Key takeaways:
A cortisone shot is an injection of a corticosteroid medication into a joint. It helps manage pain and inflammation. A local anesthetic is often administered at the same time to make the shot more comfortable.
Cortisone shots can cause side effects. You might notice short-term pain and inflammation. You might also experience skin changes and higher blood glucose (blood sugar) levels. These side effects should subside with time.
Most side effects of cortisone shots are mild. But serious side effects, such as joint infection and cartilage damage, are also possible. Tell your prescriber right away if you notice these side effects. They can help you manage them safely.
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Many people receive cortisone shots for pain relief and mobility support — not just professional athletes. A cortisone shot lessens inflammation from a variety of health conditions, such as arthritis, bursitis, and carpal tunnel syndrome. A healthcare professional can inject a shot into your knees, hips, or other joints that may be bothering you.
Cortisone isn’t the actual name of the medication, though. Cortisone is a general term that people use when talking about corticosteroid shots. These injections typically contain another corticosteroid, such as triamcinolone (Kenalog) or methylprednisolone (Depo-Medrol). There is a medication called cortisone, but it’s only available as a tablet. It’s not one of the corticosteroids that can be injected as a cortisone shot.
Many people receive a local anesthetic, such as lidocaine (Xylocaine) or bupivacaine (Marcaine), at the same time as the cortisone shot. The corticosteroid helps lessen joint pain and inflammation, while the local anesthetic works to provide more immediate pain relief.
Like all injections, though, cortisone shots can cause side effects. Most side effects are manageable at home. But serious side effects might need to be managed by a healthcare professional.
Cortisone shot side effects at a glance
Common cortisone shot side effects include:
Short-term pain and inflammation in the affected joint
Skin lightening (hypopigmentation) and other skin changes
Facial flushing
Sleep changes
Higher-than-normal appetite
High blood glucose (blood sugar)
Rare but serious cortisone shot risks include:
Joint infection
Nerve damage
Cartilage damage
Tendon rupture
Allergic reaction
Here’s how to manage seven notable cortisone shot side effects.
Long-term side effects: Corticosteroids such as cortisone can have serious side effects when taken for a long time, or at a higher dose. Here are some long-term side effects that you should be aware of.
Cortisone shots for acne: Dermatologists use cortisone shots to treat cystic and nodular acne. Read more about how they work for treating skin lesions.
Corticosteroids and the immune system: Corticosteroids can suppress your immune system. Learn about what's at risk with this side effect of corticoid steroids and other medications.
1. Short-term pain and inflammation
It’s possible to experience a “cortisone flare” after receiving a cortisone shot. This is a short-term period of worsening pain and inflammation near the injection site. One study estimated that these flares happen to about 1 in 5 people who receive cortisone shots.
A cortisone flare happens when the numbing from the local anesthetic starts to wear off. This could be within hours to days of receiving the cortisone shot. Crystallization (the formation of crystals) of the corticosteroid medication in the joint causes the initial pain and inflammation after receiving the shot. Fortunately, these flares usually only last for 1 or 2 days.
To help manage symptoms of a cortisone flare, try to take it easy and rest your joint in the days following the injection. Applying ice packs to the injection area for about 15 minutes at a time can also help with pain and swelling. You shouldn’t apply ice packs directly to your skin, though — use a towel or cloth to protect your skin. You can also try over-the-counter (OTC) pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), if needed.
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If the pain becomes severe or unmanageable, let a healthcare professional know right away.
2. Skin-related side effects
Cortisone shots can sometimes lighten the skin around the injection site. This is called hypopigmentation, and it’s reported to happen in up to 1 in 25 people who receive them. This may be more noticeable in people with darker skin, and it’s slightly more common with triamcinolone-based cortisone shots.
Cortisone shots can also cause “dimpling,” or divots, in the skin around the injection site. This is typically due to loss of fat cells around the injection site.
Skin changes can last for weeks to months after receiving a cortisone shot. And while they tend to go away on their own, it may take 6 months or longer for this to happen. Speak with a healthcare professional if you have concerns about skin changes associated with cortisone shots.
3. Facial flushing
Cortisone shots can cause your face and chest to become red and warm. This is known as flushing. The reported frequency of flushing varies, but one study found that it occurred in up to 2 out of 5 people who received triamcinolone injections.
Thankfully, facial flushing isn’t a long-term problem. When it happens, it typically occurs within the first 24 hours of receiving a cortisone shot. And it resolves within 1 to 2 days.
There's not much you can do to treat facial flushing. But you should still let a healthcare professional know if you experience it. They might be able to adjust your dose and specific corticosteroid if you need cortisone shots in the future.
4. Insomnia
Insomnia, or difficulty sleeping, can happen after receiving a cortisone shot. This is because corticosteroids mimic cortisol. Cortisol is a natural hormone that’s released when you’re stressed. So, higher cortisol levels can cause insomnia.
A few simple tricks can go a long way in managing insomnia from these shots. You might consider:
Trying to schedule your cortisone shot appointments in the morning versus the afternoon, so you’re less likely to have trouble falling asleep later that night
Creating a comfortable environment to help promote sleep, such as a cool, dark room
Trying mindfulness practices, such as breathing and meditation, to help you de-stress and unwind before going to sleep
It’s not ideal to treat a medication side effect with another medication. But your prescriber might recommend trying an OTC sleep aid if you’re still having trouble sleeping.
5. Higher blood sugar
Although cortisone shots for joint pain aren’t given into the bloodstream, they can still have an effect on your blood sugar levels. Cortisone shots may raise your blood sugar for a few days after the injection. This can be problematic if you’re living with diabetes.
If you have diabetes, talk to a healthcare professional before receiving a cortisone shot. This is especially important if you’re receiving the injection from a healthcare professional that you don’t normally see. The person who manages your diabetes may want you to monitor your blood sugar more frequently in the days after receiving the shot. They might also recommend temporarily adjusting your blood sugar-lowering medications, if needed.
If you experience abnormally high blood sugar after receiving a cortisone shot, let your prescriber know right away. Possible symptoms of high blood sugar include increased thirst, frequent urination, and headaches.
6. Joint infection
Rarely, cortisone shots can cause an infection in your joint fluid. This is called septic arthritis. Symptoms of septic arthritis may include:
Pain in the joint, which can be severe
Swelling, warmth, or redness in the joint
Fever and chills
Weakness
Inability to move the joint freely
Inability to put weight on the joint
Let a healthcare professional know right away if you experience any of these symptoms. Septic arthritis can be life-threatening and is considered a medical emergency. You’ll likely need to be treated with antibiotics. And in some cases, you might need to have fluid drained out of the infected joint.
7. Cartilage damage
Cortisone shots have been known to sometimes cause joint cartilage damage — especially if you receive shots often.
Cortisone shots tend to offer the most benefit when they’re given in occasional, low doses. More frequent injections at higher doses are more often associated with cartilage loss.
Because of this risk, your prescriber might recommend that you receive cortisone shots only a few times per year. But there’s not a specific cutoff for how many cortisone shots are appropriate in a year. How many shots you receive will depend on your specific needs and your prescriber's expertise.
To help lower your risk of cartilage damage from cortisone shots, talk with your prescriber about how best to navigate cortisone shots for your condition. It’s important to know that cortisone shots are not a curative treatment. They’re meant to provide temporary pain relief.
Frequently asked questions
Yes, it might be helpful to rest the affected joint for 1 to 2 days after getting a cortisone shot. You should avoid doing heavy exercise, lifting, and putting pressure on the area during this time. Some people feel a brief increase in pain after a cortisone shot. This is called a "cortisone flare," and resting the area can help prevent the pain from worsening. After a couple of days of rest, you should be able to return to normal activities if the area feels comfortable.
How long a cortisone shot lasts depends on the affected joint and the degree of inflammation. On average, many people feel relief for about 2 to 10 weeks. But some studies on knee arthritis found that some people felt relief for up to 6 months before their symptoms returned.
Relief from a cortisone shot usually fades gradually over time, and results may vary for each individual. Your prescriber can guide you on the best schedule for you.
Yes, cortisone shots might cause some pain, but it usually doesn’t last long. You might feel a pinch or pressure in the area when your healthcare professional administers the shot. So they might use a numbing medication, such as lidocaine or bupivacaine, to make the shot more comfortable. It’s normal to experience soreness after the shot, and it usually goes away on its own. Contact a healthcare professional if the soreness doesn’t improve after a few days.
Yes, it might be helpful to rest the affected joint for 1 to 2 days after getting a cortisone shot. You should avoid doing heavy exercise, lifting, and putting pressure on the area during this time. Some people feel a brief increase in pain after a cortisone shot. This is called a "cortisone flare," and resting the area can help prevent the pain from worsening. After a couple of days of rest, you should be able to return to normal activities if the area feels comfortable.
How long a cortisone shot lasts depends on the affected joint and the degree of inflammation. On average, many people feel relief for about 2 to 10 weeks. But some studies on knee arthritis found that some people felt relief for up to 6 months before their symptoms returned.
Relief from a cortisone shot usually fades gradually over time, and results may vary for each individual. Your prescriber can guide you on the best schedule for you.
Yes, cortisone shots might cause some pain, but it usually doesn’t last long. You might feel a pinch or pressure in the area when your healthcare professional administers the shot. So they might use a numbing medication, such as lidocaine or bupivacaine, to make the shot more comfortable. It’s normal to experience soreness after the shot, and it usually goes away on its own. Contact a healthcare professional if the soreness doesn’t improve after a few days.
The bottom line
Common cortisone shot side effects include short-term pain and inflammation, skin changes, and high blood glucose (blood sugar). More serious side effects, such as joint infection and cartilage damage, are also possible. If you're thinking about receiving a cortisone shot, talk to a healthcare professional for more information. They can help you decide if a cortisone shot would be right for you.
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References
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