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A Warning about Cortisone Injections for your Pain

Posted by in Neck Pain Causes, Neck Pain Essentials |

A warning about cortisone injections for your pain

I feel that I need to warn you about cortisone injections and the possible harm they can inflict.

I was speaking to a good friend of mine who was in a great deal of pain. I asked him what had happened and he told me that a rather small problem that he had had was now a big problem. He explained to me that he had had been suffering from pain in his Achilles tendon. The doctor didn’t seem to know why he had this pain so he recommended that he get a series of cortisone injections to ‘see how that went’. After the first one he felt a bit better, then the next he felt better again and a few days before he was scheduled for his third injection he felt ‘like someone hit him in the back of the calf’ and now he had severe bruising in and around his Achilles tendon and ankle and was no longer able to walk without the aid of crutches. The doctor took a look at him and couldn’t understand what had happened so sent him off to get some physiotherapy for his ankle. This is where he should have gone to in the first place

So what is wrong with this picture?

Why don’t we first take a look at cortisone injections themselves? They have been around since the 1950s and are used to decrease tissue inflammation so that the area can then heal. This is the theory. But why is the area inflamed? This is the number one priority-getting to the cause of the problem not just treating the symptoms. Let’s take a look at another example.

I will use and example of a new client who came to see me last week. This person was suffering from neck pain and had tried everything from prolotherapy to acupuncture to chiropractic to Rolfing. However, his pain still existed. The whole time he was speaking to me he was sitting in a slouched forward head posture. I could see by his posture that this was his major problem and would be our first area to look at. The thing about poor posture and particularly a forward head posture is that it affects the upper back, neck, shoulders, lower back and so on and so forth. A forward head posture has a huge knock-on effect throughout the rest of the body. In other words, many of your problems will be caused (and fixed) by addressing this first.

I knew by looking at him that his shoulders were also forward and internally rotated which will impinged the shoulder joint and set him up for shoulder problems.  I asked him if he had had shoulder problems in the past and he said ‘oh sure, I have had 3 cortisone injections in the left shoulder and 2 in the right but they didn’t really work’.

Of course they ‘didn’t really work’ because the cortisone injections will never fix the cause of the problem which is known as ‘upper crossed syndrome’ or ‘rounded shoulders’ or  ‘shoulders that are too far forward and internally rotated which lessen the space in the shoulder joint and cause impingement or better put, constant mashing of the soft tissues.’ The cortisone may have had a temporary effect as it reduced the inflammation and impingement but the cause of the problem was never addressed (i.e. shoulders too far forward and internally rotated causing pain and inflammation) and therefore after a short while the pain returned.

The story doesn’t end there. Not only do cortisone injections hurt but they have a corrosive effect on the cartilage and soft tissues. This, I don’t need to tell you, is NOT GOOD!

This brings me back to my friend with the Achilles tendon problem.

The major cause of prolonged pain and dysfunction from injuries is from lack of appropriate rehabilitative exercises. If you have an injury you MUST do stretching and strengthening exercises as soon as possible. (After the initial 48 hour inflammatory phase).

So my friend has, in my opinion, been getting treatment in ‘backwards- forwards land.’ He has come to see the doctor and instead of getting treatment for it such as physical therapy, which means stretching and strengthening exercises and soft tissue/joint therapies he was given cortisone injections. Here was a person who needed to strengthen his tendon and stretch it out to recover it to full function but what he got instead was something that masked the problem. He should have been getting therapy to allow the fibers to knit into a strong and flexible repair so that he could regain his strength in the soft tissues. However, instead he was now walking and running around with a torn tendon but now he could apply more pressure through the tendon thanks to the analgesic properties of the cortisone. Now, he could walk harder and faster which enabled him to damage his tendon further. Every pain free step would enable him to tear those tiny fibers more and more until finally something had to give- and it did. His tendon, thanks to the deadening effects of the cortisone and the added benefits of the corrosive properties of the cortisone pushed his Achilles tendon past breaking point and it snapped. Where is my friend now? He is getting physiotherapy 3 times a week to try to heal the area which is now much worse than the original problem.

So my advice to you is this. Just because your doctor or therapist doesn’t know why you have pain is no reason to jump into a series of cortisone injections. They are not good for your body, they are a corticosteroid. There is no reason to start putting more chemicals into your body when you may not have to. Seek another opinion. More than that, make sure that the cause is being addressed not just the symptoms. Are your shoulders painful because of major muscular and structural imbalances? Can you stop your osteoarthritis getting worse simply by postural and structural modifications?

If a person has sciatica and back pain because they have disc bulges in their lower back and need surgery I would want to see first why they have disc bulges in the first place. Is it because they sit slouched at their desk all day and night? Is it because they lift things poorly? If this is the case, and they elect to have surgery and do not stop these bad habits, what is stopping the next weakest links above and below the fusion from doing the same thing? Nothing. If you have blown your L5-S1 disc because of these very reasons and then after surgery( all going well) you feel better but continue to sit, stand and lift poorly you will put these same forces on your discs AGAIN and the problems will still be there. You are still causing your discs to be pushed backwards, straining your ligaments and soft tissues. Likewise, a cortisone shot will not fix your back pain from bad lifting techniques if you continue to lift badly

Your neck is no different. You MUST remove the cause of your neck pain.

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