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Old 10-09-2009, 06:21 PM   #1
Kevin Shaughnessy
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Cortisone : yay or nay?

After dealing with golfers elbow for going on a year now I'm starting to get a little discouraged, and I'm considering more "drastic" treatment then what I've been doing so far, which has been strengthening, stretching, and massage. I've also tried rest for several months but all that accomplished was making it worse.

So I'm thinking a cortisone shot may be in order, but I'm hesitent because of what I've heard of it being only a temporary solution, breaks down all tissue not just the inflammed tissue, and that it will probably come back. Is this true? Is or isn't cortisone a viable solution to tendonitis?

There's also surgery. Could anyone relate their GE surgery experiences and tell me how long they were out, if there were any long term negatives, or anything else I might need to know?

Thank you.
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Old 10-09-2009, 09:28 PM   #2
Steven Low
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Re: Cortisone : yay or nay?

You were following this protocol?

wfs
http://www.eatmoveimprove.com/2009/08/on-tendonitis/

If it hasn't improved much if any from the ice, rest, massage, stretching flexors, strengthening extensors then it may be a good idea to look into the other alternatives I put in Section 4 I believe.

I would consider cortisone to be last ditch option (besides surgery of course) because it does not help fix the problem like you said. Just mask the pain for a bit..
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Old 10-10-2009, 01:40 AM   #3
Everett Steinbarger
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Re: Cortisone : yay or nay?

Medial epicondylitis, ( Golfers Elbow), is a tough one to make go away. Using a corticosteroid injection to calm down the inflamed tendon is a useful adjunct to strengthening the area. It does more than just mask pain, it interrupts the pain/inflammation cycle and allows tissues to heal.

I've had many patients tell me that after one injection, the cycle was broken and they never had any more pain/inflammation. Some people need a 2nd injection.

Once someone has had 2-3 injections and a year of constant symptoms, we do lay surgery out as an option.
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Old 10-10-2009, 04:46 AM   #4
Brian Strump
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Re: Cortisone : yay or nay?

Look for a doctor, most likely will be a chiropractor that is certified to do A.R.T(Active Release Treatment), or Graston. Those are 2 of the most common soft tissue techniques that are very effective. You can also look for a doctor that uses low level laser therapy.
Cortisone shot is an option, one shot may keep the inflammation away for years, but if you need more than 1 or 2, the shots will definitely speed up the degeneration of the joint.
If you need a hand looking for a qualified doctor, email me. Drbstrump@aol.com.
I'm a chiropractor in a gym, and treat people with those types of injuries often.
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Old 10-10-2009, 06:49 AM   #5
Everett Steinbarger
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Re: Cortisone : yay or nay?

Cortisone got a bad rap decades ago for degenerating cartilage inside of synovial joints. What people were doing was 2-3 injection a week, for an extended period of time. Doing an injection every 2-3 months, (which is common practice these days), has not been shown to have deleterious effects on articular cartilage.

Injecting the tendon insertion does not come close to the joint anyway.
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Old 10-10-2009, 10:43 AM   #6
Steven Low
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Re: Cortisone : yay or nay?

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Originally Posted by Everett Steinbarger View Post
Cortisone got a bad rap decades ago for degenerating cartilage inside of synovial joints. What people were doing was 2-3 injection a week, for an extended period of time. Doing an injection every 2-3 months, (which is common practice these days), has not been shown to have deleterious effects on articular cartilage.

Injecting the tendon insertion does not come close to the joint anyway.
Ah.

Is there any studies on this that show non-deleterious changes in tendons vs. the deleterious synovium?
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Old 10-10-2009, 04:34 PM   #7
Everett Steinbarger
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Re: Cortisone : yay or nay?

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Ah.

Is there any studies on this that show non-deleterious changes in tendons vs. the deleterious synovium?
I'm not fully understanding your question Steven. The structure of the sentence has me baffled.

I'm sure that someone somewhere has studied the effects/outcomes of steroids on tendons and their insertions. I don't know how those results could be compared to synovium.
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Old 10-10-2009, 05:33 PM   #8
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Re: Cortisone : yay or nay?

Meant to say articular cartilage/ synovial joints

I'll check out the "steroids" journal later
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Old 10-11-2009, 02:19 AM   #9
Everett Steinbarger
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Re: Cortisone : yay or nay?

JBJS may have something in the archives. AAOS may have something as well.
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Old 10-12-2009, 04:04 AM   #10
Matthew Apostol
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Re: Cortisone : yay or nay?

I'm going to do a bit of hikacking here...

In my experience Ortho surgeons and PTs have been very quick to recommend cortisone shots for pain. I was just wondering if studies have ever shown cortisone injections to actually cure pain instead of temporarily relieving pain.
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