Cortisone injections are used routinely by orthopedic surgeons, rheumatologists, family practice and pain management physicians. The goal of cortisone injections is to decrease the inflammation in the affected area. Pain physicians often use cortisone injections for sciatica in which a disc bulge is causing compression on a nerve root resulting in severe burning leg pain.
Cortisone is a steroid and is available in different brands and concentrations. Some examples include Depomedrol, Celestone and Solu-Cortef.
Cortisone injections flares typically occur due to the amount of steroid injected and the size of the needle used. Typical concentrations injected by physicians are 4-6mgs. A milligram is one thousandth of a gram. This dose represents 100,000 to 1,000,000 times more than your body naturally uses to control swelling. These large concentration of cortisone are associated with adverse effects including flares. Other common side effects include swelling, itching, weight gain, compromise of the immune and renal function as well as potential deterioration of the affected joint. Unlike most practices, the Centeno-Schultz Clinic uses very low dose steroids ( nanograms) which are compounded exclusively for our clinic.
The other issue associated with cortisone injection flares is the needle size. Most physicians use a 20 gauge needle. At the Centeno-Schultz Clinic we use a 25 or 27 gauge needle so as to reduce the incidence of cortisone injection flares.
Alternative to steroids include prolotherapy and the use of stem cells to reduce inflammation, repair damaged tissue and provide long term pain relief.