Question about cortisone injections

I had an injection with depo-medrol on my left shoulder about five years ago after a dirt bike event. I fell and forced my rotator cuff somewhere. Never bothered me since. This year for the first time I had some pain on my right shoulder. Eventually I got a ultrasound (I don't see doctors, I am one myself and we are bad at seeing specialists) which showed calcification on my supra spinal ligament (the top one on the shoulder). Next day I went to a radiologist friend and he infiltrated my tendon with one ml of depo-medrol. Next day I was pain free. Some months later I was goofing off and did some butterfly without warming up or whatever and the pain came back. And I went back to the same guy and had a second injection. This time I took off one month from swimming. I will try and do some specific shoulder exercises this year and wait till March after swimming two months before I attempt a butterfly. Hear this, my injury is not from swimming, but from years or decades of tennis playing. What was the question? Oh, yes I am all for cortisone injections. If you do an internet search you will see that most American Orthopaedic surgeons are for cortisone injections. Take care, billy fanstone

In what may be a first...I agree with Jim. I've had the "pleasure" of getting cortisone shots on 3 different occasions prior to: two shoulder surgeries (one on each) and knee surgery (patella reattachment). I had the treatments because I had gone to the point of no return and had to have the surgeries but wanted to continue (in the cases of the shoulders) swimming/racing thru the season and (in the case of the knee) skiing until the end of the season. Both the surgeons were very clear that the cortisone would help with the pain but offer no healing benefits and that I there was no risk of further damaging the affected areas...in all 3 cases they limited the treatments to 3 over a period of 3-4 months. I also have a question as to why your getting PT for something that is as of yet "undiagnosed"...in general it would be better to get several opinions from othropedic surgeons before going into PT and possibly getting treatment for the wrong thing...and the Doc's are the ones who should/shouldn't recommend getting the shots.

Agree with Jim and Paul, Willow. Cortisone is only a temporary bandaid and can degrade the tendons. If the injury is only tendonitis, it might help if you also begin strengthening the rotator cuff muscles. If it's tendinopathy or tearing or something else, it won't really help. The minute it wears off, you'll be in pain again. And it is odd to be in PT without a diagnosis. Have you had an arthrogram? And Paul is right, you might need multiple opinions. My orthopod missed my diagnosis (labral tearing) the first time. Like you, I have somewhat hypermobile joints. It's simultaneously good and bad. The only thing that keeps that pain at bay for me is to do RC exercises and lift weights. I also frequently use fins and do a lot of kicking in my workouts. It saves wear and tear on the shoulders, and also seems to have a positive effect on my swimming. Good luck!

My one experience with cortisone being injected into my shoulder was very positive. I fell on the ice while walking the dog and froze my left shoulder. I could not move my elbow above my shoulder and it was like this for three weeks before I had it injected with cortisone. I started swimming right after the injection and withing six weeks I had full range of motion in the left shoulder.

But Jim, icing is contradicting your own statement, you are interfering with the natural healing processes, cooling off the "inflammatory" process. Icing is so powerful it was used as an anesthetic for amputating legs during the Napoleonic invasion of Russia. Treatment for shoulder pain evokes passionate opinions and is full of diverse options. As a person with short patience for pain or for any little tendon or muscle problem that interferes with my doing my exercises I am more aggressive in my approach. But I do the other stuff also. I try and make my recovery in free style less harmful to the rotator cuffs. I will avoid all butterfly till March. I will do a specific weights program for the shoulder. But I have a personal view that the cortisone on the inflammatory process is as if you had excised the offending tissue with a scalpel, giving time for the good tissue under to grow strong. Call it empiric treatment: if works, therefore it is good. The supposedly harmful side effects of cortisone on the cells or cell membranes is more theoretical than practical, and would also be an effect after many, many infiltrations. So, if you can get a magical injection that will let you keep going pain free for a long time, give it a try.

I don't mean to offer too vehemently a counter view to our esteemed colleague, Dr. Fanstone, but... Cortisone shots, like any kind of anti-inflammatory treatments, inhibit by definition the inflammatory process, which is part of the body's healing response to acute trauma. Our bodies have evolved this response over milions of years of evolution. Interfering with it, it seems to me, is like thumbing your nose at Mother Nature. Not that she doesn't deserve it sometimes, but it's something you should consider advisedly. The other thing is that most chronic shoulder injuries, it turns out, are NOT inflammatory. They are tedinopathy as opposed to tendinitis. I personally would try the following first, then try them again, and again, till they work. Only if they NEVER work would I revisit the idea of cortisone shots: Ice--20 minutes on, 20 minutes off, repeat. Put a wet paper towel between your flesh and the ice bag to prevent frostbite Rest--avoid provocative motions, but don't avoid all motions. You want to slowly move the joint through its natural range of motion. Sometimes this is easier with heat--i.e., in a shower or hot tub. Rotor cuff and other stabilizing muscle exercises--with stretch cords and very low weight (2 lb. max) dumbbells. The main one, if you do no other ones, is external rotation--elbow at side, forearm at right angle to upper arm, fingers start out pointing straight ahead, rotate forearm out till finger tips pointing to the side. Keep in the pool--use fins to kick and eventually let your arms go thru the motions of pulling but without actually putting much force into it. As the shoulder starts to feel slowly better, increase the amount of force. Just be gradual. Good luck! Oh, and get one of those ball thrower things for your border collie! No reason he or she needs to rest!

I had a cortisone shot in my right shoulder in mid November in a final attempt to calm down some severe rotator cuff tendonitis caused by overdoing it in the weight room. I had signed up for Long Beach but my training was totally compromised by the pain and I was considering blowing it off. Of course, I had been doing P-T, ice, stretching, ART, etc. prior and was barely swimming in practice. I have to say that the treatment proved very effective. I wasn't 100% better and it didn't really help my other chronic right shoulder problem of pain caused by a lack of cartilege on the head of my humerus, but it provided very noticable relief by the third day after the shot and enabled me to put much more torque on the joint. Post Long Beach I stiff feel the beneficial effects and have been able to resume pull-ups (although without the 50 lbs. strapped to my waist) and several other upper body exercises in dry land training. My doc did say that these shots are not any type of long term cure and can be harmful if overdone, which he defined as more than once a year. Obviously, this is anectdotal evidence and I'm not claiming any scientific basis for my experience. However, for me it was very helpful. Rich

I got a cortisone shot for pain from a trapped radial nerve back in 2006. It relieved the pain for about four days, then the effect wore off. I finally had a radial nerve release operation, then discovered that somewhere along the line I had torn my rotator cuff as well. I just started another round of PT for that about a month ago. I personally would put off cortisone until I had a diagnosis. In my case the radial nerve diagnosis came after I had already had PT for tennis elbow (which I didn't actually have). That didn't really help the pain at all :sad: (The orthopaedist finally made the correct diagnosis after injecting the radial nerve with xylocaine.)

Cortisone injections not of any value to me. IN FACT THEY WERE USELESS. I went to a Doctor in Egypt and he suggested a technique change and injected me in both shoulders with novocaine and because of the technique change and the injection,I had no pain for a 44k OPW swim. Never had a problem again with my shoulders.

George, is it possible that you "never had shoulder pain again" following the 44K open water swim because you beat down and killed off every nerve in your upper body? I swam a 10K open water swim. The idea of this being just the "first lap" of a 4.4 lap race, well, it is a testimony to your heartiness that you remain alive!