Cortisone shots--maybe think twice

About a year and a half ago I was having a lot of pain in my hips—the left, especially. Because I was 78 at that point, I reasonably assumed that the problem was arthritis and that I may be in need of a hip replacement. So I went to an orthopedic surgeon prepared to go under the knife. As it turns out, x-rays showed that arthritis was not the problem. He said I had bursitis and prepared to give me a cortisone injection—a common treatment. Even though my chiropractor had said that having cortisone shots was like injecting acid into your bones, I didn’t resist. I knew that lots of people had the shots. How could one hurt?

For a week or so, I felt great. My usual aches and pains had vanished and I felt 20 years younger. Then it all came to a crashing halt. I was on the golf course and suddenly could hardly move because of the pain in my hip. I hobbled off the course. (I’m much better now, given time, orthotics, some exercises, and Advil.) For over a year after I had the shot, I had pain in the spot where he’d given the injection. Fortunately, the pain occurred only when I did certain yoga postures.

Cortisone is a hormone produced by your adrenal glands. It is released when your body is under stress and works by reducing inflammation. The cortisone you get in a shot is similar to your body’s own cortisone.

Apparently cortisone injections do work well for some people. A major study that looked at the efficacy of cortisone injections on thousands of people with tendon injuries—especially tennis elbow—found that the injections did bring fast pain relief that sometimes lasted for weeks. However, they also found that, after 6 and 12 months, those who had received cortisone shots had a much lower rate of full recovery than those who did nothing or who underwent physical therapy. Those who received the shots also had a 63 percent higher risk of relapse than people who took the wait-and-see approach.

I did have a good experience with prednisone many years ago. I had a serious case of poison ivy and sought help from the doctor, who gave me a shot of prednisone—a type of cortisone. I remember feeling the effect by the time I got to the elevator. It felt like the sores were drying up. Similarly, my husband had excellent results with prednisone pills for pain in his neck.

The side effects of cortisone and prednisone can be pretty horrific and the list is long. For one thing, repeated cortisone shots may cause deterioration of the cartilage within a joint. Also, both cortisone and prednisone suppress your body’s own immune system, making it harder to fight infections. These are not medicines you’d want to take regularly.

Next week: "Hydration" foolishness

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