CORTISONE INJECTIONS: YOU DON’T HAVE TO LIVE WITH PAIN

Many people live with chronic joint pain from old injuries or conditions like arthritis, which can prevent them from enjoying their favourite activities. But this doesn’t have to be the case; treatment options are available.

Mayfair’s expert pain management team has years of experience treating musculoskeletal and spine concerns. We use medical imaging to accurately target and treat muscle and joint pain. These procedures are low risk and often provide immediate pain relief.

For example, a cortisone injection introduces a steroid (an anti-inflammatory medication) into joints and soft tissues to decrease inflammation and stiffness, and reduce pain. With the help of fluoroscopy (a type of continuous X-ray) or ultrasound, a radiologist can use medical imaging to guide a small dose of the steroid into the specific inflamed area of concern while keeping the potential side effects to a minimum.

Conditions with inflammation as an underlying problem respond well to these injections. These can include:

• Arthritis – includes many types of joint diseases.
• Bursitis – inflammation of a bursa, or small fluid-filled sac, typically around the shoulder or hip.
• Carpal tunnel syndrome – a painful condition of the hand and fingers caused by compression of a nerve in the wrist.
• Tennis or golfer’s elbow – inflammation of the tendons of the elbow (epicondylitis) caused by overuse of the muscles of the forearm.
• Tenosynovitis – inflammation around a tendon.
• Trigger finger – tendon sheath thickening in a finger causing it to jerk or snap straight when the hand is extended, or not straighten all the way.

HOW DOES IT HELP?

At Mayfair, in addition to the cortisone medication, a short-lasting local anesthetic (freezing) is also injected so your relief can be immediate. On average, the steroid starts to work after 48 hours.

Another benefit of this injection is that you may need less of other medications and can avoid certain side effects that can accompany many oral anti-inflammatory medications, such as irritation of the stomach. Other advantages include high success rate, rapid onset, and convenient access.

WHAT ARE POSSIBLE SIDE EFFECTS?

These are very safe procedures. The most common side effect of an injection is mild pain or bruising around the area. Over-the-counter pain medications or icing the area can help. Long-term effects of repeated cortisone injections may include weakening of muscle, tendons, and local skin changes, so, to avoid this, we will make suggestions for alternate treatments or supportive care when repeated cortisone injections have failed to relieve symptoms.

As all our procedures are performed in a sterile manner according to provincial guidelines, only in very rare circumstances will a patient develop an infection or an allergy to a substance in the product. The booking staff will review your allergies with you prior to your appointment.

HOW LONG DO THE RESULTS LAST?

After your injection, the freezing may last for a few hours. Your symptoms may return until the steroid takes effect in 3-7 days. Results can last from weeks to months depending on the joint or body part involved, severity of the disease, and the cause of your pain. Some patients get complete relief after a single injection, while others may need to return for additional injections. These injections are both therapeutic (treat symptoms) and diagnostic (identify the cause of your pain). If an injection does not help relieve your pain, then you may need further evaluation. Repeated steroid injections are not recommended at the same site. We can advise on other non-steroid injections to be considered.

DO THESE INJECTIONS HURT?

There will be discomfort or very short-lived pain during the injection and when administering the local anesthetic. However, pain perception depends greatly on your pain threshold and the degree of inflammation of the area involved. Most patients find the pain tolerable. Mayfair’s expert team has extensive experience in performing these procedures and do our very best to make them as quick and painless as possible.

HOW DO I OBTAIN A CORTISONE INJECTION?

As a patient, the most important thing to do is discuss your symptoms with your health care practitioner. They will determine the best steps for treatment. Before your health care practitioner determines a cortisone injection is the best treatment for you, they may request an X-ray or ultrasound to help localize the specific cause of your symptoms.

Pain management procedures must be requested by a health care practitioner. Once the cause has been identified and treatment options reviewed, a pain management procedure may be recommended by us or requested by your practitioner. You will need a requisition from your physician. Once we have received the requisition, we will then review it and contact you to confirm the area and type of injection requested, and to book the appointment.

Mayfair Diagnostics offers pain management services at four clinics across Calgary: Castleridge, Mahogany Village, Market Mall, and Mayfair Place.

REFERENCES

Driver, C.B. & Shiel, W.C. (2022) “Cortisone Injection.” www.MedicineNet.com. Accessed August 11, 2022.

Foster, Z.J., et al (2015) “Corticosteroid Injections for Common Musculoskeletal Conditions.” American Academy of Family Physicians, October, 92(8): 694-699.

Mayo Clinic Staff (2021) “Cortisone shots.” www.mayoclinic.org. Accessed August 11, 2022.

Shah, A., et al (2019) “Musculoskeletal Corticosteroid Administration: Current Concepts.” Canadian Association of Radiologists Journal, February, 70 (1): 29-36