DR. JUREK
Dr. Jurek is a board-certified
orthopaedic surgeon specializing in shoulder surgery as well as sports medicine. She has focused fellowship training in both specialities. More about Dr. Jurek |
CORTISONE INJECTIONSCortisone shots are injections that may help to relieve inflammation and pain in a specific part of your body. They are most commonly injected into a joint such as your shoulder or knee. Depending upon your diagnosis and symptoms, Dr. Jurek may recommend a cortisone injection. The response to cortisone injections varies between individuals and is unpredictable. It usually takes several days for the cortisone to take effect. It is unlikely that you will experience immediate relief of your symptoms with a cortisone injection.
The injection usually comprises a combination of a corticosteroid medication called Depo Medrol (Methylprednisolone Acetate) and a local anesthetic called lidocaine. Be sure to let Dr. Jurek if you have an allergy to either one of these medications. The injection is performed during your clinic visit with Dr. Jurek. What to expect during the shot You may need to change into a gown or shorts to allow ease of access to the joint being injected. You will be positioned so that Dr. Jurek can easily insert the needle. The area around the injection site will be cleaned with chlorhexidine gluconate soap and isopropyl alcohol. A cold anesthetic spray called "ethyl chloride" with be used to locally numb the area prior to the injection. This feels like a very cold ice cube being applied to the skin. 
You will likely feel pressure when the needle is inserted. Let your doctor know if you have a lot of discomfort and adjustments will be made immediately. The medication is then released into the joint through the needle. This can cause an additional sensation of pressure and occasionally a temporary burning feeling. A band-aid will be applied over the injection site. Risks and considerations of a cortisone shot If you have diabetes, a cortisone shot might temporarily increase your blood sugar levels. Be sure to monitor your glucose levels very closely in the five days following the injection. Your glucose levels should return to normal over this time; it they do not, please contact your primary care doctor. The injection may also cause some patients to experience redness and a feeling of warmth of the chest and face (called "flushing") temporarily. Some people have a brief increase in pain for 1 to 3 days due to the cortisone crystallizing after the injection. Rest, ice, and over-the-counter pain medicines may help relieve this temporary discomfort. There is a small risk of bleeding and a small risk of infection any time the skin is punctured, even with a very small, sterile needle. 
What to do after the shot Protect the injection site for a day or two. For example, if you received a cortisone shot in your shoulder, avoid heavy lifting or repetitive overhead lifting for 24 to 48 hours. Similarly, if you received an injection into your knee, avoid walking long distances or going up multiple flights of stairs for 24-48 hours. It is normal to have some increased discomfort in the injected region for the first 24 to 48 hours or so. Apply ice to the injection site 20 minutes at a time, 3 to 4 times a day as needed to relieve pain. Heat is generally not helpful in relieving the discomfort from the injection as it increases the inflammatory response. For injection site soreness during the initial 24-48 hours, you may take the pain reliever acetaminophen (Tylenol). Limit this to a total of 3000mg over the course of a 24-hour period and do not take it if you have liver disease. You may also take an anti-inflammatory such as Aleve, Advil, Motrin, or Ibuprofen if you are not taking a blood thinner (Plavix, Coumadin, Eliquis, etc.), do not have bleeding tendencies, ulcers, acid reflux, etc., and you are not already taking other anti-inflammatory medications such as Meloxicam (Mobic), Celebrex (Celecoxib), Piroxicam (Feldene), etc. If you have any concerns, please talk to Dr. Jurek or your primary care physician prior to taking these medications. Watch for signs of infection such as increasing pain, redness, and swelling lasting more than 48 hours. If you notice any signs of infection following your joint injection (fever greater than 101.5 degrees, redness, warmth, drainage) call Dr. Jurek's office immediately at 206.386.2600. 
You may shower immediately after the injection but do not soak in a bathtub, hot tub, or whirlpool for 48 hours. Results Cortisone shots commonly cause a transient flare in pain and inflammation for up to 48 hours after the injection. Rest and ice are helpful to lessen the discomfort during this time. After that, the pain and inflammation of the injected joint should decrease and these results can last up to several months. Repeat Injections Depending upon your particular medical condition and your response to a previous injection, Dr. Jurek may recommend that an injection be repeated after a safe amount of time has elapsed. This is usually done for degenerative processes such as arthritis. She will typically wait 4 to 6 months before repeating an injections to prevent damage or weakening to tissues over time. A series of injections may also be recommended for specific conditions such as shoulder adhesive capsulitis. |
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