A Warning About the Use of Cortisone For Pain

I feel that I need to warn you about cortisoneThis brings me back to my friend with the Achilles
injections and the possible harm they can inflict.tendon problem.
I was speaking to a good friend of mine who wasThe major cause of prolonged pain and
in a great deal of pain. I asked him what haddysfunction from injuries is from lack of
happened and he told me that a rather smallappropriate rehabilitative exercises. If you have an
problem that he had had was now a big problem.injury you MUST do stretching and strengthening
He explained to me that he had had beenexercises as soon as possible. (After the initial 48
suffering from pain in his Achilles tendon. Thehour inflammatory phase).
doctor didn't seem to know why he had this painSo my friend has, in my opinion, been getting
so he recommended that he get a series oftreatment in 'backwards- forwards land.' He has
cortisone injections to 'see how that went'. Aftercome to see the doctor and instead of getting
the first one he felt a bit better, then the next hetreatment for it such as physical therapy, which
felt better again and a few days before he wasmeans stretching and strengthening exercises and
scheduled for his third injection he felt 'likesoft tissue/joint therapies he was given cortisone
someone hit him in the back of the calf' and nowinjections. Here was a person who needed to
he had severe bruising in and around his Achillesstrengthen his tendon and stretch it out to
tendon and ankle and was no longer able to walkrecover it to full function but what he got instead
without the aid of crutches. The doctor took awas something that masked the problem. He
look at him and couldn't understand what hadshould have been getting therapy to allow the
happened so sent him off to get somefibers to knit into a strong and flexible repair so
physiotherapy for his ankle. This is where hethat he could regain his strength in the soft
should have gone to in the first placetissues. However, instead he was now walking and
So what is wrong with this picture?running around with a torn tendon but now he
Why don't we first take a look at cortisonecould apply more pressure through the tendon
injections themselves? They have been aroundthanks to the analgesic properties of the
since the 1950s and are used to decrease tissuecortisone. Now, he could walk harder and faster
inflammation so that the area can then heal. Thiswhich enabled him to damage his tendon further.
is the theory. But why is the area inflamed? ThisEvery pain free step would enable him to tear
is the number one priority-getting to the cause ofthose tiny fibers more and more until finally
the problem not just treating the symptoms. Let'ssomething had to give- and it did. His tendon,
take a look at another example.thanks to the deadening effects of the cortisone
I will use and example of a new client who cameand the added benefits of the corrosive
to see me last week. This person was sufferingproperties of the cortisone pushed his Achilles
from neck pain and had tried everything fromtendon past breaking point and it snapped. Where
prolotherapy to acupuncture to chiropractic tois my friend now? He is getting physiotherapy 3
Rolfing. However, his pain still existed. The wholetimes a week to try to heal the area which is
time he was speaking to me he was sitting in anow much worse than the original problem.
slouched forward head posture. I could see by hisSo my advice to you is this. Just because your
posture that this was his major problem anddoctor or therapist doesn't know why you have
would be our first area to look at. The thing aboutpain is no reason to jump into a series of
poor posture and particularly a forward headcortisone injections. They are not good for your
posture is that it affects the upper back, neck,body, they are a corticosteroid. There is no
shoulders, lower back and so on and so forth. Areason to start putting more chemicals into your
forward head posture has a huge knock-onbody when you may not have to. Seek another
effect throughout the rest of the body. In otheropinion. More than that, make sure that the cause
words, many of your problems will be causedis being addressed not just the symptoms. Are
(and fixed) by addressing this first.your shoulders painful because of major muscular
I knew by looking at him that his shoulders wereand structural imbalances? Can you stop your
also forward and internally rotated which willosteoarthritis getting worse simply by postural
impinged the shoulder joint and set him up forand structural modifications?
shoulder problems. I asked him if he had hadIf a person has sciatica and back pain because
shoulder problems in the past and he said 'oh sure,they have disc bulges in their lower back and
I have had 3 cortisone injections in the leftneed surgery I would want to see first why they
shoulder and 2 in the right but they didn't reallyhave disc bulges in the first place. Is it because
work'.they sit slouched at their desk all day and night?
Of course they 'didn't really work' because theIs it because they lift things poorly? If this is the
cortisone injections will never fix the cause of thecase, and they elect to have surgery and do not
problem which is known as 'upper crossedstop these bad habits, what is stopping the next
syndrome' or 'rounded shoulders' or 'shoulders thatweakest links above and below the fusion from
are too far forward and internally rotated whichdoing the same thing? Nothing. If you have blown
lessen the space in the shoulder joint and causeyour L5-S1 disc because of these very reasons
impingement or better put, constant mashing ofand then after surgery( all going well) you feel
the soft tissues.' The cortisone may have had abetter but continue to sit, stand and lift poorly
temporary effect as it reduced the inflammationyou will put these same forces on your discs
and impingement but the cause of the problemAGAIN and the problems will still be there. You
was never addressed (i.e. shoulders too farare still causing your discs to be pushed
forward and internally rotated causing pain andbackwards, straining your ligaments and soft
inflammation) and therefore after a short whiletissues. Likewise, a cortisone shot will not fix your
the pain returned.back pain from bad lifting techniques if you
The story doesn't end there. Not only docontinue to lift badly
cortisone injections hurt but they have aYour neck is no different. You MUST remove the
corrosive effect on the cartilage and soft tissues.cause of your neck pain.
This, I don't need to tell you, is NOT GOOD!