Cortisone shots are a common treatment for shoulder pain, aiming to reduce inflammation and provide relief. These injections contain a corticosteroid medicine, a synthetic drug that mimics cortisol, a hormone naturally produced by the body to control inflammation. They are used to address various shoulder conditions, including tendinitis, bursitis, rotator cuff impingement or tears, and frozen shoulder.
When Relief Begins
Pain relief from a cortisone shot in the shoulder is not immediate. While some individuals might experience quick relief if the injection includes an anesthetic, the full anti-inflammatory effects of cortisone take several days to become apparent. Most patients can expect the cortisone to start working effectively within 4 to 5 days, with some experiencing the full benefits after about a week.
A temporary increase in pain, swelling, and irritation at the injection site, known as a “cortisone flare,” is common. This flare-up occurs within 24 to 48 hours after the shot and subsides within 1 to 2 days as the cortisone begins to reduce inflammation. Applying ice to the injection site can help manage this temporary discomfort.
How Long Relief Lasts
The duration of pain relief from a cortisone shot in the shoulder can vary significantly among individuals. The effects can last anywhere from a few weeks to several months. The longevity of effects depends on several factors, including the specific shoulder condition, inflammation severity, and individual response.
Mild inflammation may respond better and for a longer duration compared to severe or chronic inflammation. Factors such as the patient’s activity level, metabolism, body weight, and other health conditions also influence relief duration. While cortisone shots provide temporary relief, they do not cure the underlying condition, and symptoms may return as the medication wears off.
What to Expect After the Shot
After receiving a cortisone shot in the shoulder, protect the injected area for a day or two by avoiding heavy lifting and strenuous activities. Routine activities like walking are permitted. Apply ice to alleviate any pain or swelling; avoid heat pads. Avoid baths, hot tubs, or whirlpools for a few days, though showering is acceptable.
Potential side effects can occur. Some individuals may experience temporary skin discoloration, such as lightening or whitening, at the injection site, or fat atrophy, which can lead to dimpling. These dermal changes are temporary, resolving within 6 to 30 months, but can sometimes be permanent. Diabetics should be aware that cortisone shots can cause a temporary increase in blood sugar levels, which returns to normal within a few days. Diabetic patients should monitor blood glucose levels closely after the injection.
Infection at the injection site is a rare complication. Other rare risks include temporary facial flushing, cartilage damage, nerve damage, or weakening of tendons. If the shot is ineffective or symptoms return, further treatment options may include physical therapy to strengthen the shoulder and improve range of motion, or alternative pain management strategies. Healthcare providers limit the number of cortisone shots in a joint, often to no more than three or four per year, to minimize side effects and tissue damage.