Why Cortisone Injections Stop Working Over Time

Cortisone injections are often one of the first treatments recommended for joint pain.

And at first, they can feel like a miracle.

Pain decreases.
Swelling goes down.
Movement improves.

But for many people, something frustrating happens over time:

Each injection helps less  and for a shorter period.

So why does that happen?

What Cortisone Actually Does

Cortisone is a powerful anti-inflammatory medication.

It works by:

• Suppressing inflammation in the joint
• Calming the immune response
• Reducing swelling and pain signals

What it does not do is:

• Repair cartilage
• Heal damaged tissue
• Improve blood flow
• Restore joint health

In simple terms, cortisone turns down the alarm, but it doesn’t fix what’s causing the alarm to go off.

Why the First Injection Often Feels So Good

The first cortisone injection often works well because:

• Inflammation is a major driver of pain early on
• The joint hasn’t been repeatedly suppressed yet
• Tissues are still relatively responsive

For many patients, relief can last weeks or even months.

But that relief is temporary by design.

Why Cortisone Loses Effectiveness

Over time, several things happen:

1. The Underlying Problem Continues

Arthritis, tendon degeneration, or joint wear doesn’t stop just because pain is quieter.

• Cartilage continues to thin
• Joint mechanics don’t improve
• Inflammation eventually returns

2. The Body Adapts

Repeated suppression of inflammation can make tissues:

• Less responsive
• Slower to heal
• More dependent on injections for relief

3. Tissue Health May Decline

With frequent use, cortisone may:

• Weaken surrounding soft tissue
• Contribute to cartilage breakdown
• Reduce the joint’s ability to recover naturally

This is why many doctors limit how often cortisone can be given.

The “Shorter Window” Effect

Many patients notice a pattern:

• First injection: relief for months
• Second injection: relief for weeks
• Third injection: minimal or no benefit

This doesn’t mean the pain is “all in your head.”
It means the joint environment has changed, and inflammation alone is no longer the main issue.

When Cortisone Is Still Useful

Cortisone can still play a role:

• Short-term pain relief
• Acute flare-ups
• Temporary symptom control

But it’s usually not a long-term strategy for chronic joint pain.

At some point, continuing injections becomes more about managing decline than improving function.

What to Consider Instead

When cortisone stops working, it’s often time to shift the goal from:

“How do I calm this pain?”

to:

“How do I improve the health of the joint?”

Modern non-surgical treatments focus on:

• Reducing chronic inflammation more sustainably
• Improving circulation to joint tissues
• Supporting the body’s natural repair processes
• Restoring movement and function without masking symptoms

For many patients, this change in approach makes a meaningful difference.

The Bottom Line

Cortisone injections don’t fail because they were “bad medicine.”

They stop working because they were never designed to be a long-term solution.

If you’ve noticed diminishing relief from cortisone and feel like surgery is being presented as the next step, it may be time to explore non-surgical options that focus on improving joint health not just quieting pain.

At Buffalo Arthritis & Joint Pain Center, we help patients understand why treatments stop working and what options may still exist.

👉 If cortisone no longer helps the way it used to, you’re not out of options.

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