We use cortisone injections as pain-relieving treatments for arthritis and tendonitis. Cortisone directed to a joint or tendon reduces inflammation and improves pain and function. How long does a steroid shot last, and can we do anything to ensure the effect lasts longer?
What is a steroid shot?
A steroid shot is a type of corticosteroid. Corticosteroids are manufactured drugs that resemble the hormones produced by the adrenal gland called cortisol. These drugs have a powerful anti-inflammatory effect, which reduces inflammation and pain associated with arthritis and tendonitis.
What are steroid shots used for?
Generally, we use a cortisone shot to treat various musculoskeletal conditions that cause pain and inflammation. Some examples include:
How long does a steroid shot last?
Everybody responds differently to a steroid shot, with some individuals experiencing relief for a few weeks while others for a few months or longer. Overall, the effect varies from six weeks to six months. However, certain factors can affect how long the positive effect lasts, such as:
Type of cortisone
Not all cortisones are the same. Some cortisones are more potent and longer lasting, while others are less strong and have a shorter-lasting effect. For example, triamcinolone, known as Kenalog, is a more potent colloid steroid lasting 3-6 months. Alternatively, Dexamethasone is a less powerful water-based steroid lasting 2-3 weeks. Generally, more potent steroids also have harsher side effects such as skin thinning, fat atrophy or tendon weakening.
The choice of cortisone depends on the structure injected. So, we use more potent steroids such as Kenalog for large joints such as the hip or shoulder joints. Conversely, we use less potent steroids such as Depo-Medrol or Dexamethasone for tendons. Generally, more potent cortisone for tendons increases the risk of nasty side effects such as tendon weakening and rupture.
How we perform the steroid shot
We can perform a steroid shot blind or with imaging guidance. Using imaging guidance such as ultrasound increases the accuracy of steroid shots so the steroid is placed in the correct spot.
Generally, using ultrasound means that the steroid shot lasts longer than a blind injection. If you’re having a steroid shot, you should ask your practitioner about having the injection performed with ultrasound guidance.
Type of pathology injected
Purely inflammatory disease processes respond better to a cortisone injection than a degenerative process. For example, De Quervain’s tenosynovitis and trigger finger are due to tendon sheath inflammation and respond much better to a steroid shot than degenerative conditions, such as tendonitis or osteoarthritis. Also, for arthritis, we find that cortisone lasts longer in certain joints, such as the thumb or big toe than in larger joints, such as the hip or shoulder.
Severity of pathology
The degree of changes in the tissue injected influences the duration of the cortisone effect. For example, a cortisone shot in a knee joint with mild arthritis changes will usually last longer than a joint with more marked degeneration.
Post-injection treatment
Physical therapy is essential to successfully treating overuse conditions such as tendonitis and osteoarthritis. Sometimes, pain can inhibit the ability to perform rehab. A steroid shot reduces discomfort and can allow a pain-free window to progress with healing. Combining the two treatments will be more effective and ensure the steroid’s effect lasts longer.
How can we ensure the effect of a steroid injection lasts longer?
You need to consider various factors, including the type of cortisone used, how the cortisone shot is administered and the post-injection treatment. We suggest using the most appropriate cortisone for the disease process and ultrasound to help with the steroid shot. Post-injection, you should see a physical therapist to ensure you benefit from the injection.
Final word from Sportdoctorlondon regarding how long a steroid shot lasts
Various factors influence how long a steroid shot works. Generally, a steroid shot lasts from a few weeks to up to 6 months. It would be best to speak to an experienced doctor to discuss getting the most out of a steroid shot.
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