How long do cortisone shot side effects last?

Cortisone shots are a common treatment for painful inflammatory conditions. The injections can effectively reduce pain and provide localized relief to the affected area.

Although cortisone shots aim to treat only a specific area of your body, some side effects can affect different body areas and functions.

What are cortisone injections? 

Cortisone is a type of corticosteroid medication, per a 2023 article.

Doctors and healthcare professionals use many forms of corticosteroid treatments, such as:

• oral (via the mouth)
• inhaled
• topical (on the skin)
• rectal (via the anus)
• injected

When injected, corticosteroids directly affect a specific area of the body, often a joint. They can suppress the effects of the immune system and reduce inflammation in that area, helping to improve pain and swelling. 

Another 2023 article notes that cortisone injections often contain a local anesthetic. This means the shot can provide both short- and long-term pain relief, though its effectiveness can differ for everyone.

Some side effects may last only a few days, while others can last longer. Serious side effects are uncommon, and severe allergic reactions are rare.

Benefits and uses

A 2015 article explains that cortisone shots can improve a wide range of conditions, such as:

• autoimmune conditions, like rheumatoid arthritis
• conditions of the foot, such as Morton neuroma
• conditions of the hand and wrist, like carpal tunnel syndrome
• having a finger stuck in a bent position, known as trigger finger
• joint inflammation, known as bursitis
• tendon inflammation, known as tenosynovitis
• shoulder conditions, like impingement syndrome
• tennis and golf elbow, known as epicondylitis
• joint wear and tear, such as osteoarthritis

These injections can reduce pain and inflammation. They can also improve the functioning of the affected joints by enabling greater flexibility and range of motion.

Short-term risks and side effects

Not everyone will experience cortisone shot side effects, but if you do, you may feel unusual or unwell afterward. This is because the injected steroids can affect your whole body.

Here are some potential short-term risks:

• Flushing: Facial and upper body flushing sometimes happens after getting a cortisone shot, according to a 2023 review. You may feel warm, and your skin can appear red or discolored. This generally lasts fewer than 24 hours. 
• Increased blood sugar: According to the same review, people with diabetes can experience higher blood sugar in the hours to days after getting the injection.
• Increased pain: Around 1 in 5 people may experience increased pain after getting a cortisone shot. This is called a steroid flare, or cortisone flare. For most people, it improves within 3 days to a week. 
• Allergic reaction: Very few people experience anaphylaxis from corticosteroids like cortisone. This is a potentially life threatening condition that commonly occurs a very short time after injection and requires immediate medical attention.

Long-term risks and side effects

• Muscle atrophy: A 2018 literature review explains that in rare cases, injecting corticosteroids can cause the soft tissue at the injection site to weaken or waste away. It can happen within a few months of the injection and generally improves within 1 year. 
• Hypopigmentation: The same review notes that cortisone shots can cause hypopigmentation in the area where you get the shot. This means your skin can look lighter in color than the surrounding skin. This side effect should go away within a year. It can be more noticeable on darker skin tones.
• Mood or sleep changes: Although rare, some people experience mood or sleep changes like depression or insomnia. It can start within a week of the injection and last up to 10 days. However, this is more likely with regular and high doses of oral steroids than with occasional injections.
• Menstruation changes: Some people may also experience longer and heavier periods in the 9–19 days after a corticosteroid injection.
• Adrenal suppression: The shots can also cause adrenal suppression. This means the body doesn’t produce enough cortisol — a hormone similar to cortisone. This can cause weight loss, fatigue, and stomach and muscle pain, but these side effects should improve within a few weeks. 

How does the procedure work? 

Here’s how the procedure often works:

1. A doctor or healthcare professional might ask you to change into a gown. 
2. They will position you so they can easily insert the needle into the affected area.
3. They will disinfect the injection site and its surroundings and possibly apply a numbing cream.
4. If fluid is in the affected joint, they may first draw this out. They often use ultrasound or other imaging tools to double-check the needle’s placement in your body. 
5. Once the needle is in place, the person performing the procedure will inject the cortisone, which they may have mixed with an anesthetic. You may feel some pinching or a burning sensation.
6. They will then remove the needle, and they will clean and bandage the area.
7. They may ask you to bend and move the treated area to spread the medication. 

Sometimes, the doctor may ask you to stay at the clinic for up to half an hour after the procedure to ensure you don’t experience any severe allergic or painful reactions. 

Other treatments

The most suitable cortisone shot alternatives depend on the health condition being treated. For example, the treatment of arthritis can differ significantly from the treatment of golfer’s elbow or inflammation of shoulder tendons.

Some nonmedicinal therapies that might improve joint, muscle, and tendon pain and inflammation include: 

• rest
• cold or heat therapy
• splints or braces 
• physical therapy
• weight management
• surgery
• acupuncture

Alternative medications include:

• nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
  • ibuprofen (Advil)
  • indomethacin (Indocin)
  • naproxen (Aleve, Anaprox, Flanax)
  • celecoxib (Celebrex)
• biologics like:
  • infliximab (Remicade)
  • etanercept (Enbrel)
  • secukinumab (Cosentyx Unoready)
• disease-modifying antirheumatic drugs (DMARDs), such as:
  • methotrexate (Trexall)
  • sulfasalazine (Azulfidine)

A healthcare professional can recommend the most suitable approach for your health and preferences.

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Summary

Cortisone shots are a common treatment for inflammatory conditions like arthritis, bursitis, and tendinitis. Some people may experience side effects that last only a few hours, but some side effects can last longer.

Cortisone shots can cause a short-term flare in pain or flushing of the face for a few days after the injection. 

More rarely, they can cause longer-term side effects like skin color changes, muscle weakness, or changes to menstrual periods, mood, or sleep. Some of these can last up to a year. 

Alternatives to cortisone shots depend on the condition. They can include physical therapy, medications like NSAIDs or DMARDs, and surgery.

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