Cortisone injections (also known as corticosteroid injections) are a well-known treatment often recommended for conditions like Achilles tendonitis, rotator cuff pain, shoulder or hip bursitis, tennis elbow, and plantar fasciitis. They’ve become a go-to option for quick pain relief. But how effective are they, really?
In recent years, the long-term value of cortisone injections, particularly for tendon-related pain, has been the subject of growing research and debate.
How do cortisone injections work?
Cortisone works by reducing inflammation and suppressing immune activity in a targeted area. When injected into or around a tendon sheath, cortisone helps decrease swelling, relieve pain, and improve mobility. Its strong anti-inflammatory effect is why it’s often used as a first-line treatment for tendon issues.
However, while cortisone might offer short-term relief, mounting evidence suggests it may not be the best long-term solution, especially when used repeatedly or injected directly into a tendon.
Here’s what the research says:
1. Relief is temporary (Usually 4–8 Weeks)
Studies show that cortisone injections often provide only short-term pain relief. While they may reduce inflammation, their effects tend to fade within a few weeks. For chronic overuse injuries, such as tennis elbow or rotator cuff issues, the relief is often inconsistent, and in some cases, symptoms can worsen after the initial improvement.
2. Limited long-term benefit
Short-term pain relief is common, but long-term improvement is not. A 2019 study published in the American Journal of Sports Medicine tracked patients with Achilles tendinopathy who received cortisone injections. Initially, their pain reduced, but symptoms often returned within six months. In some cases, patients experienced tendon degeneration over time.
3. Risk of tendon weakening
One of the most concerning risks with cortisone injections is their potential to weaken tendons. Repeated injections, especially those placed directly into the tendon, can compromise tendon integrity, increasing the risk of partial or complete rupture. This is especially important for athletes or active individuals relying on healthy tendon function.
4. Delayed recovery and worse outcomes
Emerging research also shows that patients who receive cortisone injections may experience slower recovery times and a higher likelihood of reinjury. One-year follow-up studies have found that outcomes for those who opted for a “wait and see” or conservative rehab approach were often better than those who had a cortisone injection. In other words, doing nothing may be better than doing something (if that something is a cortisone shot!).
What’s the best first step?
Cortisone injections represent a commonly used intervention for managing tendon pain, offering short-term relief by reducing inflammation and alleviating symptoms. However, recent research has highlighted limitations and potential drawbacks associated with their use, including limited long-term efficacy and the risk of tendon weakening or degeneration.
Everyone agrees that exercise or physiotherapy is the gold standard treatment for chronic tendon injury and should be the first line of attack – and this is whether you choose to have a cortisone injection, or not…..
Chronic tendon injuries can be complex and frustrating to manage. Each case is unique, even if it affects the same tendon, and effective treatment requires more than just rest or pain relief. Skilled Physiotherapists will not only address your pain, but help guide recovery at the cellular level through targeted exercise, education and progressive load management.
Our team is here to help you move better, feel stronger, and recover with confidence.
Call us on on 02 8417 2978, or book directly here.
