Cortisone shots are often handed out without warnings or disclaimers, but at what cost?

In this episode, Stacey breaks down the real science behind corticosteroid injections and why science has shown their short-term relief may come with long-term consequences.

From cartilage damage to increased risk of joint replacement, you’ll learn why informed consent matters and what safer, evidence-based alternatives you can explore.

[00:01:00] Cortisone’s reputation vs. reality: widely used but only provides short-term relief

[00:02:22] JAMA study: Corticosteroid every 3 months = more cartilage loss, no better pain relief

[00:03:00] Risks include cartilage damage, fractures, and rare joint collapse

[00:04:40] Cortisone shots near the shoulder linked to higher risk of rotator cuff tears

[00:06:14] More injections = higher risk of total joint replacements (especially knees)

[00:08:00] Injections into replaced joints can increase infection risk

[00:09:00] Systemic effects: blood sugar spikes, insomnia, flushing, elevated BP

[00:10:12] No “safe” number of injections—many studies show risk with just 1–2

[00:11:00] Safer options available

[00:13:40] Stacey’s personal story: Why she said no to the cortisone shot (and wrote her book)

[00:17:00] Why cortisone is still widely used

[00:22:06] Studies shows changes in biomechanics can reduce arthritis pain and slow progression

[00:24:02] If surgery is coming, when to avoid cortisone

[00:25:00] Strategic use may be okay but repeat use often backfires

⚠️ Important: Cortisone injections carry risks including cartilage breakdown, rotator cuff tears, systemic side effects, and higher rates of joint replacement. Discuss all options with your provider. If surgery is planned, avoid injections within 3 months of the procedure. This information is for educational use only and is not considered medical advice. Always speak to your healthcare provider when making health related decisions.

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• AAOS Knee OA Guidelines (2021): Read Here
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• JAMA RCT on cartilage loss: PubMed
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• RSNA: Steroid injections worsen OA: RSNA Report
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• Shoulder steroid → tendon tear: PMC
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• Increased TKA risk: PubMed
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• Infection risk if <3 months before surgery: PubMed
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• Systemic effects post-injection: PMC
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• PRP vs. steroid injections (regenerative medicine commentary): Regenexx
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