Cortisone injections treat pain and inflammation in the hand and wrist by combining a corticosteroid, a potent anti-inflammatory medication, with a local anesthetic. These injections are commonly used to manage localized conditions such as carpal tunnel syndrome, tendonitis, or arthritis in the small joints of the hand. The goal is to deliver the anti-inflammatory agent directly to the affected tissues, reducing swelling and providing relief. Specific guidance on hand use is necessary immediately following the procedure because the medication needs time to localize and begin its therapeutic effect.
Immediate Activity Restrictions
Following a hand cortisone injection, prioritize rest for the treated area for the first 24 to 48 hours. This rest period is crucial because it helps prevent the medication from migrating away from the target site and minimizes the risk of complications like tendon rupture. Excessive strain could be detrimental before the medication takes effect.
During this initial period, avoid all strenuous activity involving the injected hand. This includes heavy lifting, forceful gripping, or repetitive fine motor tasks. Activities requiring significant hand strength, such as opening tight jars, weight training, or playing certain musical instruments, should be completely avoided to allow the corticosteroid to settle and begin its work.
Light, gentle activity is generally acceptable and encouraged to prevent stiffness. You can use your hand for basic daily needs, such as feeding yourself, light typing, or holding a phone, provided these activities do not increase pain. If the injection site is in a high-motion area like a finger joint, minimize even light use. Stop any movement that causes discomfort immediately.
Managing Post-Injection Pain and Side Effects
It is common to experience a temporary increase in discomfort as the local anesthetic wears off hours after the injection. The numbing agent provides immediate short-term relief but typically lasts only a few hours. Once its effects subside, the original pain may return, sometimes intensified, before the corticosteroid begins working.
A temporary reaction known as a “steroid flare” may occur in 10% to 20% of patients. This flare is characterized by an acute increase in pain, warmth, and inflammation at the injection site, usually beginning 12 to 24 hours after the procedure. It is believed to be caused by the body’s reaction to the crystallization of the steroid medication. This temporary worsening of symptoms typically resolves within 48 to 72 hours.
Managing this discomfort often involves applying a cold compress or ice pack to the area for 15 to 20 minutes, several times a day. Over-the-counter pain relievers, such as acetaminophen, are generally recommended for managing pain in the first 48 hours. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may be advised against initially, as they could potentially interfere with the steroid’s anti-inflammatory process; confirm medication use with your physician.
Monitor the injection site for signs of a rare infection, which requires immediate medical attention. Contact your healthcare provider immediately if you experience increasing, severe pain that lasts longer than 48 hours, or if you develop a fever, significant expanding redness, or warmth inconsistent with a mild flare.
Timeline for Relief and Return to Normal Use
The full therapeutic effect of the corticosteroid is not immediate, as it takes time for the drug to reduce inflammation. While some patients feel improvement within a few days, the full anti-inflammatory benefits typically become noticeable between three and seven days after the injection, sometimes up to ten days. If you do not experience any relief after about one week, the injection may not have been effective for your condition.
Once the initial 48-hour rest period is over and post-injection discomfort has subsided, gradually reintroduce activity to the hand. This progression should be slow, starting with light range-of-motion exercises. Avoid returning to full, unrestricted activity, especially those that caused the initial injury, until at least one week has passed.
A measured return to pre-injection activity levels is important to protect the healing tissue and maximize pain relief duration. Light strengthening exercises or occupational tasks should only be resumed after three to seven days. Activities involving full grip strength or heavy lifting should wait until the one-week mark or longer, based on your physician’s advice. The duration of effectiveness varies widely, often providing symptom relief for several weeks to many months.