Introduction
As the bones become heavier and heavier over the years and the joints increasingly refuse to function, many affected people have a “cortisone injection” administered by the orthopaedist of their choice. But also young adults and adolescents usually undergo this therapy after sports injuries, which is intended to relieve pain and increase mobility. But what exactly is cortisone (also written cortisone) and what is it about when we talk about a cortisone injection?
First of all, cortisone is a steroid hormone that is produced in the cortex of the adrenal gland. Steroid hormones are a group of hormones that have a certain similarity in structure due to their chemical structural formula – hence their name. Cortisone was discovered as early as 1935, in the human adrenal cortex.
In addition to cortisone, the adrenal glands also produce other important adrenal hormones such as adrenaline or oestrogen in their cortex. But what exactly does cortisone do? First of all, cortisone has no effect on the body at all and must be converted into its biologically active form, cortisol, in the liver.
Cortisol is an absolutely vital hormone that interferes with many processes in the body, for example fat metabolism, sugar balance, but also protein metabolism. Much more important for its use as a cortisone injection, however, is its anti-inflammatory and immunosuppressive effect. Inflammations are always accompanied by swelling, overheating, redness, pain and loss of function.
In other words, all the things that one does not necessarily want in a joint. A cortisone injection, when applied locally in the joint, can inhibit the inflammation and create freedom from symptoms – but it does not combat the cause of the problem. In addition, the anti-inflammatory effect is bought expensively with the immunosuppressive effect, i.e. the effect that slows down the immune system. Although the application doses are always chosen in such a way that the side effects are kept to a minimum, fever or infections are often not uncommon in long-term therapies. The side effects will be dealt with again separately due to their relevance.
Cortisone injection for herniated discs
In the case of a herniated or prolapsed disc, the disc moves forward into the spinal canal, which contains the spinal cord. The cause can be heavy lifting or a sudden, incorrect movement. The intervertebral disc moves forward and presses on the nerve fibres of the spinal cord.
A distinction is made between different procedures for administering a cortisone injection into the spinal column: First, the paravertebral injection, which is used in the case of a herniated disc and in which the cortisone is injected next to the vertebral bodies. Secondly, the epidural injection, in which the injection is injected directly into the spinal canal. Which of the two methods is used is to be decided on a case-by-case basis and also depends on the individual nature of the disease. In each case, the injection consists of a mixture of cortisone and a local anaesthetic – thus minimising pain. If at all, patients feel a slight sting, but this is out of all proportion to the severe pain for which patients usually seek treatment.
