Cortisone shots have been used by the podiatric and orthopedic community as a time honored solution for joint and tendon injuries. Cortisone shots should not be confused with anabolic steroids, which are illegal in competition and have dangerous side systemic side effects. Cortisone is a synthetic form of the glucocorticoids that are synthesized by the adrenal glands. Glucocorticoids act as the body’s stress hormone that regulates glucose stores and decreases immune function.

As an injection cortisone is commonly used for reduction of inflammation in conditions such as heel pain, arthritis, neurologic and other inflammatory conditions of the foot and ankle. How many cortisone injections are too many? There is no exact number but in our practice we administer no more than two shots in a six month period with rare exceptions in cases of extreme pain. There are however some dose related side effects like temporary steroid flare, tissue atrophy including skin and muscle and in some cases weakening of tendons and bones that can lead to ruptures or fractures.

The movie North Dallas Forty depicted above highlighted the abusive side of pro sports to mask pain to keep athletes on the field. I have also seen in my practice were fat pad atrophy from too many cortisone injections. Temporary weakening of a tendon tissue even after only one injection is possible and sometimes . doctors employ a temporary splint or cast after the injection. There are also alternative injections that also treat inflammatory conditions but without the harmful side effects of cortisone include Amnion and growth factor injections from placental matrix tissue. Consider all your options before you jump whole hog into a seies of cortisone shots.