Although they can provide immediate pain relief for soft-tissue injuries such as tennis elbow and Achilles tendinopathy, the shots can slow healing over the long term, according to a number of new studies. A comprehensive review of the available research published last year found that people who’d received cortisone shots had a much lower rate of full recovery than those who’d done nothing at all. Plus, they had a 63 percent higher risk of relapse.
Missing link: Trying to figure out exactly what’s going on inside overtaxed tendons and ligaments. In fact, scientists don’t fully understand the mechanics of injuries like tennis elbow and Achilles problems, so they don’t know how best to treat them—except to say that cortisone shots don’t appear to do the trick.
Comments
Cortisone shots should take care of the inflammatory component of a tendon injury, thereby decreasing pain and visible and palpable swelling. If however, the amount of cortisone injected eliminates all inflammation present then the "inflammatory soup" necessary for stimulation of healing is no longer available and thus the formation of new tissue becomes hindered. As most tendonopathies are inflammatory AND degenerative in nature (tennis elbow, achilles tendonopathy to name just a few) it is difficult to know how much cortisone to inject to reduce the amountof inflammation to a useful level. It's a double edge sword, too much inflammation slows healing, too little inflammation also impedes healing, and too much cortisone can weaken the newly formed tendon tissue - striking a balance of exactly the right amount of inflammation with the right amount of stimulation (via activity) of new tissue growth would seem to be the best approach.
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