If you’ve ever been offered a cortisone injection for joint or tendon pain, you probably heard promises of fast relief—but not much about the possible downsides. Cortisone shots can certainly calm inflammation and reduce pain in the short term, but research is revealing important details that most people (and even some providers) never share in the exam room.
Below are five things you should know before getting—or repeating—a cortisone shot.
1. Relief is short-term—and repeated shots may damage your joint
Cortisone injections can relieve pain for several weeks or months, but they’re not a long-term solution. In fact, the American Academy of Orthopaedic Surgeons (AAOS) now classifies cortisone as “short-term relief only.” In one JAMA study, patients with knee arthritis who received cortisone injections every three months for two years had more cartilage loss and no better pain relief than those who received simple saline injections.
Other imaging studies have shown that repeated injections can accelerate joint degeneration, increase the risk of fractures within the joint, and in some cases, lead to collapse of the bone surface. While a single shot may be reasonable to calm a severe flare, repeated injections can do more harm than good.
2. Cortisone shots in the shoulder are linked to higher rotator cuff tear risk
Steroid injections in the shoulder have been associated with a higher rate of rotator cuff tendon tears—sometimes up to seven times higher than in those who never had the shot. Cortisone weakens collagen and can reduce the tendon’s ability to heal or withstand normal stress.
However, if a cortisone injection was given months before a shoulder surgery (that’s what “remote from surgery” means), some studies have found no negative impact on post-surgical healing. Timing matters—having the shot too close to surgery is riskier than having one many months prior.
3. More cortisone shots may mean a higher chance of future joint replacement
Several observational studies have found that patients who received repeated cortisone injections were more likely to progress to total joint replacement, such as knee or hip arthroplasty. The risk appears to increase with the number of injections—what researchers call a dose-dependent relationship.
While these studies can’t prove cortisone causes the need for joint replacement, the consistent link across large groups of patients suggests that injections may speed up the degenerative process, especially when overused.
4. Timing around surgery is crucial
If you’re planning a joint replacement, having a cortisone shot too close to your surgery can increase your risk of post-operative infection. Research shows that injections within three months before surgery carry a higher risk of infection, while waiting at least six months is generally considered safer.
That’s one reason many orthopedic surgeons now recommend avoiding cortisone shots in the months leading up to joint replacement.
5. Cortisone isn’t completely local—it can affect your whole body
Even though cortisone is injected into one area, it doesn’t always stay there. Studies show it can temporarily raise blood sugar levels, especially in people with diabetes or prediabetes. It can also cause short-lived systemic effects such as insomnia, facial flushing, or temporary increases in blood pressure.
These reactions are usually brief—but they’re still important to consider, especially if you already struggle with metabolic or hormonal balance.
Why cortisone shots are still given so often
If cortisone shots come with these risks, why are they so common? The simple answer: insurance coverage. Cortisone injections are typically covered, while regenerative options like platelet-rich plasma (PRP) or SoftWave therapy are often not. As regenerative medicine expert Dr. Chris Centeno has noted, the system is financially set up to favor quick, reimbursable procedures—even if they’re not the most healing-oriented in the long term.
The bottom line
Cortisone may be helpful once in a while, but it’s not a long-term strategy for healing. If you’ve already had multiple shots with only temporary relief, your body is signaling it’s time for a different plan.
At New You Health and Wellness, we focus on restoring the body’s ability to heal—naturally and sustainably—by addressing inflammation, circulation, tissue regeneration, and movement patterns.
If you’re wondering whether a cortisone shot is right for you, schedule a consultation to discuss safer, longer-lasting solutions that support true recovery—not just quick relief.
FAQ
Q: Is it ever okay to get one cortisone shot?
Maybe. One well-timed cortisone injection could be reasonable for severe pain while you work on underlying causes like inflammation or mechanical issues. The key is to avoid making it a repeat habit or avoiding it all together.
Q: How long should I wait after a cortisone shot before surgery?
Ideally, wait at least three months, and if possible, six months before elective joint surgery to reduce infection risk.
Q: Are there safer alternatives?
Yes. Physical therapy, PRP injections, SoftWave therapy, and regenerative medicine approaches can stimulate true healing without damaging joint tissue. Research has shown adjusting how you are moving, or walking can significantly decrease pain and progression of arthritis.
Q: What if I already had several cortisone shots?
It’s not too late. Focus on rebuilding joint health through movement, circulation, and cellular repair. A regenerative medicine provider can help you plan the next step. Call us about our Softwave Therapy and how this addresses bone on bone, arthritis and other joint issues.
References
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McAlindon TE, et al. JAMA. 2017;317(19):1967–1975.
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American Academy of Orthopaedic Surgeons (AAOS). Knee Osteoarthritis CPG, 2021.
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Dragoo JL, et al. Am J Sports Med. 2014;42(9):2217–2227.
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Bedard NA, et al. J Arthroplasty. 2017;32(3):959–963.
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Redelmeier DA, et al. Radiology. 2019;293(2):388–397.
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McMahon SE, et al. Bone Joint J. 2013;95-B(3):377–383.
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Habib G, Clin Rheumatol. 2009;28(8):749–756.
