I have a painful right shoulder from rheumatoid arthritis (RA). Everyone tells me not to have cortisone injections. When is this recommended?

Cortisone is a form of corticosteroids, a treatment for inflammation. When injected into the joint, corticosteroids give relief of painful symptoms. The change in symptoms can be quite dramatic. However, pain relief may only be temporary. A flare-up in this disease can occur at any time.

Drugs taken by mouth (oral) are the first line of treatment for RA. Oral antiinflammatories for pain and swelling are often combined with physical therapy to improve motion and function. When this treatment fails, injections may be used to delay surgery.

Too many injections can have a bad effect on the soft tissues. Doctors advise no more than three injections. More than one injection is allowed when the patient gets good results with the first.