Getting the Cortisone shot

depending on where the shot is and how its administered... cortisone can hurt like a b-tch.

I was a pitcher and had a number of them throughout my career in my elbow ... some with pretty intense pain and an inability to move my arm for a day or 2.... after that though they work like a charm for 4-6mo! 

I got a few shots in my lower back in college.  PAINFUL.  And unfortunately, they don't work on everybody.  They didn't for me, even though the doctors said they would (it literally wore off by the end of the day).  I played my senior soccer season in a lot of pain that year.

That being said, it couldn't hurt to try!

That is the theory I am going with...going to hurt, but I really have nothing to lose as it hurts like #$%@ now when I run.

When I was in college, I got a cortisone shot by my Achilles tendon. I would not say it was painful, but def uncomfortable. I had trouble walking normally for about 2 days after that, but it did hep lot for a couple months.

I would have to say that the pain really depends on several factors,
1. how much pain you are currently in... the more intense pain now, then the shot and its aftermath won't be as painful, if your current pain levels are low.
2. How good the doc is. Seen patients that came from doc hack and most were in really severe pain, no matter what their previous pain levels were. My theory was the doc was jamming into the bone/joints causing more damage.
3. If the patients rested from their activities that caused pain to begin with. Too many times the people would feel "great" right after the shot (some docs put Lidocaine in the cocktail, which is like novocaine the dentists use)

Just remember to rest even tho you feel great, and if you are in great pain from the shot, RICE... rest, ICE, compression, and elevation... but mostly ICE, ice, ice.... did I mention the word ICE?

Hope all works out for you...
Ken

I had a shoulder injury that just wouldn't go away. The tendons were inflamed just enough that raising my arm straight out to the side was painful. Since that's a motion that it was hard to avoid making in life, it just continued to rub on the socket and stayed inflamed.

I got a cortisone shot that reduced the swelling long enough for it to finally heal properly. Unlike others, though, I didn't have much pain. It was a little sore that afternoon, but by the next day, I was good to go. No pain from the shot and no pain from moving the arm through a full range of motion.

Have you looked into ART Active Release Therapy?  It has done wonders for me.  I have arthritis in my right knee from a previous downhill skiing injury, had a pretty significan IT band issue and right hip pain.  My ART guy keeps me running pain free.


Edited by KeriKadi 2010-08-14 2:08 PM

I recently got a cortisone shot that didn't hurt at all (in my trapezius muscle). Not certain if they can do this for knees/joints. First, he used a topical lidocaine, then he gave me a lidocaine shot and when that was done and I was numb, then he gave me the cortisone shot and I truly felt nothing. It was actually really weird because I kept expecting it to hurt like they have in the past.Thinking about it, they may not do that for joints because of the increased risk of infection (from getting two shots.)

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Here's the problem I have with getting cortisone shots... yes it can reduce the inflammation which is causing your pain, but it doesn't do diddly squat to solve the root cause of the inflammation in the first place. So basically, you get your shot, start feeling better, get back to your normal training routine, getting worse, getting another shots, etc. etc. etc. Each time, the injury is getting worse and worse.

I'm not saying that I would not get the shot if I was in your shoes (you're less than a month away from IMOO), but as soon as your pass that finish line, have a plan ready to how to treat your injury and what changes you need to make to ensure that you won't have the same problem again further down the road.

If your an Ironman I wouldn't worry about the shot itself. The results are the concerning part. Sometimes they work sometimes they don't. My understanding of the medicine would require you to take a little time off for the best chance of long term results.

About 8 years ago I was having constant knee pain-it would give out on me, hurt when I stood up after sitting, etc.  I went to a local highly recommended joint specialist and he gave me a d%@$ cortizone shot-btw, didn't really hurt.

I felt like I needed a 2nd opinion, so I went to another Dr.  He said it wasn't my knee causing the pain-it was my back.  Long story short, went to some rehab, started doing this one simple exercise, and the pain went away, and never came back. 

It's not necessarily the shot itself that hurts, although a shot into a joint is uncomfortable to say the least. Some people (I'm one) get what's called the "steroid ache". It's an unrelenting toothache-like ache that starts about 24 hours after the shot and lasts for about 24 hours. Not everyone gets it. Whether you get the ache or not has no bearing on whether the injection will work for you.

Many years ago I had them in my shoulder.....as an RN it's kind of necessary to have the shoulder to hang iv's and such....well, it hurt so bad post injection that I would call off to work on days I got steroid shots!

IM steroids for asthma flares hurt like a b*tch too!

I had a cortisone shot in my knee a few years ago and the shot itself wasn't too bad (it really was a sting followed by burning just like the doctor said). The feeling of having a swollen knee for several days was worse than the pain from the shot.

btw the shot did nothing for my knee pain.

Hello,

I've spent a fair bit of time in fluoroscopy (think of real time, or video x-ray) suites watching folks get various injections.

It is amazing how much a needle can deflect from its intended path. Although inserted with the correct landmarks in the proper orientation, the tip (where the medicine comes out) can easily end up some distance from the intended target. A few mm off can mean the difference between working and not working for quite a few types of injections.

Although the knee space is very large and would be tough to miss, I'd personally be hesitant to get most anything injected by a doc who didn't use fluoro. Also, although there are exceptions, with a good radiologist using fluoro I'd estimate that 99/100 injections are painless, or nearly so.

My 2 cents. ymmv, and of course discuss this with your physician and make a decision based on that rather than posts on a tri forum.

 

That's the plan....thanks for all of the notes everyone.  I'm not really worried about the pain from the shot....just not looking forward to it. 

Well heres one snag for you.  Pain is often your body's way to telling you there is something damaged and it wants you limit the motion of that something so it can heal.  A cortisone shot takes away the pain but the actual damage remains.  In fact, you tend to feel so well that you increase activity/intensity and thus cause further damage.  When the cortisone wears off you may find that the pain is worse and in fact the original damage considerably worse.  Just saying, this is not a "Fix" to an injury.  In fact, one more happy throught from Dr. Killjoy:  Steroid shots can cause tendons to pop/detach.  I dont' have references or stats to quote you, but I've been told this by enough folks (and Drs.) to accept it as fact.
  Be sure you have all of the pros and cons prior to doing anything medically to "get you through" something.

When I got my shot I didn't feel a thing.  Of course it didn't do a thing either.  A month later I was getting surgery.  Hope yours is not that bad.

Hello

I have gotten them in my shoulder, knee and foot.  The Dr should apply something cold and then a numbing shot and then the Cortisone shot. 

Uncomfortable yes- hurt no

They last from 3 to 6 weeks.

Kevin

I've had two one in the hip and one in the shoulder.  Neither hurt and both helped resolve the issue I was having.  Note I said helped resolve the issue.  You still have to do the work to resolve the underlying issue or the cortisone will wear off and you will be back a square one.  For me that meant PT and lots of stretching for both the shoulder and the hip.

Yeah, when I saw the Dr. X-rays were taken and a full exam was given.  He said he thinks it could be a minor tear in the cartilage that is being aggravated because I have the beginnings of arthritis in my knee.  He believes the shot will definately help but said that it was up to me.  By the way this is at a sports medicine facility that specializes in these types of injuries so it isn't your garden variety Dr. ...... who still knows more than I do.....

Definitely consider the above.  I had two occasions this year to consider cortisone shots to get me through a race (LA Marathon: hip bursitis; IM St George: ITBS).  Talked it over with orthopedist in the first situation, primary care doc in the second and opted for oral steroids instead of the shot both times (orthopedist's suggestion originally).  The risk of weakening of tendons (mentioned by both) was more than I wanted to take on.  (This can also occur from oral steroids, but I've been told the risk is somewhat lower...and they don't present the post-injection pain issue.)

Have you considered oral steroids?  Worked like magic with my bursitis (which had persisted for over two months with no sign of resolving):  Gone in 48 hours and hasn't ever come back.  Less successful with the ITBS, but it definitely moderated the discomfort from the injury (started on the pills 8 days before IMSG).  If you haven't discussed this option with your doc, you might want to.  Just something to consider.