Dooley Noted: 4/8/2015
Every single day of my four-year chiropractic rehabilitative practice has featured at least one patient who has received a cortisone injection.
The results are always within the following three bullet points:
1. The patient’s pain is exacerbated by the injection.
2. The patient experiences no pain relief whatsoever.
3. The patient receives 24-48 hours of relief, followed by a swift return to their initial discomfort.
I’ll give it to the people injecting cortisone. The theory sounds appealing.
They inject a corticosteroid with its anti-inflammatory capabilities. Then, the cortisone acts like a fire extinguisher to put the brakes on inflammation. The result should be less pain.
Here’s the problem.
You produce your own corticosteroids. Why aren’t they working for you?
You don’t have a cortisone deficiency.
Cortisone has a host of side effects, ranging from my favorite (like not working at all) to the scariest (like allergic reactions, tendon softening and immune system depression).
Inflammation gets a very bad rap. It’s a natural response to the body attempting to protect itself.
Overuse a tendon, and it becomes inflamed and becomes painful.
Overstress a joint, and it becomes inflamed and swells up like a balloon.
These natural responses to inflammation are absolutely as helpful as they are inconvenient.
After all, pain is no fun, and people are quick to get out of it.
But here’s where I stand with cortisone injections.
They are going nowhere near my sites of future pain.
If I’m inflamed and painful, there’s a reason.
If an area is inflamed, I’m quick to ask the following questions:
1. Why do I have pain here?
2. When did it start?
3. Is it symmetrical?
4. Does it travel?
5. Is it positional?
6. Is it new or familiar?
7. Is my movement affecting it?
8. Has my diet changed to include inflammatory foods?
9. Is my current level of stress perceived as harmful by me and to me?
10. Am I breathing/eliminating/sleeping properly?
11. Has my mood changed around the time of discomfort? Has it been affected by the discomfort?
12. Do I have swelling/limited range in the painful area?
13. Have I added in any new exercises or positions in my daily life that could have increased pain perception?
14. How recently have I had my movements analyzed by a professional?
I look to these things to understand my pain.
After all, the only one perceiving it is me. I had better insource before I outsource.
If your doctor is not asking these questions, then you have the right to politely decline the injections.
Even if they do ask these questions, you can still decline.
And if you don’t, please prepare for your pain to return.
I guarantee that you don’t have a cortisone deficiency.
You have options.
As always, it’s your call.
– Dr. Kathy Dooley