Should I Get a Cortisone Shot?
5 Things Your Doctor Never Told You About Cortisone Injections
Cortisone injections, also known as corticosteroid injections, are commonly used to provide temporary relief from inflammation and pain in arthritic joints. While they can be effective for short-term pain relief, research shows that cortisone shots for the knee, hip, shoulder, or other joints may have unintended consequences on long-term joint health—potentially accelerating arthritis and tissue degeneration over time.
Below are the five biggest things most patients aren’t told before getting cortisone injections—and safer, more regenerative alternatives you should know about.
1. Relief is short-term—but the damage can be long-term
Cortisone suppresses inflammation, which is part of why it feels so effective at first. But inflammation isn’t always bad—it’s a crucial part of your body’s natural healing process. Suppressing it too aggressively can interfere with tissue repair.
In a JAMA study on patients with knee osteoarthritis, those who received cortisone injections every three months for two years had greater cartilage loss and no better pain relief compared to those who received simple saline.
Over time, this can lead to accelerated cartilage degeneration, worsening the very condition the injection was meant to help.
2. Cortisone can weaken ligaments and tendons
Corticosteroids don’t just affect cartilage—they also impact connective tissues like tendons and ligaments. Research shows repeated cortisone exposure can weaken these structures, making the joint less stable and increasing the risk of tendon tears, such as rotator cuff injuries in the shoulder.
While one injection may not cause harm, frequent or high-dose injections can degrade collagen and impair the body’s ability to heal. In fact, people who’ve had multiple shoulder injections are significantly more likely to suffer a rotator cuff tear within the following years.
3. Cortisone can contribute to bone loss
Long-term or repeated use of corticosteroids—whether injected or taken orally—has been linked to bone loss (osteoporosis) and an increased risk of fractures. This weakening of the bone structure can make joints more vulnerable to injury and speed up arthritis progression.
When the bones surrounding the joint become less dense, they no longer support joint surfaces as effectively, leading to further wear and tear.
4. Cortisone can mask the problem and delay real healing
Because cortisone often provides quick relief, it’s easy to assume the underlying problem is fixed—but in reality, it may just be hidden. This masking effect can encourage people to resume high-impact or repetitive activities before the tissue is ready, resulting in even more damage.
This is one of the main reasons regenerative medicine specialists recommend using cortisone sparingly. It may calm pain temporarily, but it doesn’t help rebuild or restore tissue health.
5. Repeated shots can change your joint environment
Every joint contains synovial fluid, which lubricates and nourishes the cartilage. Repeated cortisone injections can alter the composition of that fluid, reducing its viscosity and protective function. Over time, that can lead to increased friction, faster joint wear, and a higher likelihood of needing joint replacement.
Research also shows that people who receive frequent cortisone injections are more likely to undergo total joint replacement later, suggesting a connection between injections and progressive degeneration.
So why do doctors still recommend cortisone shots so often?
The truth is, cortisone shots are widely available, familiar, and—perhaps most importantly—despite the known risks, covered by insurance. Regenerative and restorative treatments such as PRP (platelet-rich plasma) or SoftWave Therapy often are not, even though they promote healing rather than simply numbing pain.
Prominent regenerative physicians that I have spoken to have pointed out that the medical system tends to favor “covered care” rather than curative care. Cortisone shots may fit insurance models—but they rarely fit the long-term healing model your joints actually need.
Better, safer alternatives for long-term relief
At New You Health and Wellness, we combine functional medicine, biomechanics, and SoftWave Therapy—a regenerative, noninvasive treatment proven to stimulate the body’s natural healing response.
SoftWave helps:
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Increase blood flow and tissue oxygenation
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Decrease inflammation naturally
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Support tissue regeneration
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Provide lasting pain relief without the side effects of cortisone
If you’ve tried physical therapy or biomechanical correction without success, SoftWave Therapy is the next step before considering injections or surgery. Combined with manual therapy and a personalized plan (our Pain Free Formula), this approach can help you heal rather than simply mask pain.
When to seek professional guidance
If you’re experiencing joint pain or arthritis, it’s essential to get a full assessment from a qualified healthcare professional—such as a physical therapist, orthopedic specialist, or functional medicine provider. The right plan should focus on the root cause of pain and the long-term health of your joints.
To learn more about how SoftWave Therapy and our Pain Free Formula can help, call (414) 299-8121 to schedule a consultation.
FAQ: Common Questions About Cortisone Injections
Q: How long do cortisone shots last?
Typically, cortisone provides relief for a few weeks to a few months. The effects are temporary, and pain often returns as inflammation rebuilds.
Q: How many cortisone shots can I safely have?
Most orthopedic specialists recommend no more than 3–4 shots per year per joint, though even that can carry risks. Frequent injections may increase degeneration.
Q: Are cortisone shots safe before surgery?
Injections given within 3 months before joint replacement surgery are linked to higher infection risks. Waiting at least 6 months is safer.
Q: Can cortisone shots cause weight gain or high blood sugar?
Yes. Cortisone can temporarily raise blood sugar and cause fluid retention. These effects are usually short-lived but can be more noticeable in diabetics.
Q: Are there any people who shouldn’t get cortisone shots?
People with uncontrolled diabetes, joint infections, or significant immune suppression should avoid cortisone. Always discuss your health history before any injection.
Q: What are the alternatives to cortisone?
Options include physical therapy, SoftWave Therapy, PRP, functional medicine approaches, and lifestyle changes such as anti-inflammatory nutrition and stress management.
Q: Can cortisone shots delay or prevent joint replacement?
Sometimes they delay surgery short-term, but evidence shows repeated injections may actually increase the chance of needing a joint replacement later.
References:
McAlindon, T. E., LaValley, M. P., Harvey, W. F., Price, L. L., Driban, J. B., Zhang, M., & Ward, R. J. (2017). Effect of intra-articular triamcinolone vs saline on knee cartilage volume and pain in patients with knee osteoarthritis: A randomized clinical trial. JAMA, 317(19), 1967–1975. https://doi.org/10.1001/jama.2017.5283
Wijn, S. R. W., Rovers, M. M., van Tienen, T. G., Hannink, G., & Scholtes, V. A. B. (2020). Intra-articular corticosteroid injections increase the risk of requiring knee arthroplasty: A multicentre observational study using data from the Osteoarthritis Initiative. The Bone & Joint Journal, 102-B(5), 586–592. https://doi.org/10.1302/0301-620X.102B5.BJJ-2019-1376.R1
Guermazi, A., Hunter, D. J., & Kloppenburg, M. (2023). Debate: Intra-articular steroid injections for osteoarthritis – harmful or helpful? Osteoarthritis Imaging, 3(3), 100163. https://doi.org/10.1016/j.ostima.2023.100163
Burnett RA 3rd, Khalid S, DeBenedetti A, Terhune EB, Angotti ML, Della Valle CJ. Intra-articular corticosteroid injections are associated with a dose-dependent risk of total knee arthroplasty at 5 years. Knee Surg Sports Traumatol Arthrosc. 2023 Feb;31(2):426-431. doi: 10.1007/s00167-022-07017-z. Epub 2022 Jun 30. PMID: 35773523.
Schairer WW, Nwachukwu BU, Mayman DJ, Lyman S, Jerabek SA. Preoperative Hip Injections Increase the Rate of Periprosthetic Infection After Total Hip Arthroplasty. J Arthroplasty. 2016 Sep;31(9 Suppl):166-169.e1. doi: 10.1016/j.arth.2016.04.008. Epub 2016 Apr 22. PMID: 27221820.
