Injection Treatment

What are non-surgical orthopedic treatment options?

Although some orthopedic conditions require surgery, we believe in pursuing conservative treatment options when possible. One non-surgical treatment option includes injections to reduce inflammation and joint pain.


What is Cortisone?

Cortisone is the name used to describe a group of drugs correctly known as corticosteroids. Cortisone is used to treat pain in various parts of the body where inflammation is felt to be the cause of this pain. The reason why cortisone is effective in treating such pain is because it is a powerful anti-inflammatory.


What are the indications for a cortisone injection?

Bursitis (eg. Shoulder-subacromial bursitis and Hip-trochanteric bursitis)

Arthritis (eg. Knee, ankle, hip)

Tendinosis and Tenosynovitis (eg. Tennis elbow)


What is involved?

The skin is prepared using an antiseptic agent. The needle is then inserted into the relevant body part (sometimes under radiographic guidance). The degree of discomfort during the procedure is generally mild as the needle used is fine and numbing anesthetic is used as well.


Benefits, Risks, Complications and Side-Effects

There are risks associated with the administration of cortisone. The decision to inject cortisone is not taken lightly and is carefully made by your doctor and based on your signs, symptoms and past medical history, as well as suspected diagnosis. This procedure is more likely to provide you with a benefit, which outweighs the small risk of suffering from the side effects.


The risks of a cortisone injection include:

Allergy to any of the substances utilized during the procedure, such as the cortisone, dressing, local anesthetic or antiseptic. This is usually minor and self-limiting. The cortisone may result in palpitations, hot flushes and mild mood disturbance. This usually resolves within 24 hours and no treatment is necessary. Infection. Infection is a rare but serious complication, especially if injected into a joint. If you suspect an infection, contact Dr. Robert Lee’s nurse at 208-680-2326. If you are unable to reach the nurse, report to the nearest emergency department. 


Local effects:

Bruising, skin atrophy, hypopigmentation. Mild increase in blood sugar levels in diabetic patients for several days. Transient increase in pain at the injection site before the cortisone takes effect. Occasionally this may be severe, however usually lasts only 4-24 hours and is treated with a cold pack, acetaminophen and anti-inflammatory medication. If this occurs and you are concerned, especially if the pain is not settling despite the above treatment, then please contact Dr. Robert Lee’s nurse at 208-680-2326. If you are unable to reach the nurse, report to the nearest emergency department.

Cortisone injection administered directly into a tendon has been reported to weaken and damage the collagen fibers thus carrying a risk of delayed rupture.

An extremely rare complication is avascular necrosis (bone death), which some doctors suspect may rarely occur when cortisone is injected into a joint, though this has not been proven.

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