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how long in between cortisone shots?
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TOPIC: how long in between cortisone shots?

how long in between cortisone shots? 2 years, 4 months ago #24849

  • jamieb
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Hi again, My shoulder has just not been the same since my surgery 24 weeks ago. I am in more pain now than I was pre biceps tenodesis. Although the surgery did fix the bicep tendon subluxing every time i moved my arm, it did cause a lot of bursitis and thickening of the subacromial busra, not to mention a lot of scar tissue. i had a cortisone shot 13 weeks post-op which only gave me about 1-2 wks worth of relief. Now im back on the Norco at night, and I see my OS in 4 weeks for either another shot, or possibly scheduling a second surgery. My question is how often can I get cortisone injections? If I do get one at my next appt, which is June 26, it will be about 15 weeks since the first one back on March 13. Is it really worth it do get another shot since the first one didn't help much? Or am I better off just getting the surgery to clean it out.


Prior to my biceps tenodesis I had a cortisone injection about 1 yr before the surgery. Not sure how many you can get, but I will going on my 3rd shot, if I do decide to give it another try in June.


I really appreciate your feedback. This forum has helped me so much, I wish I would have found it before my surgery.
2/09 R wrist- TFCC repair, ulnar styloid removal, radial tunnel release
12/11 R shoulder- biceps tenodesis, SAD
6/12 R shoulder complete bursectomy
12/12 R shoulder, subcoracoid decompression, coracoplasty
8/13- R shoulder, pulsed RFA
3/14- R shoulder, neuroma excision and multiple nerves removed

Re: how long in between cortisone shots? 2 years, 4 months ago #24850

  • ljansen
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It's typically recommended you have no more then 3 cortisone injections in one area over the course of a year...so on avg every 3 months, but you can have them sooner than that. The issue with cortisone injections is that unless your problem is strictly inflammatory and pain caused by inflammation, cortisone is more of a band-aid solution. I have had various success with cortisone injections over the years, sometimes they work and sometimes they don't. I usually do end up going with the cortisone to see if buying me some time may help me to avoid surgery, because in my experience, I would rather deal with possible risks associated with the injection as opposed to another surgery.

At the end of the day, your decision is really based on your level of pain and dysfunction. If this is something that has been at a plateau for quite some time and you feel the conservative treatment isn't doing anything, well, maybe it's time to at least discuss the next step with your OS and PT. Always exercise caution when considering surgery, as we all know, there are significant risks/comlications that could occur but at the end of the day, you need to decide what point it becomes intolerable and some action needs to be taken.

Before getting another injection, talk with your OS and get his opinion on your progression/prognosis and go from there.

Hope that helps.
R. Shoulder Capsular Shift - Sept. 03
L. Shoulder Bankart/SLAP/Capsular Shift/Rotator interval & SS repair - Jan. 05
L. Shoulder MUA/adhesion release - Jan. 06
L. Shoulder SAD/Bursectomy - Sept. 07
L. Shoulder Biceps Tenodesis - Mar. 09
L. Shoulder Open Latarjet & Arthroscopy - Nov. 24, 2011
L. Shoulder Capsular Release/SAD - June 11, 2012
L. Shoulder Capsular Release/Screw Removal/Biceps Tenotomy - Mar. 22, 2013
L. Shoulder Arthroscopic Latarjet Screw Removal, Interval Repair, Axillary Neurolysis, Debridement

Re: how long in between cortisone shots? 2 years, 4 months ago #24851

  • jamieb
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Thanks so much for your reply. My last visit to the OS in April, said it was just a bad case of bursitis and it should settle down by the 6 month post op mark (that will be on June 26). However the pain has gotten worse since that last visit. The pain will come out of nowhere and take my breath away. Sometimes bring tears to my eyes and making me sweat haha. He was not thrilled on giving me another cortisone injection in June b/c the last one I had didn't help much. I really don't want another surgery (even if he said it's not as complicated as the tenodesis). Not sure how much longer I can live with the pain. I built a tolerance to the pain meds so that doesn't work much any more. And I don't want to have to rely on Advil PM to help get a decent night of sleep.

My OS had my discontinue physical therapy since he said I have complete ROM and my strength would come back in time. However I am noticing my ER is becoming more painful, which is starting to worry me since that was the first motion I got back to normal.
2/09 R wrist- TFCC repair, ulnar styloid removal, radial tunnel release
12/11 R shoulder- biceps tenodesis, SAD
6/12 R shoulder complete bursectomy
12/12 R shoulder, subcoracoid decompression, coracoplasty
8/13- R shoulder, pulsed RFA
3/14- R shoulder, neuroma excision and multiple nerves removed

Re: how long in between cortisone shots? 2 years, 4 months ago #24852

  • riderk
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I can relate to what you are going through and agree with leanne about the shots. i had two, and they did absolutely nothing as cortisone could not possibly affect the problem i really had.

multiple surgeries also bring their own issues, and believe me, they are not good. reading my latest op report - it is nothing but "completely altered surgical field", nerves scarred to tendon, totally altered anatomy, thick adhesions.... there is no way anyone but a very experienced expert could have addressed this.

as for the pain meds, are you seeing a pain specialist? been there, too. i am all for pain relief but you have to be so very careful. before this last surgery, i started nucynta. it is relatively new, so very few docs know about it. but it was helpful, and does not have (or supposedly - must take everything with a grain of salt) the negative effects of narcotics such as addictive nature, constipation, etc.

Re: how long in between cortisone shots? 2 years, 4 months ago #24854

  • jamieb
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I've had 2 previously and didn't help much. The first shot I got pre-surgery sent me to the ER because I could not move my arm and was screaming in pain. The second shot I had the usual "flare" but nothing like the first one. I'm not too sure I want another one since it doesn't seem to be much help.

That's the thing about having another surgery. How do I know if I do the "simple clean up" surgery that I am going to have a god outcome? I'm not sure I want to take that risk, especially since this surgery caused me more pain than what I was in before.

I am not seeing a pain specialist. My OS has not mentioned that to me at all. I am very skeptical to take the Norco because I do not want to get addicted to it. However with the amount of pain I am in I really don't think twice about it. I'm considering calling my OS to see if I can get in sooner than June 26. I don't know if he can order an MRI without seeing me but I need something to be done. I also want to call my PT to see what he recommends.
2/09 R wrist- TFCC repair, ulnar styloid removal, radial tunnel release
12/11 R shoulder- biceps tenodesis, SAD
6/12 R shoulder complete bursectomy
12/12 R shoulder, subcoracoid decompression, coracoplasty
8/13- R shoulder, pulsed RFA
3/14- R shoulder, neuroma excision and multiple nerves removed

Re: how long in between cortisone shots? 2 years, 3 months ago #24875

  • Grady
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To answer your question........ forever! I had 4 series of shots in a 13 month period. It was as much my stupidity as it was the 2 surgeons that gave me the shots, to think the shots would make a difference. The 1st 3 series of shots were Marcaine & Celestone and they gave me a very bad case of insomnia. Neither surgeon ever heard of that but God and my wife as my witness, it was brutal. My last shot was Lidocaine, (which is another form of Marcaine) it actually seemed to help for the 1 week that I didn't do any PT and after that, it was back to normal, normally screwed up

You mentioned having the all mighty famous "clean up" surgery. The term used when they don't have a clue what could be wrong and the OS figures it's a 50-50 shot to find something wrong. In my opinion it's nothing but a "cutter's" way of showing an attempt, oh and making some more $.

Good luck with your upcoming appt.
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