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Information about Cortisone Injection

Injections are frequently given into joints and around tendons to reduce inflammation and help pain. The medication that is injected is usually a local anaesthetic such as Lignocaine or Marcaine. This is injected together with Cortisone (Depomedrone or Triamcinolone).

The local anaesthetic has an immediate numbing effect on the pain. The effect of Lignocaine lasts for about one hour and Marcaine lasts for about four to five hours. If the discomfort is relieved completely following the injection, this means that the injection has been given in the correct spot. The addition of local anaesthetic allows us to know a few days in advance if the cortisone will be helpful when it starts to work a few days later.

Cortisone works as an anti-inflammatory over a few days and reduces swelling and provides pain relief. After the effects of Lignocaine or Marcaine wears off, the injection area will ache as any other injection. This may last for a day or two and then as the cortisone starts to work, the discomfort goes away. Cortisone usually works for about two to three months. Often by that time the problem that caused the irritation around the tendon or the joint has gone away also. If not then there may be recurrence of pain and a second injection might be necessary.

Multiple injections in the same area should be avoided as cortisone may cause some damage to the tendon or joint. The cortisone, which is used for injection, is mixed with a carrier so that it stays in place where it is injected. Because of this there are no general effects to the body.

Allergic reactions or other side effects are rare. Sometimes the pain may get worse before getting better. There may be some swelling or redness around the injected area for a few days.

If there is severe pain or redness or swelling in excess of that described above, then you should report back to your doctor.

Nasser Hyder
Consultant Hand Surgeon
FRCS (Trauma & Orth)

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