Cortisone injections are a popular treatment for joint pain and inflammation. Many people suffering from conditions like knee, shoulder, hip, or spine pain have likely been advised to consider these injections. However, a common question that arises is whether rest is necessary after receiving a cortisone shot and how physical therapy can play a vital role in long-term relief.
What Exactly Is a Cortisone Injection?
A cortisone shot is an injection of corticosteroids, designed to reduce inflammation in affected joints or soft tissues. While these injections do not treat the root cause of the problem, they can provide temporary pain relief by addressing inflammation. This may lead to improved mobility and reduced pain in the short term, but it’s important to understand that cortisone only manages symptoms and does not promote healing.
Research on Cortisone Injections
Studies have shown that cortisone injections are effective for short-term pain relief, particularly in cases of inflammatory conditions like bursitis, tendinitis, and osteoarthritis. A study in the Annals of Internal Medicine in 2015 found that cortisone shots provided relief for up to four weeks in individuals with knee osteoarthritis, but had no lasting effects after six months. Another study from the British Journal of Sports Medicine in 2021 showed short-term improvements for people with shoulder impingement but no long-term benefits.
However, there are risks to consider. Research suggests that repeated use of cortisone injections may delay healing and even cause long-term damage to soft tissues. A 2019 study in The Lancet found that individuals who received cortisone injections for tennis elbow had poorer long-term outcomes compared to those who did not. Repeated exposure to corticosteroids has also been shown to affect the structure and viability of tendon cells.
How Physical Therapy Complements Cortisone Injections
Cortisone injections are not inherently harmful, but they should not be the sole solution for recovery. When combined with physical therapy, cortisone shots can provide a temporary window of relief, allowing patients to start engaging in rehabilitation exercises such as strengthening, movement retraining, or neuromuscular re-education—things that might have been too painful to address initially. This approach can be highly effective when inflammation is impeding the healing process.
At our clinic, we recommend pairing cortisone injections with physical therapy in cases where:
- Pain is severe enough to prevent movement or manual therapy.
- There’s noticeable inflammation confirmed by imaging (like bursitis or joint swelling).
- The injection is used strategically to manage pain while focusing on long-term rehabilitation.
Are There More Effective Alternatives?
Cortisone shots aren’t always the best option for long-term healing. Depending on your specific condition, there may be other treatments that are more effective for promoting recovery. For example:
- Dry Needling + Physical Therapy: This combination is particularly helpful for treating myofascial pain, trigger points, and neuromuscular activation. It can be more effective than cortisone for soft tissue issues.
- Platelet-Rich Plasma (PRP): This treatment is gaining popularity for conditions like chronic tendinopathies and mild osteoarthritis. Studies have shown PRP outperforms cortisone at 6- and 12-month follow-ups.
- Exercise-Based Therapy: Often the most effective approach for musculoskeletal pain. Sometimes, it’s possible to avoid injections altogether by focusing on a well-structured exercise program with the right progression.
What to Expect After a Cortisone Injection
After receiving a cortisone injection, rest is typically recommended for 24 to 48 hours. This allows the medication to settle into the affected area and reduces the risk of further irritation. During this time, it’s important to avoid strenuous physical activity, even if you experience immediate pain relief.
For joint injections, such as those in weight-bearing areas like the knees or hips, longer rest may be necessary. General guidelines for post-injection care include:
- Light stretching and gentle range-of-motion exercises after two days.
- No heavy lifting or high-impact sports for at least seven days.
- Gradual return to full activity under professional supervision.
This careful approach ensures that the injected area is not over-stressed during the healing process.
Managing Common Side Effects
While cortisone injections are generally safe for most individuals, they can cause temporary side effects, including increased pain and inflammation (steroid flare). Other potential side effects include:
- Flushing of the face
- Blood sugar spikes (in people with diabetes)
- Changes in blood pressure
- Atrophy of subcutaneous fat at the injection site
- Skin discoloration
At our clinic, we closely monitor your response to the injection and adjust your treatment plan as necessary to ensure your recovery continues smoothly.
The Role of Exercise in Post-Injection Recovery
Even though cortisone injections can provide short-term pain relief, maintaining an exercise routine is crucial for long-term success. Corticosteroids reduce inflammation quickly, but without strengthening exercises and neuromuscular training, the underlying issues remain unresolved. A proper rehabilitation program helps:
- Relieve pain while stabilizing the joint
- Improve tendon health to prevent future injuries
- Enhance mobility, allowing for a return to normal activities
Physical activity is essential for complete recovery, and returning to exercise should be done gradually, with a focus on controlled movements.
When to Consider Cortisone Injections for Athletes
For athletes, cortisone injections can be a helpful tool, but they are not the first choice. We recommend them in specific cases, such as:
- When pain is preventing basic rehabilitation exercises.
- If there’s a need for quick pain relief before a major event.
- In cases of significant inflammation (e.g., bursitis or arthritis) impacting performance.
The key is timing. An injection should serve as a bridge to recovery, not a permanent solution. Athletes can then engage in a comprehensive rehabilitation program after the injection to restore function and prevent future injuries.
Supporting Your Recovery Journey
At our clinic, we believe in combining the right treatments to optimize recovery. If you’re considering a cortisone shot, we’ll help you decide whether it’s the right step and guide you on how to proceed with a comprehensive rehabilitation plan. Whether you’re recovering from an injury or simply looking for long-term pain relief, we’re here to support you every step of the way.
Conclusion
Cortisone injections can offer temporary relief, but they shouldn’t be the only part of your treatment strategy. When paired with physical therapy, they can help manage pain while working towards long-term healing. At our clinic, we focus on addressing the underlying cause of your pain, not just masking the symptoms. If you’re considering this treatment, let’s talk through your options and determine the best path for your recovery.
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