Do Cortisone Shots Work?

The number one thing people have been searching to get to this site lately is “cortisone shots” (or, as someone wrote it, “cortizone shoots”), which apparently directs them to a post I wrote about why I got a cortisone shot in my foot. It seemed appropriate, then, that I should update these visitors on if it worked or not.

In short: yes, the cortisone shot worked.

The day of the shot my entire leg hurt and I didn’t do anything except sit around. The next day, my foot was still sore and slightly swollen, but I could water run. And, by two days after I was able to do a test run, which went fine, and then a slightly longer test run the next day, which was when I realized it wasn’t my foot that was going to hurt me during the marathon.

So, yes, it sort of worked. My foot hurting is not why I dropped out of Boston. But, a cortisone shot doesn’t solve all your other problems, which have come about as a result of whatever is the reason you need to get a cortisone shot, so it’s only sort of a cure-all.

In theory, now, the cortisone should last for a few months, but after our daily 4-5 miles of walking around Boston my toe started to feel sore. (We had to walk a mile each way to get to the train station, through neighborhoods full of some creepy-ass East Coast big houses.) My toe has been on and off sore-like for the last week, meaning I can usually run a few miles, but I’m never sure if I’ll be able to. This leads me to believe one of two things: either the shot isn’t as effective as purported or the problem is not necessarily inflammation as much as it is some other bone-type issue, like a fracture.

Both of those scenarios mean one thing: doctors suck.

Cortisone Shots: Why I Got One

(Edit Note: OK, so what I wrote yesterday about why women who qualify should get their elite license clearly hit a nerve because it got six or seven times the usual readership and people were quite worked up elsewhere on the internets. To be clear: I am not calling out anyone specifically. Like I said, there are plenty of individual reasons not to upgrade, but on the aggregate when far fewer women make that choice there’s a problem. At some other point I will perhaps expand on why, if triathlon was really done the way I want, we should have amateur, elite amateur, and professional categories. But since triathlon’s not run the way I want,  we gotta do the best with what we got.)

UPDATE: I wrote this post about how the cortisone shot worked out for me at Boston and after.

This morning, all other things aside, I got a cortisone shot in my foot. It looked just like this:

It won't hurt at all.
It won’t hurt at all.

Actually, I didn’t even notice the needle that much because the doctor had sprayed stuff to freeze my foot and numb it.

There are lots of reasons not to get cortisone shots. And, at first, it seemed that my toe joint was getting better with regular anti-inflammatories and ice, so I wasn’t worried and wasn’t going to get the shot. But, after running on it last week, it simply stopped getting better. It seemed that I had badly inflamed one spot and it just kept hurting. The doctor thought a cortisone shot would bring the inflammation down enough to make the pain go away. Since I’m planning on running Boston either way, it would be better if it didn’t hurt when I did that.

But, if you start reading about cortisone shots, there are lots of problems. They don’t solve the initial cause of the pain, so often that problem comes back. And, that will likely be the case for me. It seems that I also have a small bone spur at the base of my toe that rubs when it bends or pushes off, so that’s causing the inflammation and I may eventually have to get it filed down or whatever it is you do with a bone spur.

Lots of times people get cortisone shots for things that aren’t really things cortisone shots will fix. Cortisone is just a steroidal anti-inflammatory, so no, it’s not going to fix a tear or muscle problem.

There can also be side effects, like increased stiffness or pain or possible infection at the injection point. And, the doctor did tell me that I would likely have more pain and swelling for a couple days. That also means that often you can’t do activity or are supposed to let it rest for a couple days, which is typically counter-productive to why you got the shot in the first place.

The biggest side effect, though, is that by masking the pain people are able to ignore the cues their body is giving them and can do worse damage. I was assured this was not the case for my problem, since I was getting the shot in a toe joint and not in a tendon or ligament — which really doesn’t sound like a good idea. You can also only get so many cortisone shots, because it can damage the ability of the cartilage to grow.

So, all that makes it sound like not a great idea. Yet, I got the shot.

Largely, many of the issues and problems sounded like they weren’t going to be problems for my specific injury. I can’t do long-term damage; it’s just going to hurt like a mother. And, because the main source of my pain is the inflammation, the shot may bring that down enough to help fix the overall issue.

But, mostly, I got the shot because it’s sort of a last resort. I’m going to line-up at the start of the race on Monday pretty much no matter what at this point. The main hindrance to finishing well is going to be how much it hurts. If we can get it not to hurt enough, then I can race, rest for a good amount of time after (since I don’t have anything else on my schedule), and possibly fix the underlying bone spur problem.

At least that’s the plan. Plan B was: hope. That’s still our back-up solution right now.

Have you ever got a cortisone shot? Tell me it worked out great.