ADVANCED FOOT AND ANKLE SPECIALISTS, PA
Jay S. Weingarten, DPM, FACFAS, FACFAOM
Podiatric Physician and Surgeon
Board Certified Physician – Treating Pediatrics to Geriatrics
Cortisone Injections
Cortisone is an injectable anti-inflammatory medication that has been used for decades to
treat chronic or acute inflammatory conditions of the body. Known in the sports arena as the
“miracle drug,” it is frequently used to treat soft tissue disorders in muscles, ligaments, tendons, and
even joints. It works very well in the lower extremity because no one wants to stop walking and/or
to use crutches, rolling walkers or wheel chairs to allow the swelling to recede (i.e. swelling leads to
pain). Oral steroids and/or non-steroidal anti-inflamatories do not work as well and are usually used
in combination with injectable steroids.
Cortisone is a hormone secreted by the adrenal gland, which is a small gland next to the
kidney. These glands secret many different kinds of hormones needed for regulation of body
processes. Some regulate sodium and potassium, some have an effect o blood sugar, protein and fat
metabolism, and some the same effect as sex hormones.
Cortisone is needed by metabolic systems for utilization of carbohydrates, proteins and fats
and for resistance to physical and mental stress and infections. The adrenal gland releases cortisone
in response to stress caused by trauma, infection, intense heat or cold, surgery, and almost any
debilitating disease.
Cortisone is primarily used therapeutically for its anti-inflammatory properties. It is the
body’s most powerful natural resistance to inflammation.
Inflammation
Swelling causes inability to move joints, and is a natural method of immobilization.
Swelling causes us to avoid using or touching the painful area, so as to rest the part involved.
Inflammation is not a disease, but a localized reaction of body tissues to injury, trauma,
surgery, or overuse. What characterizes the inflammation process is the reaction of blood vessels.
The four cardinal signs of inflammation are REDNESS, SWELLING, HEAT, and PAIN.
Inflammation is a normal process, which is set into motion by a complex series of events, which is
set into motion by a complex series of events, which try to heal and reconstitute the damaged body
tissues. However, inflammation itself may be potentially harmful.
Inflammation reactions underlie the effects of crippling rheumatoid arthritis. . Reparative
efforts may lead to disfiguring scars. Fibrous bonds limit joint movement and scar tissue hampers
the function of organs.
Cortisone, made in the body from the steroid cortisol, is indicated for the treatment of most
inflammatory conditions and come non-inflammatory conditions. For localized injections, manmade
cortisone-like preparations are used. These compounds enhance the anti-inflammatory properties
and decrease the other less desirable metabolic properties of cortisone. The manmade preparations
are more potent anti-inflammatory with less metabolic side effects than cortisone.
Indications
The inflammatory conditions that respond to local cortisone injections are as follows:
JOINT INFLAMMATORY CONDITIONS such as osteoarthritis, rheumatoid arthritis, gouty
arthritis, and others.
 Bursitis: inflammation of the bursae
 Peri-arthritis: inflammation of the structure surrounding a joint.
 Tendonitis: inflammation of the tendon on its sheath, i.e. ganglionic cyst.
 Neuritis: inflammation of a nerve or its surrounding structures, i.e. neuroma.
 Fibrositis: inflammation of muscle or its surrounding tissue.
The non-inflammatory conditions are as follows:
 For reduction in painful areas of scar tissue.
 Reflex Sympathetic Dystrophy; a rare and painful condition caused by trauma and stress.
 For symptomatic relief of joint, muscle, and tendon pain.
 Dermatological diseases.
 Certain allergic states.
Symptomatic improvement can occur within the first 24 hours: improvement in pain and
stillness is sometimes dramatic. A post injection reaction is possible, but usually subsides within 2-3
days. Maximal relief from pain and swelling is up to 2 weeks or longer. Corticosteroids are used
locally (in joints or other soft tissue structures) and sometimes are mixed with a local anesthetic for
symptomatic relief.
A local injection in the foot or ankle does not have the generalized metabolic effects of an
oral or intravenous route; the effects are localized.
Again, local injections of a small amount of a cortico-steroid have very few, and rarely
adverse reactions compared to long-term cortisone therapy. Local injections use a small amount of
cortisone, injected in a small, limited, local area. And is usually fully absorbed in two weeks or less.
The cortisone used is not long acting, allowing for quicker absorption. Injections are usually spaced
no closer than 7-14 days apart or longer.
Your doctor can answer any questions you may have regarding your particular concerns, and
explain treatment plans using local cortisone injection therapy. Other treatments used in
combination with cortisone injections can often include, physical therapy, medication and shoe
modifications.
1233 SE Indian St., Suite 102, Stuart, FL 34997
tel. 772-223-8313, fax 772-223-8675
1106 W Indiantown Rd, Suite 4, Jupiter, FL 33458 tel. 561-744-6683, fax 561-744-7033