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Cortisone shots & Pain vs. Car Problems & Headphones

Let me ask you a question. What would you think if you took your car to the mechanic because it was making a strange noise, and the mechanic said, "I've got just the solution. I'm going to give you a pair of noise cancelling headphones you can wear, and you won't hear the noise anymore!"

I'm going to imagine that however you might respond to that, it would not be to happily pay a fee, schedule a follow up and expect to potentially get a further bill in the mail in a few months. In fact, that is probably the last thing you would do. So why do we do it when the doctor offers us a cortisone shot?

While there may be a time and a place for the use of pharmaceuticals in orthopedics, I do not think it is at the frequency they are actually used, or as a standalone solution to pain. Yes, I understand cortisone reduces inflammation and inflammation causes pain, but we have to think about what is causing that inflammation in the first place. Just like our car, the noise is not usually the problem, but it is an indication that there is a problem, and if we ignore it too long it will probably get worse and the fix will get a lot more complex.

Much of the time, "tendonitis" "bursitis" and similar problems are actually symptoms, rather than diagnoses. If a tendon is inflamed because it is not being properly used, or a bursa is inflamed because of "friction around it" it is actually movement patterns that need to be addressed with an active approach so this inflammation and pain is permanently reduced, rather than just covered up.

Yet often times, many people with pain are advised to see their doctor every few months for a cortisone shot, which tends to decrease pain for some amount of time, but within 3 months they are calling to make a new appointment for another pair of "noise cancelling headphones (or pain-cancelling cortisone). However, just like the headphones don't actually decrease the noise, the cortisone doesn't actually solve the problem, and in some cases, has been shown to even further break down tissue leading to more permanent damage.

Now, all of this being said, I understand some injuries are quite painful, and inflammation can linger and limit movement, so having something like a cortisone shot to allow for more comfortable and progressed movement work is something I can get behind, just like if your car is making so much noise it is hard for the mechanic to get close enough to see the problem they may need headphones. However, getting a shot as your only solution is just not something that makes sense to me.

The way I see it, active problems (meaning pain and problems that are affected by your activity and positions) require active solutions. Getting with a professional who can address the root cause of your problems, rather than just putting a bandaid over the symptoms is the key to long term health. If you are surviving on cortisone shots every few months, send me an email at to see if we can discuss your case and how to get your " car" up and running like brand new to last you many years to come.

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