Many physicians and patients think a cortisone shot is a magic bullet when it comes to things like tennis elbow. Such corticosteroid injections can produce quick pain relief, but their long-term benefits are less obvious. They may also trigger unwelcome side effects.
Will a Cortisone Shot Help or Hurt?
Q. I suffered with tennis elbow in both arms for more than a year. It is no joke and quite painful.
My doctor gave me a cortisone shot, but I found it just made the pain worse. How is that possible?
Treating Tennis Elbow:
A. Cortisone injections are a common treatment for joint pain such as tennis elbow (lateral epicondylitis, in doctor-speak). Although such shots can often provide some immediate relief, there is evidence that the benefits fade over time.
In an Australian meta-analysis of 12 international studies, corticosteroid injections resulted in more pain than other treatments (including placebo) after six months (Lancet, online, Oct. 22, 2010). More recently, a Norwegian study found that that steroid injections eased discomfort at six weeks, but produced no significant difference from placebo at 12 weeks and by 26 weeks had led to worsening of symptoms (BMC Musculoskeletal Disorders, online May 20, 2015).
Most people with tennis elbow recover within a year regardless of the treatment. Exercises to strengthen the forearm muscles may help just as much or even more than a cortisone shot.
Steroid Shot Side Effects:
Most people think that if they get a shot of cortisone or some other corticosteroid in a joint that the medicine will only stay in that area and will not produce systemic side effects. There is some reason to believe that the steroid may migrate into the surrounding bone and potentially increase the risk for osteoporosis down the road. Other side effects may include fluid retention, headache, anxiety, nervousness, insomnia, increased blood pressure, increased blood sugar, muscle weakness and loss of potassium.
Colleen in Edmonton, Canada shared this:
“I received a cortisone injection into my back. The nightmare began that night: anxiety, insomnia and night sweats lasted for two weeks. I also had a racing heart, nausea, indigestion, weak legs, weight loss, acid reflux and cystitis. My doctor didn’t think it was the steroid injection but I was a healthy person before the injection.”
Natalie in Denver, Colorado had a similar experience:
“I had a steroid injection in my neck. Within five days I had anxiety, severe insomnia, rapid pounding heart beats, diarrhea, weight loss, blurred vision, panic attacks, weakness and severe tremors. I had the injection on August 3rd and here it is September and I still have 50 percent of the symptoms mentioned.”
We know that many people do benefit from cortisone injections and do not experience side effects. But the research seems to suggest that for tennis elbow, the benefits are relatively short lived and there may be unexpected problems down the road.
