Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

help me understand how cortizone works...

Posted by rebecca h on 1/01/02 at 19:35 (068392)

I got a cortizone injection for sesamoiditis last Thursday.
Wow, so far it has really made a difference!!!!!!!!
My forefoot feels so much better!!!!!!!

I was just curious...

Is cortizone only a pain killer or does it actually help in the healing process?

What exactly does cortizone do?

Thanks for your time,
rebecca

Re: help me understand how cortizone works...

DR Zuckerman on 1/01/02 at 20:34 (068396)

It removes the swelling from the area that it is injected. It can enhance
healing. The releif could last from days to weeks or forever. Very important to find out the cause of the sesamoidits

Re: well, for starters, it's spelled with an "s" :-)

elliott on 1/01/02 at 20:35 (068397)

It reduces inflammation, thereby promoting fast healing. Of course, it will also thin out tissue and weaken bone, hence the caution against repeated application or in inadvisable locations (e.g. achilles). More likely to work if the pain is very localized and so the cortisone hits it dead on.

Cortisone used responsibly is certainly worth a shot, especially to avoid surgery. Sometimes, a lucky shot permanently removes pain. Then you won. Other times--often, in fact--the relief from cortisone is only temporary. Depends on what's wrong.

Sometimes they mix cortisone in with other things such as painkillers or nerve blocks.

Re: help me understand how cortizone works...

rebecca h on 1/02/02 at 22:07 (068486)

I've been rackin' my brains trying to figure out HOW I got sesamoiditis.
Here are some possibilities I guess:

1.Bouncing babies on my knees too many times singing 'ride a little horsie goin' to town..' lotsa pressure on forefeet...

2. Carrying loads of laundry up and down wooden basement stairs.

3. Helping out with a children's program last summer where we did alot of wild and crazy crouching down and running through tunnels of kids with their hands joined above our heads.

4. Line dancing in the kitchen with my husband. Sometimes while holding a child or toddler.

5. walking in an airport a long way in bad shoes.

Which one would you vote for as the cause?

Re: well, for starters, it's spelled with an "s" :-)

Dr. David S. Wander on 1/03/02 at 20:24 (068593)

Interestingly, many believe that reducing inflammation does not enhance healing. There seems to be a contradiction. Many feel that inflammation is an integral part of the healing process, and by reducing the inflammation, the healing process is actually prolonged. ESWT actually causes inflammation doesn't it? The healing process then begins with increased collagen, etc. Additionally, practitioners that believe in prolotherapy actually do not believe in ice, anti-inflammatories, cortisone, etc., or any other modality that reduces inflammation. Their belief is similar to the mechanism of ESWT. That is that causing inflammation actually begins the healing process. The use of cortisone to reduce inflammation and the use of ESWT and prolotherapy to basically cause inflammation are considerably opposing views that both seem to have success in the right cases.

Re: help me understand how cortizone works...

BG CPed on 1/03/02 at 21:25 (068600)

I would add to the list
1,plantarflexed 1st met head
2,flexible flimsy footwear e.g. easy spirits, keds, reebok dmx etc.
3,barefoot, socks or slippers in the house(sesamoids dont know your in the house, just that they are not getting protected)
4,tight heel cords

Make sure if you have your footwear evaluated by a good practitioner. A nice thick pair of sport sandals that slip on are much better to wear in the house if you wont wear an athletic shoe.

good luck

Re: well, for starters, it's spelled with an "s" :-) Orthotics spelled with a "t" not orthodics

Ed Davis, DPM on 1/04/02 at 21:44 (068770)

Elliott:
A while back I showed Scott a spell check feature he could include on this web site. It could help with the regular 'orthodic' posts....
Ed

Re: help me understand how cortizone works...

DR Zuckerman on 1/01/02 at 20:34 (068396)

It removes the swelling from the area that it is injected. It can enhance
healing. The releif could last from days to weeks or forever. Very important to find out the cause of the sesamoidits

Re: well, for starters, it's spelled with an "s" :-)

elliott on 1/01/02 at 20:35 (068397)

It reduces inflammation, thereby promoting fast healing. Of course, it will also thin out tissue and weaken bone, hence the caution against repeated application or in inadvisable locations (e.g. achilles). More likely to work if the pain is very localized and so the cortisone hits it dead on.

Cortisone used responsibly is certainly worth a shot, especially to avoid surgery. Sometimes, a lucky shot permanently removes pain. Then you won. Other times--often, in fact--the relief from cortisone is only temporary. Depends on what's wrong.

Sometimes they mix cortisone in with other things such as painkillers or nerve blocks.

Re: help me understand how cortizone works...

rebecca h on 1/02/02 at 22:07 (068486)

I've been rackin' my brains trying to figure out HOW I got sesamoiditis.
Here are some possibilities I guess:

1.Bouncing babies on my knees too many times singing 'ride a little horsie goin' to town..' lotsa pressure on forefeet...

2. Carrying loads of laundry up and down wooden basement stairs.

3. Helping out with a children's program last summer where we did alot of wild and crazy crouching down and running through tunnels of kids with their hands joined above our heads.

4. Line dancing in the kitchen with my husband. Sometimes while holding a child or toddler.

5. walking in an airport a long way in bad shoes.

Which one would you vote for as the cause?

Re: well, for starters, it's spelled with an "s" :-)

Dr. David S. Wander on 1/03/02 at 20:24 (068593)

Interestingly, many believe that reducing inflammation does not enhance healing. There seems to be a contradiction. Many feel that inflammation is an integral part of the healing process, and by reducing the inflammation, the healing process is actually prolonged. ESWT actually causes inflammation doesn't it? The healing process then begins with increased collagen, etc. Additionally, practitioners that believe in prolotherapy actually do not believe in ice, anti-inflammatories, cortisone, etc., or any other modality that reduces inflammation. Their belief is similar to the mechanism of ESWT. That is that causing inflammation actually begins the healing process. The use of cortisone to reduce inflammation and the use of ESWT and prolotherapy to basically cause inflammation are considerably opposing views that both seem to have success in the right cases.

Re: help me understand how cortizone works...

BG CPed on 1/03/02 at 21:25 (068600)

I would add to the list
1,plantarflexed 1st met head
2,flexible flimsy footwear e.g. easy spirits, keds, reebok dmx etc.
3,barefoot, socks or slippers in the house(sesamoids dont know your in the house, just that they are not getting protected)
4,tight heel cords

Make sure if you have your footwear evaluated by a good practitioner. A nice thick pair of sport sandals that slip on are much better to wear in the house if you wont wear an athletic shoe.

good luck

Re: well, for starters, it's spelled with an "s" :-) Orthotics spelled with a "t" not orthodics

Ed Davis, DPM on 1/04/02 at 21:44 (068770)

Elliott:
A while back I showed Scott a spell check feature he could include on this web site. It could help with the regular 'orthodic' posts....
Ed