I recently came across and NY Times article which questions the wisdom of Cortisone Shots (http://well.blogs.nytimes.com/2010/10/27/do-cortisone-shots-actually-make-things-worse/?scp=1&sq=cortisone&st=cse). Often when people are in pain, they are irritable and also impatient because of what the pain does to their normal daily activities. The cortisone shot has been used for the quick fix for heel spurs, knee pain, shoulder pain, bursitis and other maladies. It is usually administered by an orthopedist or a physiatrist.
The problem with this solution is that while it can cause a significant amount of relief, it will also cause bone loss and problems with healing at the site of injection if overused. The other problem is that this injection will resolve the problem because the problem is that the area is painful. This misunderstanding is natural since most people believe no pain, no problem. Since inflammation rarely just happens, and it is usually due to a mechanical problem, it requires a mechanical solution. Injecting an area that is inflamed, even though we do not understand why is not a mechanical solution. It really is a shot in the dark, with the hope that it gets rid of the pain. If you and/or your doctor have little understanding as to the mechanism of pain (hint; rarely is inflammation a mechanism however it is a response to unusual stress and irritation), you are likely to have the problem continue to reoccur and develop other related problems at other times and think these are also just pain. The reality is, symptoms are just a warning that something is wrong. Years later, that degenerated joint warned you about what is eventually coming down the road.
In our office, we look at symptoms, dig for facts and try to understand and the explain the mechanism of inflammation and then get to the mechanical cause. The benefits of this approach are:
1. Real long lasting solutions.
2. Your joints are less likely to wear out because we are resolving the forces damaging the joint.
3. You are less likely to develop other related problems because the true cause has been resolved.
4. You enjoy a better quality of life and fewer doctors office visits with less pain.
5. You will rarely ever need a cortisone shot.