Cortisone shots, a common anti-inflammatory treatment, effectively manage pain and inflammation in various conditions. These injections deliver corticosteroids directly to a specific area to reduce swelling and discomfort. However, cortisone shots may temporarily influence blood pressure levels, especially in certain individuals. This potential effect requires careful consideration and awareness.
How Cortisone Influences Blood Pressure
Cortisone, a type of corticosteroid, can elevate blood pressure through several pathways. A primary mechanism is the retention of sodium and water in the kidneys. Corticosteroids mimic natural hormones that promote salt and fluid reabsorption, increasing overall blood volume. This expanded fluid volume places a greater load on the heart, contributing to higher blood pressure.
Additionally, these steroid hormones can heighten blood vessel sensitivity to naturally occurring substances that cause vasoconstriction. Substances like norepinephrine, which constrict blood vessels, exert a stronger effect when corticosteroids are present. This increased vascular tone means blood vessels become tighter, restricting blood flow and raising blood pressure. Corticosteroids are also known to affect components of the renin-angiotensin-aldosterone system (RAAS), which regulates fluid balance and blood vessel constriction. The combined impact of fluid retention and increased vascular responsiveness contributes to the observed changes in blood pressure.
Duration and Variability of Blood Pressure Changes
The elevation in blood pressure following a cortisone shot is usually temporary, resolving within five to seven days after the injection. Onset can be rapid, with some individuals experiencing increased blood pressure within a few hours of receiving the shot. The duration and intensity of these blood pressure changes are not uniform, as several factors can influence the response.
The dose of cortisone administered plays a significant role; higher doses generally pose a greater risk for more pronounced and sustained blood pressure elevation. The specific type of corticosteroid used also matters. Some, like hydrocortisone, have stronger mineralocorticoid effects that promote more fluid retention, while others, such as dexamethasone and methylprednisolone, have weaker effects on fluid balance. While localized injections are often thought to have fewer systemic effects, they can still lead to systemic absorption, influencing blood pressure. Individual patient characteristics, including pre-existing conditions like hypertension, cardiovascular disease, kidney issues, or diabetes, can heighten the risk and variability of blood pressure responses.
Monitoring and Responding to Blood Pressure Changes
Monitoring blood pressure is important after receiving a cortisone shot. Individuals, especially those with a history of hypertension or other cardiovascular concerns, should track their blood pressure, particularly in the days following the injection. Regular blood pressure checks can help identify significant changes early.
Be aware of symptoms that might indicate severely elevated blood pressure. These include:
Sudden onset of headaches
Chest pain
Dizziness
Changes in vision
Difficulty breathing
Nausea
Confusion
Buzzing sensation in the ears
Nosebleeds
Heart arrhythmias
If concerning blood pressure changes or these symptoms occur, communicate promptly with a healthcare provider. They can assess the situation, offer guidance, and determine if adjustments to existing blood pressure medications or other interventions are needed.