Cortisone was supposed to be the easy button.
You show up, the doctor finds the spot, the needle goes in, and for a while, the fire goes out. It’s a small miracle, and for millions of people, it’s enough.
But not always.
Sometimes the relief lasts three weeks instead of three months. Sometimes it never comes at all. Sometimes the fourth shot does less than the first one did, and your doctor starts using the word “diminishing returns” in a way that feels less like medicine and more like a warning label.
This is the moment most people quit. They assume the next step is surgery, or a lifetime of pills, or just… learning to live with it.
It’s not.
The problem with cortisone
Cortisone treats inflammation. It’s very good at treating inflammation. What it doesn’t do is talk to the nerve that’s screaming, or the muscle that’s been in spasm since forever, or the signal that’s gotten so loud your brain now treats a whisper of pain like an air raid siren.
If your pain is a nerve problem, an anti-inflammatory is bringing a mop to a electrical fire. Useful tool. Wrong job.
So what’s next?
Rhizotomy: turning down the volume at the source
A rhizotomy doesn’t fight inflammation. It goes straight to the nerve carrying the pain signal and turns it off — using heat or cold, depending on the version.
Think of it less like a treatment and more like cutting a wire. The joint or the tissue underneath might still have some wear and tear. But if the phone line reporting the damage to your brain gets disconnected, the damage stops being your problem, at least for a while.
It’s not permanent — nerves regrow, usually over six months to two years. But for people who’ve been told “there’s nothing else we can do,” six pain-free months is not a consolation prize. It’s a season of your life back.
Botox: not just for foreheads
Everyone knows Botox relaxes muscles. Fewer people know that a relaxed muscle can’t spasm, and a muscle that can’t spasm can’t clamp down on the nerve running through it.
For migraines, for myofascial pain, for the kind of chronic tension that turns your shoulders into concrete — Botox isn’t cosmetic. It’s mechanical. It interrupts a feedback loop: pain causes tension, tension causes more pain, more pain causes more tension. Cut the loop anywhere, and the whole cycle loses its grip.
It takes a few days to weeks to kick in. It’s not a miracle. But it’s a different lever, and when the cortisone lever has stopped moving anything, a different lever is exactly what you need.
Ketamine: rebooting the whole system
Here’s the strange one. Ketamine was an anaesthetic. Then people noticed something odd: in low doses, delivered slowly through an IV, it didn’t just numb pain — it seemed to reset how the nervous system processed it.
Chronic pain isn’t only a signal. Over time, the nervous system itself can become the problem, amplifying, misfiring, refusing to stand down even after the original injury has healed. This is called central sensitisation, and it’s why some pain outlives its cause by years.
Ketamine infusion therapy works on the receptors involved in that amplification. For conditions like CRPS, fibromyalgia, and certain kinds of nerve pain that haven’t responded to anything else, it’s not a last resort because it’s weak — it’s a last resort because it’s a completely different category of intervention, and doctors save the different categories for when the familiar ones stop working.
The real lesson here
Pain isn’t one thing. It’s not one dial that every treatment turns down by the same amount. There’s inflammation. There’s nerve signaling. There’s muscle spasm. There’s a nervous system that’s learned, wrongly, to stay on high alert.
Cortisone is a great tool for exactly one of those problems. When it stops working, that’s not evidence that nothing will work. It’s evidence that you’re dealing with a different problem than the one cortisone was built for.
The people who get better are rarely the ones who found one miracle treatment. They’re the ones who kept asking “what else could this be” until they found the tool that matched the actual problem.
That’s not a medical mystery. It’s just good problem solving.
Contact us to find out more.