Cortisone shots are corticosteroid injections, synthetic versions of hormones naturally produced by the body. These injections primarily reduce inflammation and alleviate pain in specific areas, such as joints or tendons. Heartburn is a burning discomfort in the chest, typically behind the breastbone, caused by stomach acid flowing backward into the esophagus.
Understanding the Connection
Heartburn is a potential side effect of corticosteroid use. Although cortisone shots deliver medication locally, some can be absorbed systemically, leading to broader effects. While uncommon, heartburn after a cortisone shot is a documented response. Its likelihood varies among individuals, potentially linked to dosage or personal sensitivity.
Mechanisms Behind Heartburn
The physiological basis for cortisone shots potentially leading to heartburn involves their influence on the gastrointestinal system. Corticosteroids increase the production of gastric acid in the stomach. An elevated level of stomach acid can heighten the risk of irritation if it refluxes into the esophagus. Additionally, corticosteroids affect the lower esophageal sphincter (LES), the muscle preventing stomach contents from moving back up into the esophagus. If the LES tone is reduced or it relaxes inappropriately, stomach acid can more easily reflux, resulting in heartburn.
Strategies for Managing Symptoms
Individuals experiencing heartburn after a cortisone shot can explore several management strategies, often starting with over-the-counter remedies. Antacids, such as Tums or Mylanta, neutralize stomach acid and provide rapid relief. Histamine-2 (H2) blockers, including famotidine, reduce stomach acid production and offer longer-lasting relief than antacids. For more persistent or severe symptoms, proton pump inhibitors (PPIs) like omeprazole significantly decrease stomach acid production and aid in esophageal healing, though they may take a few days to reach full effectiveness.
Alongside medication, lifestyle adjustments can help alleviate heartburn. Eating smaller, more frequent meals reduces pressure on the stomach. Avoiding late-night eating and waiting two to three hours after a meal before lying down prevents acid reflux. Elevating the head of the bed helps gravity keep stomach acid down. Limiting trigger foods like spicy or fatty items, coffee, chocolate, and citrus fruits, plus avoiding smoking and excessive alcohol, can minimize heartburn symptoms because these substances relax the LES.
Heartburn symptoms following a cortisone shot are typically temporary. However, seek medical advice if heartburn becomes persistent or severe, if there is difficulty swallowing, or if chest pain is experienced, as these could indicate a more serious underlying condition. Consulting a healthcare provider is also recommended if symptoms do not improve with over-the-counter remedies or if these medications are needed for more than two weeks.