What Is a Cortisone Injection in the Spine?

The World Health Organization names musculoskeletal disorders as the leading contributor to disabilities worldwide. Approximately 1.71 billion people globally suffer from musculoskeletal conditions, which include neck, back and extremity pain. These conditions are sometimes caused by spinal issues, such as herniated discs, spinal stenosis or sciatica.

One common treatment for these issues is a spinal cortisone injection. Through this procedure, corticosteroids are injected into the epidural space surrounding the spinal cord and nerves. It aims to reduce inflammation and alleviate the pressure in the spinal nerves, helping lessen pain. While cortisone does not directly relieve pain, it has anti-inflammatory properties that help reduce the swelling and irritation that cause discomfort.

Cortisone injections are often used for managing pain associated with a variety of spinal conditions. However, it’s important to note that these injections only provide temporary relief. They are typically part of a broader treatment plan that includes physical therapy, lifestyle changes or even surgery if needed.

What Is a Cortisone Injection Used For?

Cortisone injections are primarily used to treat chronic pain caused by inflammation around the spinal nerves. Some of the most common conditions cortisone injections are prescribed for include:

• Herniated discs: When a spinal disc ruptures or bulges, it can press on nearby nerves, causing pain, numbness and weakness. Cortisone injections reduce the inflammation around the affected nerve roots and help relieve symptoms.
• Sciatica: This compression of the sciatic nerve, which runs from the lower back through the buttocks and down the legs, can cause pain, tingling and weakness in the lower extremities. Cortisone injections can help reduce the inflammation that irritates the sciatic nerve.
• Spinal stenosis: This condition occurs when the spaces within the spine narrow, putting pressure on the spinal cord and nerves. Cortisone injections help alleviate the pain and inflammation caused by this compression.
• Degenerative disc disease: As the discs in the spine wear down over time, inflammation can develop, causing chronic pain. Cortisone injections help reduce this inflammation and provide relief from the associated pain.
• Facet joint arthritis: Arthritis or injury can cause inflammation in the spine’s facet joints. Cortisone injections reduce this inflammation and help manage pain.

Types and Formulations of Cortisone Injections

There are different types of cortisone injections, depending on the specific location in the spine where they are administered. The three most common types are:

• Interlaminar epidural steroid injection: Cortisone is injected into the back of the spine, where it spreads to the affected nerve roots. This type of injection is commonly used when multiple nerve roots are inflamed.
• Transforaminal epidural steroid injection: Cortisone is administered directly into the foraminal space, where the spinal nerve exits the spinal canal. This technique is more targeted and is often used when only one nerve root is affected.
• Caudal epidural steroid injection: Cortisone is delivered at the base of the spine and spreads throughout the lower spinal region. It’s used for more generalized pain relief in the lower back.

Cortisone injections typically contain a combination of corticosteroids and local anesthetics. The corticosteroids reduce inflammation, while the local anesthetics provide immediate, temporary pain relief. The most commonly used corticosteroids are:

• Hydrocortisone: A short-acting corticosteroid that provides fast relief but has a shorter duration
• TriamcinoloneandMethylprednisolone: Intermediate-acting corticosteroids that provide relief for a longer period, lasting several weeks to months
• Dexamethasone: A long-acting corticosteroid with a slower onset but longer-lasting effects, making it useful for extended relief

What Should Patients Be Aware Of?

Cortisone injections are generally considered safe, but patients should note several important factors:

• Temporary relief: Cortisone injections offer temporary pain relief. They can alleviate inflammation and discomfort, but they don’t address the underlying cause of the problem. Depending on the patient and the condition, the relief can last anywhere from a few weeks to several months.
• Limited use: Cortisone injections are typically limited to three to four times per year due to potential side effects. Overuse can lead to adverse effects such as weakening of the bones and cartilage.
• Possible side effects: Some patients don’t tolerate cortisone injections well. They may experience side effects like temporary pain increase, facial flushing, mood changes, insomnia, infection and high blood sugar.

Special Instructions for Patients With Chronic Conditions

Cortisone injections can affect patients with chronic medical conditions differently. Certain precautions need to be taken, particularly for those with diabetes or osteoporosis.

1. Diabetes

Cortisone injections can temporarily increase blood sugar levels, which can be problematic for people with diabetes. This spike can last anywhere from a few days to a week. Diabetic patients are advised to:

• Monitor blood sugar levels closely after receiving an injection.
• Adjust their diabetes medication as needed, with guidance from their healthcare provider.
• Discuss the potential risks and benefits with their doctor before receiving the injection to ensure it’s the best option.

2. Osteoporosis

Frequent cortisone injections can contribute to bone thinning, which could worsen conditions like osteoporosis. Corticosteroids can reduce bone density over time, especially if used frequently. Patients with osteoporosis are highly recommended to:

• Limit the number of cortisone injections to avoid further weakening of the bones.
• Ensure adequate intake of calcium and vitamin D supplements.
• Engage in weight-bearing exercises to strengthen bones, with guidance from their doctor.

3. Heart Disease

Cortisone injections may cause fluid retention and elevated blood pressure, which can be concerning for patients with hypertension or heart disease. Patients with heart ailments are advised to:

• Monitor their blood pressure closely after receiving an injection.
• Avoid cortisone injections if their cardiovascular condition is not well-controlled, or discuss alternative treatment options with their healthcare provider.

Special Pre- and Post-Injection Instructions

Below are important reminders for patients receiving cortisone injections:

• Inform your doctor of any medications or supplements you are taking, especially blood thinners, as you may need to stop them before the injection.
• Avoid strenuous activity for 24-48 hours after the injection to allow the cortisone to settle and work effectively.
• Monitor for side effects, including signs of infection (redness, fever, increased pain), and notify your doctor if any occur.

Cortisone injections in the spine are an effective treatment for reducing inflammation and managing chronic pain caused by conditions like herniated discs, sciatica and spinal stenosis. While these injections can provide temporary relief, they should be used as part of a broader treatment plan.

Patients with chronic conditions like diabetes, osteoporosis or heart disease need to take extra precautions, monitor their health and discuss potential risks with their healthcare provider. By understanding the benefits and limitations of cortisone injections, patients can make informed decisions about their pain management options and work toward long-term relief.

Advantages of Seeking Treatment From Our Spine Experts

Desert Institute for Spine Care (DISC) is an orthopedic spine center in Phoenix, Arizona, specializing in the diagnosis and treatment of numerous spine concerns. Our team of top-rated surgical specialists is among the best in the field, allowing us to provide patients with the most cutting-edge treatment options.

The benefits of choosing us for spinal care include:

• Minimally invasive treatment: We prioritize the least to minimally invasive techniques to facilitate faster recovery for our patients.
• Over 50 years of experience: We’ve served patients for decades, utilizing the most innovative and effective treatments available.
• Customized patient care: We tailor our treatment plans according to our patients’ specific needs. Whether for simple or complex spine injuries, we can develop a unique treatment and recovery plan that fits their lifestyle.

Find Spine Relief With DISC

Explore a wide array of treatment options specifically designed for your unique spine concerns. Schedule a consultation with our specialists at DISC and let’s restore your lifestyle.