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Doctor Patient Cortisone

Cortisone injections can be extremely helpful in the treatment of conditions such as bursitis, arthritis, nerve pain, gout, plantar fasciitis and tendonitis.

If appropriately and expertly administered, they can make the world of difference to someone experiencing serious pain and discomfort.

I’ve practised medical law for more than two decades and it was only two years ago that we first started seeing these types of claims.

These cases have highlighted how incorrectly administered injections can have serious long-term effects on patients.

Side effects can include allergic reactions, palpitations, hot flushes, insomnia, mood disturbances, infection, bruising, fat atrophy, hypopigmentation (whitening of the skin).

I believe cortisone injections are best administered by a radiologist who can see where the needle is being inserted – through the use of an ultrasound – so that they can ensure that the cortisone is being delivered to the right place.

By doing this they can consider any underlying structural issues that are apparent on the imaging.

Unfortunately, I think for some GPs it’s easier to give patients an injection instead of referring them for testing to identify the underlying issue and or referring for other treatment such as physiotherapy, anti-inflammatory medications, exercise or surgery.

One such example is Nicola Ninyett who visited her GP in early 2016 after suffering a lower back injury at work, which resulted in buttock pain and sciatica.

Her GP performed right and left tronachanteric bursal (hip) injections (cortisone), hours after which she started experiencing worsening pain that radiated down her right leg and prevented her from walking.

After several weeks of pain and further investigations, Ms Ninyett was diagnosed with septic arthritis and had to undergo hip replacement surgery.

She now has restrictions with her ability to walk, sit and stand, impaired balance, inability to run, squat, swimming bend or work as a result of the inappropriate use of a cortisone injection.

I have concerns that some patients undergo these injections, going for a “quick fix” but aren’t aware of the serious side effects.

We have clients who have been given the impression that the injection will fix their problems, but people need to know that if it’s not done properly or is done for the wrong reasons, conditions will not improve and could possibly worsen.

If you decide to go ahead with a cortisone injection, check that the doctor is appropriately trained and experienced in the injection procedures and, if not, opt to be referred to a radiologist.

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