When a gout flare-up occurs, the symptoms can become debilitating in an extremely short space of time. While some preventative measures might help to hold off the more severe signs of gout for a while, the condition can quickly become extremely painful and difficult to manage. So, what do you do if painkillers aren’t helping? Could a cortisone shot help with gout symptoms?
Common management techniques for gout
Gout is an inflammatory condition caused by a build-up of uric acid in the blood. Over time, this acid forms sharp crystals in the joints - most commonly the feet - which can cause debilitating pain, swelling, and redness.
There is no cure for gout and treatment of the condition largely focuses on the prevention of flare-ups and symptom management. Common management techniques include diet changes, such as switching to a low-purine diet, the use of supplements to reduce levels of uric acid in the body, and painkillers to help manage pain associated with the condition. However, in severe cases of gout, these methods may not be sufficient.
What is a cortisone shot?
Cortisone contains a synthesised form of cortisol, a hormone produced naturally in the body, alongside an anaesthetic. They are administered in the form of injections or ‘shots’ directly to the affected area. Cortisone shots - also called steroid shots or steroid injections - can be used in a variety of settings to help relieve pain and reduce swelling and inflammation in a specific area of the body.
Similarly, hydrocortisone injections or a topical formulation can be applied to achieve similar results. Both hydrocortisone and cortisone are corticosteroids; however, unlike hydrocortisone which can be applied topically (directly to the skin), cortisone requires conversion in the liver. Corticosteroid injections may be considered to relieve pain and inflammation following injury, associated with gout and arthritis, or in the treatment of other conditions, including certain autoimmune diseases and asthma.
The effects of cortisone shots can be felt for up to a few months; however, both hydrocortisone and cortisone have relatively high glucocorticoid activity which can cause fluid retention. Therefore, cortisone shots are generally unsuitable for long-term use.
Cortisone shots for gout
In severe cases of gout, your healthcare provider may recommend cortisone injections. These shots can only be administered by a trained doctor in a GP surgery or hospital clinic and are only available through prescription in the UK. Immediately following a cortisone or hydrocortisone injection, pain and other symptoms may become more pronounced; however, this usually subsides after a few days.
These corticosteroids can affect your immune system, potentially making you more vulnerable to infections. Injections are therefore not administered regularly. Still, depending on the area being treated, some patients may have corticosteroid injections up to four times a year.
Cortisone can also be taken orally (by mouth) in the form of pills. Evidence shows that Prednisone (a cortisone-like medicine) treatment is as effective as non-steroidal anti-inflammatory drugs (NSAIDs) that are commonly prescribed in acute gout. The study also concludes that oral steroids are also a reasonable choice as a first-line treatment.
Conclusions
To conclude, while cortisone shots may offer relief from severe gout symptoms, they should be considered as part of a comprehensive treatment plan under the guidance of a healthcare professional. The most common management techniques for gout remain diet modifications alongside the use of supplements for prevention and painkillers during flare-ups.
Cortisone shots for gout may be considered by your healthcare provider if you are unable to achieve satisfactory relief with other methods; however, your doctor will always weigh the benefits of potential symptom relief against potential side effects, including immune system suppression.
