Cortisone: Miracle Drug or Joint Killer?

Please keep in mind that this post is NOT intended as medical advice. It’s just my opinion. If you’re injured, see a doctor — I cannot stress enough how important that is.

You might already know that before dropping out of the US Open to deal with my ongoing knee injury, I tried getting a cortisone shot to see if that would get me back on track. I posted this on Instagram, and received a lot of… opinions stating that cortisone would “trash my joints” even worse.

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This, of course, is bullshit.

When cortisone was introduced commercially in the 1940s, it was basically considered a wonder drug, because it works pretty darn well. Unfortunately, cortisone — like many effective, powerful drugs — can be abused. Abuse of cortisone, just like other drugs, can cause deleterious effects. In this case, multiple cortisone shots in the same joint in a relatively short period of time can degrade the quality of that joint.

What about the idea that cortisone is just masking the pain? Again, pretty much bullshit. Cortisone greatly decreases inflammation, leading to a reduction in pain, but the “numbing” associated with cortisone is typically just referring to the short-term effect of the Lidocaine that it’s often mixed with. In reality, that decrease in inflammation is the main purpose of the injection.

That’s important, because when the inflammation is reduced, you can then engage in pain-free physical therapy to correct the underlying causes of the injury.

Unfortunately, most people are lazy, skip the rehab, return to activity, and the pain flares up again. So they decide the cortisone didn’t work, go get another shot, and the cycle repeats. Eventually they’ve busted their joints and blame the cortisone. No, dude, the cortisone didn’t hurt your joints. Your dumbass hurt them by not addressing the real reason you ended up injured in the first place.

You’ll hear the stories too, from the few people who didn’t need to go through the rehab process, which does happen occasionally. If that’s you, be grateful, but assume you need to do PT!

What you probably won’t hear: all the people who got a cortisone shot, followed their doctor’s instructions, did their rehab, and got better. After all, they have no reason to sing praises of cortisone, nor to blame it for any problems. They simply used the drug for its intended purpose, just like Advil or Claritin, and then went about their normal lives.

My rant’s over, but I do hope this helps to address some of the many questions and comments I received on social media. Make sure to talk with a doctor before pursuing injury treatment of any kind.


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