It is often asked whether a patient should get a “cortisone shot” or receive some other form of treatment for certain conditions such as tennis elbow, shoulder pain, etc. This a decision that should be made by the patient and their doctor after examining the risks, benefits and alternative forms of treatment.
When comparing the success of Soft Tissue Manipulation to Corticosteriod injections, the British Medical Journal found that the injections have been shown to be more effective for short-term relief. Corticosteriod injections, however, have a much higher reoccurrence rate of injury/ pain and also have poorer outcomes in the long term when compared to soft tissue manipulation. Also, those who received soft tissue manipulation for their initial treatment sought significantly less other forms of treatment.
The study concluded that the corticosteriod injection does not aid in the healing of the tissue and does not correct any flaws in the biomechanics. This being said, a conservative approach to many soft tissue injuries would be to apply soft tissue manipulation and/or therapeutic exercises. This treatment would be aimed at releasing the structures that are tight and rehabbing the structures that are weak. If these are unsuccessful the use of corticosteroid injections is still an option that can be considered. Some of the risks associated with corticosteroid injections are avascular necrosis (especially of the hip) and the inhibition of certain connective tissue that aids in the healing process which therefore increases the risk of tendon rupture.
As with any form of treatment, there is "A Time and A Place" for everything, and this decision should be made collectively between you and your doctor.
If you would like the references used in the article or more information on Soft Tissue Manipulation performed at In Motion Spine and Joint Center, please contact us at (615) 302-4747.