Cortisone injections are an overused and ineffective treatment for the management of shoulder pain. While cortisone is a powerful steroid that limits pain and inflammation, it rarely provides a long lasting solution and comes with many complications. Understanding the pro’s and con’s of cortisone injections will help you make better decisions about what to do for your shoulder pain.
Reasons to Avoid Cortisone Injections For Shoulder Pain
Worse Long Term Outcomes
Cortisone injections provide temporary pain relief. However, they often lead to worse long term outcomes. First, these injections have been shown to weaken tendons they are injected into. Weakening of the rotator cuff or biceps tendon increases the likelihood of suffering a complete rupture.
In addition, studies have shown cortisone injections damage articular cartilage and speed the degenerative process. Receiving a cortisone injection into the bursa or shoulder joint itself deteriotes the articular cartilage of the shoulder joint. This leads to more pain and more arthritis in the shoulder for worse long term outcomes.
Studies have shown that repeated cortisone injections into the shoulder weakens tendons and deteriorates cartilage.
Doesn’t Solve The Issue
While cortisone injections ease shoulder pain, they do not address the cause of your pain. Many people who receive cortisone shots find that the pain returns once the steroid wears off. This leads to a second (and third, fourth, etc.) injection which increases the likelihood of a full tendon rupture or needing surgery.
Longterm solutions to shoulder pain requires you to address the underlying causes. Finding and addressing the root causes of shoulder pain helps to ease pain while keeping active and maintaining your lifestyle. This starts with improving movement and building shoulder strength to prevent reaggravating your shoulder pain.
Mid Back stiffness is one common cause of shoulder pain that cortisone injections don’t address.
First Step To Surgery
When repeated steroid injections fail to solve your shoulder pain, surgery is often the next recomendation. Shoulder surgery is expensive, dangerous, and has limited effectiveness in adults. One recent study found that two thirds of rotator cuff surgery patients still reported pain after six years and only a small minority had an improvement in range of motion.
Adults with shoulder pain rarely require surgery and yet it is still commonly recomended after multiple rounds of cortisone injections. Treating your shoulder pain with more effective, conservative treatments will decrease the probability of needing surgery.
Most causes of shoulder pain in adults can be resolved without surgery. Given the expense, complications, and limited effectiveness of of surgery it should be avoided at all costs.
To sum it up, the traditional approach to treating shoulder pain is not working. Pills, injections and surgery provide temporary pain relief but fail to solve the issue. With so many better options than cortisone shots, it’s time to start changing your approach. Massage, Graston, acupuncture and other manual therapies can be used to ease pain and speed healing. Physical therapy and strength training programs can be used to strengthen tissues and prevent long term issues. Understanding your options will help you make better decisions about your specific shoulder pain.