Cortisone is a naturally occurring hormone the body produces in the adrenal glands, referred to as the "stress hormone" because it raises blood pressure during times of stress and illness. Synthetic cortisone is shown to have similar effects to natural cortisone and is used as a medical treatment because of its immediate pain-relieving effect. Cortisone shots can immediately lessen various acute symptoms, according to the Mayo Clinic. The Mayo Clinic reports that intravenous or intramuscular cortisone shots, and oral cortisone medications, are taken as a steroid inhibitor for short periods for a variety of medical reasons and show little side effect or risk. Injections are used to temporarily reduce inflammation or swelling to a localised injury to the body, and the Mayo Clinic reports they are effective for short-term treatment of joint injuries, cutaneous and subcutaneous swelling.
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There is concern about the risks of continued usage of cortisone shots for prolonged illness or chronic joint pain. Patients with chronic disease such as rheumatoid arthritis, osteoarthritis, lupus, autoimmune disease or remitting illness are given a maximum injection amount per month to minimise complications associated with repeated cortisone steroid use. Arthritis Treatment and Relief.com reports that skin thinning is one possible risk of repeated cortisone injections to the same site, increasing the possibility of skin breakage causing life threatening infection if not immediately addressed. Also, a concentrated amount of cortisone build-up can cause skin pigment to lighten around the injection site. Improper sterilisation of instruments and the injection site can also cause infection, and less commonly, allergy to the sterilising solution Betadine will cause skin reactions.
The Journal of the American Medical Association reports that after prolonged use of cortisone shots directly injected into the bone, there is an increased possibility of avascular necrosis of the bone. This means the bone effectively begins to deteriorate and, if left untreated, the bone will begin to cause extreme pain and eventually die. Most patients who suffer from this will need ongoing preventive treatment to stop further bone loss or the need for surgical treatment for irreversible bone destruction.
According to the Mayo Clinic, repeated use of cortisone shots can cause and elevate various conditions including high-blood glucose in patients with diabetes mellitus. It can also cause steroid-induced diabetes to patients not previously suffering diabetes and can, in extreme cases of accidental overdose and over-prescription, may cause sepsis, or death.
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