Whichever approach is used, the actual injection site can be marked with a fingernail imprint or the barrel of a pen. Next, sterile preparation with a povidone iodine preparation (Betadine) and alcohol can be performed. A 22- to 25-gauge needle can be used for the injection. Local anesthesia with lidocaine before the injection can be used, but with a small gauge needle this is not always necessary. Alternatively, an ethyl chloride spray can be used for local anesthesia. Following puncture through the skin and into the joint space, the injection is accomplished. If resistance is encountered, redirection of the needle may be necessary.
Cortisone injections are extremely safe, but they do still have potential problems. If you are concerned about having a cortisone shot, talk with your doctor. While cortisone is a powerful treatment for many orthopedic conditions, there are usually other options that can also be tried. Many doctors will offer an injection as they are quick, easy, and most often effective. However, your doctor should also be able to offer other treatments for inflammation that may also be effective for those that cannot have, or don't want, a cortisone injection.