Cortisone injections are a common medical treatment used to address inflammation and pain in specific areas of the body. These injections deliver corticosteroids, manufactured drugs that resemble cortisol, a hormone naturally produced by the adrenal glands. Cortisone shots are often administered into joints like the shoulder, knee, hip, or spine to alleviate discomfort stemming from conditions such as arthritis, tendinitis, or bursitis.
Heart palpitations refer to the sensation of a heart beating too fast, fluttering, pounding, or skipping beats. While alarming, they are frequently harmless and can be triggered by various factors, including stress, exercise, or certain medications.
Cortisone Injections and the Cardiovascular System
Cortisone injections can sometimes cause heart palpitations. This effect typically arises from systemic absorption of the corticosteroid medication into the bloodstream, even when injected locally. While most medication targets the injection site, some can circulate throughout the body, influencing various physiological systems.
Corticosteroids impact the body’s fluid and electrolyte balance. They can promote sodium retention and fluid accumulation, leading to increased blood volume and potentially elevated blood pressure. This fluid retention can strain the cardiovascular system, influencing heart rate and rhythm.
Corticosteroids can also affect the sympathetic nervous system, which plays a role in regulating heart rate and blood pressure. An altered sympathetic response can contribute to sensations of a rapid or irregular heartbeat.
For diabetic patients, cortisone injections can temporarily increase blood sugar levels for several days. Cardiac side effects, including palpitations, are generally temporary and resolve within a few days to a week after the injection. The likelihood and severity of these effects can be dose-dependent.
Recognizing Other Potential Side Effects
Cortisone injections can also lead to other common side effects. One of the most frequent immediate side effects is temporary pain or soreness at the injection site, sometimes described as a “cortisone flare.” This discomfort typically subsides within 24 to 72 hours.
Skin changes can also occur around the injection area, including lightening or discoloration of the skin, or even thinning. These localized skin effects may last weeks to months, or in some cases, be permanent. Another common temporary side effect is facial flushing, where the face and sometimes the chest become red and warm; this usually resolves within 24 to 48 hours.
For individuals with diabetes, a temporary elevation in blood sugar levels is a well-documented side effect that can last for several days. Cortisone can also influence sleep patterns, potentially causing insomnia or difficulty sleeping, and may lead to mood changes such as anxiety or irritability. These systemic effects usually occur within the first few days after the injection.
When to Seek Medical Advice
It is important to be aware of certain symptoms following a cortisone injection that warrant prompt medical attention. While temporary palpitations can occur, seek immediate medical advice if they are severe, persistent, or accompanied by other concerning symptoms. Such symptoms include chest pain, shortness of breath, dizziness, or fainting.
Any signs of a severe allergic reaction, such as difficulty breathing, significant swelling, or a widespread rash, require emergency medical care. Also, watch for signs of infection at the injection site, which include increasing pain, redness, warmth, or swelling that lasts more than 48 hours, or the development of a fever.
If you experience unusually high blood sugar levels, especially if you have diabetes and they are difficult to manage, contact your healthcare provider. Similarly, report any significant or prolonged mood disturbances, severe headaches, or vision changes. Always communicate any new or worsening symptoms to your prescribing doctor to determine the appropriate course of action and ensure your safety.