Why Cortisone Shots Might Not Be the Quick Fix You Think They Are

Why Cortisone Shots Might Not Be The Quick Fix You Think They Are

By Anna Staehli Wiser, DPT, FAAOMPT

In 1948, Dr. Philip Hench earned a Nobel Prize after administering the first corticosteroid injection to a woman suffering from rheumatoid arthritis. Just three days later, she was up and walking again1. The powerful anti-inflammatory effects of corticosteroids were undeniable—and today, cortisone shots remain a popular treatment option for joint and muscle pain.

But here’s the problem: quick relief isn’t always long-term healing.

⚠️ The Risks Behind the Relief

Cortisone injections can temporarily reduce inflammation and pain, but research increasingly shows that they may accelerate joint damage over time, especially when used repeatedly.

Here’s what the evidence tells us:

Cortisone inhibits the body’s collagen production, making tendons and ligaments more prone to injury2.
Tendon ruptures, especially in the shoulder or Achilles, are strongly linked to cortisone use2.
A systematic review found increased rates of revision surgery when cortisone was used after rotator cuff repair3.
A study found a 3x higher risk of knee arthritis progression in patients who had cortisone injections (Zeng et al., 2019), and 44% of patients who had hip injections showed accelerated osteoarthritis on X-ray within 6 months4.
Even a single epidural steroid injection has been linked to bone mineral loss in postmenopausal women5 and increased vertebral fracture risk6.

⏳ Short-Term Gain, Long-Term Consequences

Most cortisone injections offer only 2–4 weeks of symptom relief7. And for athletes, there’s added concern: steroid injections have been associated with delayed healing and higher rates of joint replacement later in life8,9.

If cortisone doesn’t correct the underlying muscle imbalances, posture issues, or movement dysfunctions, the pain will likely return—sometimes worse than before.

💡 What Should You Do Instead?

If you're facing joint pain, consider your options:

Physical Therapy – addresses the root cause of your pain and promotes natural healing.
Cortisone Injection – temporary relief, but may lead to long-term issues.
Surgery – invasive, and should only be considered after conservative care has failed.

The best first step? Physical therapy. A targeted, evidence-based plan can restore joint function, correct movement patterns, and prevent future injury—without the long-term risks.

✅ Take the Long View

Quick fixes are tempting. But when it comes to your body, healing the right way takes time. Trust the process, give your body what it needs, and invest in treatments that support your health in the long run.

📞 Questions?
Contact Dr. Wiser at Discover Osteopractic Physical Therapy to schedule a consultation.

References:

1. Yasir M, Goyal A, Sonthalia S. Corticosteroid adverse effects. In: StatPearls. StatPearls Publishing; 2025.

2. Kamel SI, Rosas HG, Gorbachova T. Local and systemic side effects of corticosteroid injections for musculoskeletal indications. AJR Am J Roentgenol. 2024;222(3):e2330458.

3. Puzzitiello RN, Patel BH, Nwachukwu BU, Allen AA, Forsythe B, Salzler MJ. Adverse impact of corticosteroid injection on rotator cuff tendon health and repair: A systematic review. Arthroscopy. 2020;36(5):1468-1475.

4. Simeone FJ, Vicentini JRT, Bredella MA, Chang CY. Are patients more likely to have hip osteoarthritis progression and femoral head collapse after hip steroid/anesthetic injections? A retrospective observational study. Skeletal Radiol. 2019;48(9):1417-1426.

5. Kim YU, Karm MH, Cheong Y, et al. Effect of epidural steroid injection on bone mineral density in postmenopausal women according to antiosteoporotic medication use. Pain Physician. 2016;19(6):389-396.

6. Stout A, Friedly J, Standaert CJ. Systemic absorption and side effects of locally injected glucocorticoids. PM R. 2019;11(4):409-419.

7. Raynauld JP, Buckland-Wright C, Ward R, et al. Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2003;48(2):370-377.

8. Hainline B, Derman W, Vernec A, et al. International Olympic Committee consensus statement on pain management in elite athletes. Br J Sports Med. 2017;51(17):1245-1258.

9. Fernandes GS, Parekh SM, Moses JP, et al. Intra-articular injection administration in UK ex-professional footballers during their playing careers and the association with post-career knee osteoarthritis. Sports Med. 2020;50(5):1039-1046.

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