Why Cortisone Shots Suck

You have pain and your doctor doesn’t know why (shocker). Here’s some unfortunate news: those poor souls are paid according to how many patients they can see in a day and are even penalized if they spend too much time with you. You are one of possibly 30 people they see in just one day! I know multiple people in the industry who can confirm this. This means that most doctors only have time to listen to a snapshot of what’s going on with you and treat your symptoms instead of treating the cause. There simply isn’t enough time for them to see the whole picture.

If you are having pain that’s not a broken bone or a torn ligament, they often recommend cortisone shots. It’s America! Why not get a super quick fix for the pain you are experiencing? Right…?

Sorry friends, maybe it’s not. Here is why you should think twice before you let anyone “fix” your pain with a shot.

What is a Cortisone Shot and What Does It Do?

Cortisone is a type of corticosteroid (steroid medication). Steroids are meant to reduce inflammation and are often given as treatment for diseases like allergies, lupus, arthritis, etc. They are also given in shot form to specific areas of inflammation or pain. They are a common “treatment” for things like plantar fasciitis, carpal tunnel, knee pain, elbow pain, and many more. It is supposed to decrease inflammation and thereby get rid of pain. Many cortisone shots are also mixed with a numbing agent in order to ensure at least a temporary pain fix.

What Are the Side Effects?

Here’s where it gets good. Did you know that there are side effects of these shots? There are a few mild ones such as acne, weight gain, and puffiness of the face (your typical possible reactions to a steroid). They can also cause pain and swelling. Yes, you heard right. Cortisone could potentially cause worse pain and swelling than the condition you were trying to treat with said shot (https://www.arthritis-health.com/treatment/injections/cortisone-injection-risks-and-side-effects). Most severely, it is possible to cause avascular necrosis and osteonecrosis. Those are fancy words, so let me translate: death of blood vessels and death of bone (https://www.medicinenet.com/cortisone_injection/article.htm).

Most of the my clients who’ve had one were never told any of these possible effects.

I’ve had one cortisone shot. I was 21 years old and playing in my senior college volleyball season. I was having excruciating pain in the ball of my foot, most likely from the flat court shoes I had been wearing for years even though I have high arches. My doctor, a rare gem, actually told me that while he could give me a shot to “numb” the pain, there was a possibility that the cortisone could weaken the ligament under my big toe enough that it could snap while playing. That’s a pretty terrifying possibility, but since it was my senior season and I didn’t yet understand what it could possibly mean to have a life outside of competitive volleyball, I said “Do it!”

My foot held up through my season without pain, although I still feel that same pain from time to time almost 10 years later. I also still get nervous when I hike mountains or play recreational volleyball because I know that the cost of that shot was a weakening of that tissue.

Thankfully, I only got the one shot. I’ve seen quite a few clients in my practice that have had multiple in the same spot. This is where it gets dangerous. Multiple shots, especially where your skin and muscles are thin, can start thinning your bone tissue and destroy your connective tissue at that injection site. That’s like localized osteoporosis. Weakening and death of your bone tissue can make it easy for you to break that bone, and it can be harder for tissues to stay attached to it. I’ve had a few client’s now with terrible plantar fasciitis (foot pain) who got rid of about 80% of their pain with Kinetix bodywork, but we could not get rid of that last 20% because they had many cortisone shots around their heel or Achilles tendon and unfortunately, the tissue was just too damaged to fully recover.

Damaged blood vessels are also a big deal. Blood flow is a critical factor for healing. You need a healthy blood supply to your injured area in order to get essential nutrients in, carry toxins out, and quicken the healing process. If your blood vessels are damaged, it will be extremely difficult to get that ideal blood supply.

The Problem:

Cortisone shots are not necessarily meant for pain relief. They are meant to reduce inflammation. It is possible if your pain is caused from inflammation that your pain may get better, if it’s not, you will feel no different; while also potentially subjecting yourself to some not-so-great side effects.

Here is the other danger: cortisone can “numb” the pain. That is totally possible. The bad news is that just because you can’t feel the pain, that doesn’t mean that your problem is solved.

If your left hip is killing you, and you get a cortisone shot and the pain is gone–does that actually mean you are healed? The short answer is no. Sorry buddy. When you feel pain, know that your body is not trying to hurt you, it’s trying to HELP you. It’s telling you that something is wrong! “Help me!” If you shut down your body’s ability to give you necessary information about the something that’s wrong, how do you expect to solve your problem? I’ve seen this countless times in my practice where a first time client says, “I got a cortisone shot and it worked great for a few months and then the pain came right back with a vengeance.” That is because, if we continue to use the hip pain example, you walked on your hip and went hiking and did kickboxing and everything that you could think of because you couldn’t feel anything. But what if your hips are out of alignment? Or your gait is off? Or your fascia is so tight that you have substantial muscle imbalances? Now you might have just made your issue worse because you continued on with your daily activities without being about to FEEL what you were actually doing to your body.

The Solution:

Cortisone shots are commonly just a short term fix. Let them be a last resort. There are so many other options that you can try first that will keep your tissue in tack and may help you stay out of pain for good.

Physical therapy or strength training with a qualified personal trainer can help you correct muscle imbalances and build enough strength to support your body. It’s amazing how many people suffering from low back pain simply needed to strengthen their core and glute muscles. No need for a scary shot in your back!

Pain is also very often coming from fascia restrictions. If this is the case, there are many modalities that work with fascia that can restore space and blood flow to your injured area. Kinetix is one of these bodywork options! Kinetix is a fascia stretching technique that breaks apart adhesions (parts that are stuck together) in your tissue and can help relieve pain quickly.

I would encourage you not to turn off your ability to listen to what your body is trying to tell you by numbing it. It’s not necessary to damage your tissue and potentially limit yourself from being able to heal completely. Fix the source, don’t just cover the symptom.

I think this where the rainbow comes up with “the more you know” logo.

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