Fields of application

Inflammations of the joint apparatus (knee, hip, etc.) can have various causes. They can be caused by overexertion, incorrect loading, age-related wear and tear (degeneration), autoimmune diseases (the body destroys its own tissue) or bacterial infections.

Depending on the type of illness, your doctor will try to improve the symptoms by immobilising and relieving the joint, physiotherapy, administration of anti-inflammatory drugs (so-called non-steroidal anti-rheumatic drugs, in short: NSAIDs) and, if necessary, painkillers. Only if the causal treatment does not result in a significant reduction in inflammation and pain should the use of cortisone injections be considered. However, they must not be administered for the treatment of acute bacterial inflammation!

It is important to know that the administration of cortisone does not eliminate the cause. However, the resulting inflammation is effectively combated and pain is quickly relieved. This restores the patient’s freedom of movement and quality of life.

The injection (injection) of cortisone (cortisone) can be either directly into the synovial fluid or at tendon insertions, in tendon sheaths, bursae, etc., depending on where the inflammation is active. The use of a cortisone injection may be considered for the following conditions:

Persistent inflammatory joint diseases for which causal therapy does not provide significant relief
Non-infectious joint inflammation (rheumatoid arthritis)
Inflammatory attacks in wear-related joint diseases (activated knee arthrosis, hip arthrosis), e.g. caused by worn cartilage
Inflammatory irritations at the transition between tendons and bone (e.g.

tennis elbow, heel spur)

Non-bacterial tenosynovitis (tendovaginitis)
Non-bacterial bursitis (e.g. shoulder roof bursa: subacromial bursitis)
Joint capsule inflammation (synovitis)

A cortisone injection into the knee is usually given into the joint. This is usually used to treat inflammatory diseases of the knee which could not be treated by other methods of treatment. For example, rheumatoid arthritis, arthrosis, joint capsule inflammation or (non-bacterial) bursitis can be treated with cortisone.

Cortisone therapy in the joint is usually not the doctor’s first choice at the beginning of therapy. This is because therapy with cortisone (even when applied locally) can have side effects. If the therapist nevertheless decides to use cortisone therapy, he will first disinfect the skin over the affected joint thoroughly.

This is very important to prevent skin germs from entering the wound. The needle is then inserted through the disinfected skin and the cortisone is injected into the affected area (e.g. joint space or bursa). If the joint is difficult to reach (e.g. the hip joint), an X-ray or ultrasound machine can be used.

These serve to provide a better overview of the needle guide and show the dentist exactly where the needle is in the joint. The puncture through the skin is accompanied by a slight, stabbing pain, comparable to a vaccination. During the injection, a feeling of pressure in the knee joint may occur.

After the injection, pressure is applied to the puncture site with a sterile swab to stop the bleeding. The symptoms should now subside after a few hours. Sometimes there may be an initial worsening of the pain within the first two days.

This is because the crystalline structure of cortisone can irritate the tissue. These symptoms can be combated by cooling or painkillers. The shoulder joint can also become inflamed and then painful and its mobility can be restricted.

Inflammation of tendons due to chronic irritation is often responsible for this. One example is the impingement syndrome. In this syndrome, tendons (especially of the supraspinatus muscle) or parts of the joint capsule are trapped in the joint space.

These inflamed soft tissues can be treated by cortisone therapy. Cortisone heals the irritated and inflamed tendon. It is important, however, that the shoulder is nevertheless spared in order to ensure that the damaged soft tissue structures heal.

Bursitis or rheumatoid arthritis can also be treated with cortisone injections. The cortisone has an anti-inflammatory effect in the shoulder joint, thereby reducing pain and increasing mobility. The course of the cortisone injection is usually similar to the injection into other joints.

Treatment with cortisone (cortisone) can be administered in tablet form via the bloodstream (systemic). However, especially in the case of joint diseases, the administration of a cortisone injection is the more effective solution to combat local inflammation. The active ingredient is injected directly where it is needed to effectively combat the inflammation.

This means that the risk of suffering the side effects common to cortisone is considerably lower than when taking tablets, where the active substance first has to be transported through the whole body. So-called crystal suspensions are used for injections (“syringe”). The special thing about this is that the active substance is present in an alcoholic solution in the form of tiny crystals (< 10 ?m in diameter).

When injected into the diseased region, they decompose only slowly and thus act over a longer period of time. This “depot effect” ensures longer lasting freedom from pain. In this way, the cortisone injection provides the patient with pain-free movement again, increases his mobility and provides him with a plus in quality of life. However, care should be taken to ensure that the sudden freedom from pain does not lead to excessive stress on the joint. The causative disease could reoccur or worsen.