• Blog Post Cortisone myths
  • Will Cortisone Make Things Worse?

    The question seems simple enough, right? Yet, how many people have thought to ask it? Most of my life I’ve heard about cortisone as an wonder drug that miraculously helps decrease swelling and reduces injury. But, the story get’s complicated. Here is a short we did to catch you up to speed.

    So the take home message really is that cortisone can make things worse, if you don’t understand how it works. The science points to that answer. But to really understand this topic you have to understand the Basics of Cortisone.

    Here is the actual VO script to the video just incase you prefer reading about it instead of watching the video:

    Cortisone Basics: A Narrated 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.

    cortisone in sport injuries like football

    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?

    Cortisone shot stick figure

    To understand it you have to know more about cortisone.

    What is 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.

    Cortisone is a corticosteroid

    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 suppresant aka anti-inflamatory.

    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.

    I mean, 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 releif – 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

    A big thanks to OrthoCarolina for teaming up with us to make this video successful.

    Written by Rob Nelson

    Rob is an ecologist from the University of Hawaii. He is also an award winning filmmaker. As principle director of the Untamed Science productions his goal is to create videos and content that are both entertaining and educational. When he's not making science content, he races slalom kayaks and skydives.

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