We often get asked:
“Should I get a cortisone shot for this pain?”
It’s a reasonable question—especially when you’re dealing with stubborn conditions like arthritis, frozen shoulder, back or neck pain, carpal tunnel syndrome, or joint pain after injury or surgery. Cortisone injections are commonly offered as a fast solution. And when you’re in pain, the idea of a quick fix can be incredibly tempting.
But we believe it’s important to pause and look at the bigger picture. While cortisone injections can reduce inflammation in the short term, they may also come with long-term risks—some of which are rarely discussed in a typical office visit.
This article explores why we approach cortisone injections with caution, and how acupuncture and Traditional Chinese Medicine (TCM) offer a safer, more sustainable approach for many people living with chronic pain.
What Is Cortisone?
Cortisone is a synthetic corticosteroid often injected into joints, soft tissues, or the spine to relieve pain and inflammation. It works by suppressing the body’s natural inflammatory response—but that suppression can have consequences.
Why We’re Cautious About Cortisone Shots
1. Cartilage and Bone Loss Over Time
One of the most concerning long-term risks of cortisone injections is their potential to accelerate the breakdown of cartilage and weaken the surrounding bone—especially when used repeatedly in the same joint. Cartilage serves as a cushion that protects the bones where they meet at the joints. Once this cushioning wears down, it doesn’t regenerate easily.
Research has shown that patients who received cortisone injections every few months over the course of two years had significantly greater cartilage loss than those who received placebo (saline) injections. In some cases, the injections that were intended to relieve inflammation and preserve joint function may actually contribute to the degeneration of that joint.
This is especially important to consider in weight-bearing joints like the knees, hips, and spine, which are already under mechanical stress. And for individuals who are postpartum, in perimenopause, or over age 50—when bone density tends to decline naturally—this added risk of bone thinning or osteoporosis is even more relevant.
2. Potential Link to Osteoarthritis Progression
Cortisone is often used to manage symptoms of early osteoarthritis—but emerging evidence suggests that, paradoxically, it may worsen the disease over time.
By numbing pain and reducing inflammation without addressing the cause, cortisone can give the illusion that a joint is doing fine. As a result, people may continue overusing the joint, unknowingly aggravating the condition. Meanwhile, repeated steroid exposure may directly contribute to tissue breakdown, joint space narrowing, and accelerated progression of osteoarthritis.
In this way, cortisone can set up a cycle:
Relief → Overuse → Breakdown → More pain → More injections.
While that initial relief may feel like a blessing, it can mask the deeper need for restorative care that supports healing at the root.
3. Adrenal Suppression and Hormonal Disruption
Cortisone is a synthetic version of the body’s natural steroid hormones, which are produced by the adrenal glands. When you introduce high levels of synthetic corticosteroids into the system—especially on a repeated or ongoing basis—your body may begin to downregulate its own production of these essential hormones. This condition is known as adrenal suppression.
Why does this matter?
Your adrenal hormones are crucial for:
- Managing stress and emotional resilience
- Maintaining blood pressure and electrolyte balance
- Regulating immune response and inflammation
- Supporting energy levels, mood, and metabolism
Adrenal suppression can leave people feeling fatigued, mentally foggy, emotionally flat, or chronically inflamed, and it can take months—or even years—for natural hormone production to fully rebound.
This is especially relevant for those already navigating hormonal changes or stress-related imbalances, such as during postpartum recovery, perimenopause, or after chronic illness.
Cortisone’s systemic effects may also include:
- Elevated blood sugar
- Increased blood pressure
- Reduced bone density
- Increased risk of infections
- In rare cases, symptoms of Cushing’s syndrome (weight gain, facial puffiness, skin thinning)
Because these effects can build quietly over time, many people don’t realize cortisone may be contributing to other health challenges beyond the joint it was intended to treat.
Acupuncture vs. Cortisone Shot: Which One Works Best?
While cortisone may temporarily mute the signal of pain, acupuncture works to address both the symptom and its underlying cause.
In Traditional Chinese Medicine, chronic pain is often related to:
- Qi and Blood stagnation
- Cold or Damp accumulation
- Organ system imbalances (e.g., Kidney or Liver Deficiency)
By treating the root pattern—not just the pain signal—acupuncture helps the body heal in a more complete and lasting way.
How acupuncture supports lasting recovery:
✅ Reduces inflammation and promotes healthy circulation
✅ Stimulates the body’s natural pain-relief mechanisms
✅ Supports tendon, bone, and joint health by strengthening internal systems
✅ Regulates the nervous system and reduces stress-related pain
✅ Carries no risk of tissue damage or systemic hormone disruption
For chronic pain conditions—whether caused by injury, repetitive stress, aging, or postural strain—acupuncture is a gentle yet powerful treatment that works with your body, not against it.
Can Cortisone and Acupuncture Be Used Together?
Yes—and in some cases, combining both is the most effective approach.
- Cortisone can offer short-term relief when inflammation is severe.
- Acupuncture can support long-term healing, reduce the frequency of flare-ups, and minimize the need for repeat injections.
- Acupuncture may also help mitigate the side effects of cortisone and promote tissue recovery.
Working with both your medical provider and TCM practitioner ensures your care is coordinated and comprehensive.
When Might a Cortisone Shot Work Better?
There are times when a cortisone injection might be appropriate:
- For acute pain that hasn’t responded to more conservative treatments
- When inflammation is severely limiting mobility, work, or caregiving responsibilities
- As a short-term solution before transitioning to long-term care options
Even in these situations, we recommend using cortisone cautiously, and pairing it with therapies like acupuncture that address the root cause of pain and support tissue healing over time.
Final Word
If you’re living with chronic joint, tendon, or soft tissue pain—whether from arthritis, frozen shoulder, a sports injury, repetitive stress, or neck pain—know that you have options beyond temporary relief.
At Five Seasons Healing, we use acupuncture and Traditional Chinese Medicine to help your body repair, restore, and thrive—without the long-term risks of repeated cortisone injections.
👉 Book an appointment today to explore how acupuncture can support your healing journey in a safe, sustainable, and whole-body way.
References:
- Local and Systemic Side Effects of Corticosteroid Injections for Musculoskeletal Indications.
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- Osteoarthritis of the Knee. Sharma L. The New England Journal of Medicine. 2021;384(1):51-59. doi:10.1056/NEJMcp1903768.
- Systemic Absorption and Side Effects of Locally Injected Glucocorticoids. Stout A, Friedly J, Standaert CJ. PM & R : The Journal of Injury, Function, and Rehabilitation. 2019;11(4):409-419. doi:10.1002/pmrj.12042.
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- Intra-Articular Glucocorticoid Injections and Their Effect on Hypothalamic-Pituitary-Adrenal (HPA)-axis Function. Johnston PC, Lansang MC, Chatterjee S, Kennedy L. Endocrine. 2015;48(2):410-6. doi:10.1007/s12020-014-0409-5.
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