Cortisone shots are a form of steroid injection that delivers synthetic corticosteroid medication directly into a specific body area. These injections mimic cortisol, a hormone naturally produced by the adrenal glands, to reduce inflammation. By calming the body’s inflammatory response, cortisone shots aim to alleviate pain and swelling.
Healthcare providers commonly use cortisone shots to address painful musculoskeletal conditions. This treatment is frequently applied to joints like the knee, shoulder, hip, and ankle, as well as the spine, tendons, and bursae. Conditions such as arthritis, tendinitis, and bursitis often benefit from this targeted anti-inflammatory approach.
Understanding Post-Injection Discomfort
Following a cortisone injection, some individuals may experience a temporary increase in discomfort known as a “cortisone flare.” This reaction can manifest as increased pain, swelling, and warmth at the injection site. These flares occur in approximately 1 in 5 people who receive cortisone shots.
This phenomenon occurs because the corticosteroid medication is formulated with slow-release crystals that can temporarily irritate surrounding tissues as they settle. This irritation triggers a localized inflammatory response before the cortisone’s anti-inflammatory effects begin. This flare is a common side effect and does not indicate infection or injection failure.
Timeline of Pain After a Cortisone Shot
The initial needle stick pain is typically brief and subsides quickly. However, the subsequent cortisone flare, characterized by increased pain, usually lasts for a short duration. This flare generally resolves within 1 to 3 days, though some individuals might experience it for up to 5 days.
After the flare-up diminishes, pain relief from the cortisone shot typically begins. While a local anesthetic often mixed with cortisone can provide immediate, but temporary, numbness, the full anti-inflammatory effects of the corticosteroid usually take a few days to a week to become noticeable. In some instances, it may take up to 10 days or even three weeks for the shot to provide full and sustained pain relief.
Strategies for Pain Relief
Managing post-injection discomfort typically involves several steps to ease temporary pain. Applying ice packs to the injection site can help reduce swelling and soreness. It is recommended to apply ice for 15 to 20 minutes at a time, several times a day, ensuring a cloth or towel protects the skin.
Resting the affected area is also beneficial, and it is advisable to limit strenuous activity for 24 to 48 hours after the injection. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can be used to manage discomfort. During the initial 48 hours, it is best to avoid baths, hot tubs, or swimming, though showering is generally permissible.
When to Contact Your Doctor
While post-injection discomfort is common, certain symptoms warrant immediate medical attention. Contact your doctor if you experience severe, worsening pain that does not subside or significantly increases after 3 to 5 days. Signs of a potential infection, such as fever or chills, also require prompt evaluation.
Additional concerning symptoms include excessive or spreading redness, warmth, or swelling around the injection site, or any pus or drainage. New numbness or weakness in the affected limb should be reported. For individuals with diabetes, it is important to monitor blood sugar levels closely, as cortisone can temporarily increase them.