Treatment with cortisone injections:

1. Infections: Cortisone injections should not be administered if there is an active infection in the area of the injection. The presence of infection can increase the risk of spreading the infection or interfering with the body’s immune response.

2. Systemic Infection: If a person has a systemic infection or a severe infection elsewhere in the body, cortisone injections should generally be avoided. The injections can potentially suppress the immune system and hinder the body’s ability to fight off the infection.

3. Allergy or Hypersensitivity: Individuals who have known allergies or hypersensitivity to corticosteroids or any components of the injection should not receive cortisone injections. Allergic reactions can range from mild skin reactions to severe anaphylaxis.

4. Bleeding Disorders: People with bleeding disorders, such as hemophilia or thrombocytopenia, have an increased risk of bleeding complications. Cortisone injections can potentially worsen bleeding or delay clotting, so caution should be exercised.

5. Uncontrolled Diabetes: Uncontrolled diabetes affects wound healing and increase the risk of infection. Cortisone injections often elevate blood glucose levels temporarily, so careful monitoring is necessary in individuals with diabetes.

6. Local Anesthetic Allergy: Cortisone injections are usually combined with local anesthetics for pain relief. If a person has a known allergy to local anesthetics, alternative approaches must be considered.

7. Structural Damage: Cortisone injections are generally not recommended when there is significant structural damage to a joint or tendons. Injections may provide temporary pain relief but may not address the underlying problem, potentially leading to further damage. Cortisones stop very good any inflammation. As natures Healing process often uses Inflammatory cytokines (messengers molecules) in the process, no real healing can occur under cortisone use.

8. Pregnancy: The use of cortisone injections during pregnancy is to be avoided, particularly during the first trimester!

It’s essential to disclose your complete medical history and any medications (also from other doctors) you are currently taking in your Visit to Dr. Hans or any other orthopedic surgeon before considering cortisone injections. This will assess your individual situation and determine if cortisone injections are suitable or if alternative treatments should be pursued. (see Biologic Treatments)

Reasons of Using Injections with Cortisone mix in my Orthopaedic clinic:
Cortisone injections are a commonly used treatment in Orthopaedics to alleviate pain and reduce inflammation associated with various musculoskeletal conditions. These injections contain corticosteroids, which are synthetic versions of the body’s natural hormone cortisol. Cortisone injections are administered directly into the affected area, such as a joint, tendon, or bursa, to provide targeted relief. Here is an explanation of the use of cortisone injections in Orthopaedic treatment:

1. Inflammation Reduction: Cortisone injections are primarily used to reduce inflammation, which is a common factor in many Orthopaedic conditions. Inflammation can cause pain, swelling, and limited mobility. Corticosteroids work by suppressing the immune system’s response, reducing the release of inflammatory chemicals, and decreasing swelling in the affected area.

2. Pain Relief: Cortisone injections can provide significant pain relief for individuals suffering from conditions such as osteoarthritis, tendinitis, bursitis, and certain types of joint inflammation. By reducing inflammation, corticosteroids help alleviate pain associated with these conditions, allowing individuals to perform daily activities with less discomfort.

3. Diagnostic Tool: In some cases, cortisone injections are used as a diagnostic tool. If Dr. Hans suspects that a specific structure, such as a joint or tendon, is the source of pain, a cortisone injection may be administered. If the injection provides immediate and significant pain relief, it can help confirm the suspected diagnosis.

4. Non-surgical Treatment Option: Cortisone injections offer a non-surgical treatment option for many Orthopaedic conditions. They can be an effective alternative to surgery, especially when conservative treatments like physical therapy, rest, and medications have not provided sufficient relief. Cortisone injections can help patients avoid or delay the need for surgical intervention.
5. Temporary Relief: It’s important to note that cortisone injections typically provide temporary relief rather than a permanent solution. The duration of pain relief varies among individuals and depends on the specific condition being treated. The effects of cortisone injections can last anywhere from a few weeks to several months. In some cases, multiple injections may be necessary to achieve optimal results.

Dose relation: Since medical experience shows that here is critical daily dose, that one should avoid to not start any side effects, the dose varies from Tablets to local injections.
While oral doses at the rheumatologist can be 25-300 mg daily, the injection doses are adapted to joint size and problem strength. In Doc Hans Clinic is usually uses 3, 6, 8 or 10, 20 mg of Christal Cortisol (Trispan, Depomedrol, Kenalog) and 4/8 or 10mg max for the water-soluble versions. (Dexamethasone)
In case of any contraindication Dr. Hans J. Poessel has enough experience to find an alternative for you. Examples are to be found in the Biologic Treatment chapter.