When one or more injections don't provide the desired relief, surgery is often the next step. But it can be discouraging to learn that cortisone injections don't work to relieve pain. Fortunately, there are other options that may be more effective. Before giving a cortisone injection, your provider should have taken x-rays or performed other diagnostic tests.
If they didn't, you may want your diagnosis confirmed. Conditions such as rheumatoid arthritis must be treated with specific medications that slow the progression of the disease. Cortisone injections may work together with these medications, but they won't work on their own. It may take some time to see if the steroid is actually working.
In some cases, the medication will take action as quickly as 24 to 48 hours, but in others, it may take up to a week before it starts to work. These injections use a steroid solution that is injected into the spine to reduce inflammation and pain. In addition, repeated steroid injections can weaken nearby bones and connective tissue, so you can only receive these injections a few times a year. If your provider didn't use an x-ray or ultrasound to guide the injection, it's more likely that the injections won't relieve the pain or only reduce it for a short period of time.
There are several alternative treatments available if facet joint injections haven't worked. If it's due to inflammation, you may need to take medications to reduce inflammation before trying another type of injection. If you experience any pain relief with the initial injection into the facet joint, your provider may suggest repeating the injection to see if it is still useful. Hyaluronic acid injections and PRP injections are often effective in patients with mild to moderate levels of joint degeneration.
When facet joint injections don't relieve pain, additional tests should be performed to identify the exact cause of the pain. Another treatment option could be epidural steroid injections; however, what happens if epidural steroid injections don't work? If you're wondering what to do when epidural steroid injections don't work, there are several options available. Physical therapy can help strengthen muscles and improve flexibility and range of motion in affected areas. Acupuncture can also help reduce inflammation and pain in affected areas.
Other treatments such as chiropractic care and massage therapy can also help reduce pain and improve mobility. In some cases, surgery may be necessary if other treatments don't provide relief. Surgery is usually recommended when other treatments have failed or when there is a structural problem that needs to be corrected. Your doctor will discuss all of your options with you and help you decide which treatment is best for you.