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Cortisone shots - good or bad?

I have a lot of patients who have had cortisone shots or are considering getting one for joint pain.  I read this article a while ago, but it is still pertinent. Phys Ed: Do Cortisone Shots Actually Make Things Worse? By GRETCHEN REYNOLDS.  This article sites a study in the British medical journal, The Lancet, that tried to figure out the answer.  The bias of my training is to be somewhat skeptical of cortisone shots, but on the other hand I have had some patients report great results.  Please follow the links to get the full rundown, but the short answer is that cortisone shots can help in the short term, but not the long term.  In some cases they can make the situation much worse. This will now be something I will give all patients who are considering getting cortisone.