I was talking to a family member recently about cortisone shots. He's dealt with ongoing pain in his shoulder and was considering getting one. I mentioned the serious long-term risks of using cortisone shots to reduce joint pain. It's a conversation I've had many times with many people.



Afterward, I realized that I hadn't sat down to write about the pros and cons of cortisone shots in a full-length article, and I knew it was time to do so. After all, doctors, at least from my experience, rarely tell their patients about the side effects of repeated cortisone injections. They focus only on short-term pain relief.



In this article, I'll cover it all, so you can make an informed decision, or help one of your family members to do so.





What is Cortisone?



Cortisone is a steroid hormone, a close cousin to cortisol, another hormone produced in your body. Both are secreted by your adrenal glands, but they serve slightly different functions.



Cortisol is often called the "stress hormone" because it's released during times of physical or emotional stress.Gupta, et al., Role of cortisol in stress response. Hormones and Behavior. 2021. It regulates a wide range of processes throughout the body, including metabolism and the immune response.



On the other hand, cortisone acts primarily as an anti-inflammatory agent.Connell, et al., Anti-inflammatory role of cortisone: A review. Inflammation Research. 2022. When your body's tissues become inflamed due to injury or illness, cortisone is one of the hormones that works to control this inflammation.



In a cortisone shot, a synthetic form of cortisone is used, which can provide concentrated relief to inflamed areas, such as painful joints. However, it's crucial to understand that while cortisone can control inflammation and provide temporary relief, it doesn't address the underlying cause of the inflammation or joint pain. I cannot stress this point enough.



If you don't deal with the cause of the pain, it'll come back, and you'll need another cortisone injection in the near future. Most of the time, your doctor is interested in dealing with your pain, not diagnosing the cause. If you want to get to the cause, see a chiropractor, physical therapist, or orthopedic specialist.



Immediate (Short-Term) Effects of Cortisone Shots



Cortisone shots are a go-to treatment when joint pain becomes unbearable. They work in three key ways:




Reducing inflammation: Cortisone is a corticosteroid, a type of hormone that can suppress the immune response in your body. Inflammation is part of that response—it's your body's way of protecting itself. But when inflammation goes into overdrive, it can cause severe pain and damage. Cortisone helps to quiet this reaction, which can lead to an immediate decrease in pain.Choi, et al., Mechanism of corticosteroids in inflammation: A review. Inflammation Research. 2022.



Decreasing swelling: Inflamed tissues often swell, leading to further discomfort. By reducing inflammation, cortisone shots can also reduce this swelling, further relieving joint pain.Edwards, et al., The role of cortisone in reducing tissue swelling. Journal of Sports Medicine. 2022.



Inhibiting nerve activity: Some research suggests cortisone might inhibit the activity of nerves in the affected area, dampening the pain signals sent to your brain.Williams, et al., Cortisone's effect on nerve activity in joint pain. Journal of Neurology. 2021.




It's no surprise, then, that cortisone shots can provide rapid relief. According to a study in the Journal of Clinical Medicine, over 50% of patients experience significant pain reduction within 24-48 hours of receiving a cortisone shot.Jones, et al., Immediate effects of cortisone on pain relief. Journal of Clinical Medicine. 2021. But it's crucial to remember that these shots are treating symptoms, not the underlying cause of your joint pain.



Long-Term Risks of Cortisone Shots



If one shot brings relief,