Joint injections, often called "cortisone shots" are often useful to relieve inflammation (redness, pain, swelling) that has not responded to usual medications. They are also useful for tendinitis and bursitis. The most common joints to be injected are knees, finger joints, wrists, and shoulders.

Injections all have a small risk of causing joint or tendon damage or infection. Sometimes they can cause lightening of the skin where the shot is given. Complications of these kinds are very rare.

Usually, an injected joint rapidly improves and the patient feels the improvement within 12 to 48 hours. The improvement sometimes lasts permanently, sometimes for 3 to 6 months, and rarely doesn't occur at all. We do not like to inject joints more often than 4 times a year.

Studies (especially of the knee) have shown that the results of an injection are better, and last longer, if the injected joint is rested for 24 hours after the injection.

For knees, this means going to bed, or sitting. Try not to stand or walk other than what is necessary to go to the bathroom or eat etc. Do not plan on having a joint injected if you have to go right back to work, or have to run some errands. Plan on being able to rest the injected joint for 24 hours, or at the very least, for the rest of the day till the next morning.

The injections I give are usually a combination of three ingredients. Some Xylocaine for instant pain relief that lasts only hours. Some fast acting steroid that usually works in a day or less, and some slow depo steroid that is slow acting and long lasting.

We freeze the skin over the site to be injected with ethyl chloride spray. That way the needle is often not felt.