they examined individuals 6 months later, they found that those with cortisone shots had a lower rate of full recovery and were 67% more likely to have a relapse of the injury. How is that possible?

To understand it you have to know more about cortisone.

Cortisone is a corticosteroid. Its produced naturally in the body via the adrenal cortex (kidneys). If you’re familiar with cortisol aka the stress hormone, it works similarly.

You see, when your body is in a stressful situation, this hormone is released. It works like this, you want to get sugar to your brain - the most important thing. So the hormone, stimulates the breakdown of fat, protein and carbs into useable energy int eh blood. That means your blood glucose levels rise. It also suppresses other activities that aren’t vital in that immediate stressful situation, like the immune system. And that’s the main role of a cortisone shot - it’s as an immune suppressant aka inflammatory.

So, you can use it medically to cure problems with immune response - like

asthma
rhematoid diseases
bell’s palsy
spinaly chord injuries
dermatalogic conditions

The problem is that the they are best used as a short term solution.

Think about it, you don’t want your body filled with stress hormones long term because, there are side effects to what we associate with having high stress levels. Namely:

mood swings and sleep disturbances
hypoglycemia
decrease in the bodies natural corticosteroid production
decreased bone density
fat atrophy.

Fat atrophy probably sounds good, except when it occurs at the point of a cortisone injection.

In the end, there are somethings you would not use cortisone for - like
rotator cuff disease
Shoulder pain - like adhesive capsulitis
spinal injuries like cervical radiculopathy
knee osteoarthritis

Of course, with that said, the science does point to cortisone helping with things like:
lumber radiculopathy, plantar fasciatis, and morton’s neuroma.

So there you have it, Cortisone, is not the cure all treatment it was once thought to be. Know though that while it helps with some things, it can help with temporary pain relief - and well, it might decrease long term recovery. So if you’re an athlete or someone with a random tendon issue, you might want to think twice about getting cortisone. But, that’s what the doctors are for. Let them help you decide if it’s right for you

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