To Cortisone or not?

[Dastardly]

I have a Hip Labrum Tear which has been with me a long time now, the symptoms used to come and go but for about 19 months it has been consistent and always there. It has been very troublesome at times, which includes right now! Feels torn to shit inside and I can barely bend over/dip down.

When seeing ortho they explained that the usual diagnostic procedure is to give a cortisone shot, and if the patient gains any relief than this means that surgery may have a productive outcome. And if no relief is found, then surgery will be a waste of time so the case will be dropped.

I refused the shot, demanded a scan which raised eyebrows and caused a lot of uncomfortable shuffling and phone calls. But I was granted an MRI, which I have had and am awaiting results/consult for in coming weeks.

At the moment I am not sure if I want to have surgery, I have some silly lifting goals and desire to work, travel and do a bunch of outdoorsy stuff this year. If I could gain some temporary relief that was non-destructive I would take it. Pain itself does not bother me, but when it feels so absurdly torn up and the whole joint is mechanically locking up and grinding to sensations of further tearing. It is difficult to do anything!

So to cut a long story short, and excuse the pun.. is Cortisone worth a shot?

Ortho totally denied any negative effects when I asked him, not sure if I trust the fellow. And before you ask, I did try "not lifting" for a period last year, didn't help.

[Mark Rippetoe]

Cortisone typically does nothing constructive for an injury that actually needs a repair. I have no experience with an acetabular labrum injury. We'll ask.

[John Petrizzo]

Dastardly,

I have worked with several patients who have had either arthroscopic debridements or repairs of their labrums. The recovery can be a slow process, but ultimately you should be back to lifting without restriction in a few months (the time frame will vary a bit depending on whether they do a repair or debridement). The population I have seen with this injury have been high school athletes, and all of them suffered labral damage secondary to congenital bony abnormalities of their hip joints. As is typical, the stronger, more athletic kids have recovered faster and with fewer complications than the weaker, less athletic kids. I would think your previous training history will ultimately be helpful to you in your recovery if you do need to go the surgery route.

[Dastardly]

Thanks for the post John,

Ill update this thread again when I get my consultation/results. I guess what I was asking for the time being, is simply whether there are negative effects of the cortisone. I have heard suggestions that it weakens connective tissue but do not know in practice how much of an issue this is. If I were to try out a shot, and it reduced symptoms, (which I doubt will occur but ortho's suggest is common) I would be happy continue getting shots periodically till I am settled on the surgery.

[John Petrizzo]

Others can probably speak to the long term effects of repetitive use of cortisone shots better than I can, but my opinion is that too many shots in any one area is ultimately harmful to the integrity of the healthy tissues. In addition, while the cortisone itself may ease the inflammation in a particular area, if the underlying cause of the inflammation is not addressed, then once the cortisone wears off, you are back to square one. Ultimately, if you have an injury that is going to require surgery, than cortisone probably is not the answer other than just for some short term relief.

[David Kirkham]

I had a cortisone shot in my back once. Miracle for pain relief--for a couple of days. Pain came back. Squatting ultimately fixed it--no pain since. I have seen many people get these shots with very little long term relief. The only thing I have seen give long term relief is LP lifting. If you need surgery you might as well get it over with so you can get back to LP. No shame in lifting an empty bar. The only shame is not lifting.