Cortisone Injections: The Good, The Bad, and The Reality

Clear, unbiased information to help you make informed decisions.

What Is a Cortisone Injection?

A cortisone (corticosteroid) injection is a medication delivered directly into a painful or inflamed area—commonly joints, bursae, tendons, or around nerves.
Its purpose isto decrease inflammation and reduce pain.

When effective, cortisone can:

• Decrease pain, sometimes significantly

• Improve movement and functionin the short term

• Create a “window of opportunity”to begin or progress rehab

• Help calm a flare-up when pain is the main barrier to activity

These benefits make cortisone apotentially useful tool, especially when pain is preventing meaningful participation in physical therapy.

But Here’s the Caveat…

Because cortisone often decreases pain quickly, people sometimes:

• Feel “fixed”

• Push too hard, too soon

• Re-irritate the area

• End up in a pain → push → flare → repeat cycle

The relief is temporary, usually lasting2–10 weeks(sometimes up to 3 months). This leads some people to rely on repeated injections for relief—without addressing the root cause(s) of the problem.

What CortisoneDoes NotDo

It does not:

• Change the structure of muscles, tendons, or joints

• Improve how you move or absorb/load forces

• Correct strength deficits, mobility limitations, or poor movement habits

• Solve the “why” behind your pain

In other words, cortisone is a passive solution to an active problem.
It can calm the fire, but it doesn’t rebuild the house.

Potential Downsides of Repeated Injections

Current evidence shows thatrepeated cortisone injections—especially when given too frequently—may:

• Weaken collagen tissue

• Reduce tendon integrity

• Accelerate cartilage wear in some joints

• Delay long-term healing if overused

These risks are dose- and frequency-dependent, and should be considered when deciding how often cortisone is appropriate.

So… Is It Good or Bad?

It depends on how it's used.
Cortisone can be extremely helpful when:

• Pain is severe

• You cannot tolerate rehab

• You need short-term symptom relief to function or sleep

• You're using it asone toolwithin a larger plan

It becomes problematic when:

• It’s used repeatedly without rehab

• You rely on it as the primary treatment

• It delays addressing underlying issues

• You return to high-load activities before rebuilding strength and capacity

The Bottom Line (From a Physical Therapist)

A cortisone injection can absolutely be included in a comprehensive plan of care. It can calm pain, create an entry point into rehab, and help break the flare-up cycle.

But it should not be the only strategy.
Long-term improvement comes from:

• Graded loading

• Strengthening

• Mobility work

• Movement retraining

• Lifestyle and activity modifications

• Identifying and addressing the true underlying cause

Cortisone can turn down the pain, but rehab changes the system so the pain doesn’t keep coming back.