A cortisone shot is a common treatment for trochanteric bursitis, which involves inflammation of the bursa cushioning the outside of the hip joint. The injection delivers a potent corticosteroid directly into the inflamed area to reduce swelling and pain. The body’s response and the path to relief follow a predictable timeline. The injection creates a pain-free window, allowing a patient to address the underlying causes of the hip pain.
The First 48 Hours: Managing the Cortisone Flare
Immediately following the injection, the hip may feel numb due to the local anesthetic mixed with the corticosteroid. This temporary numbness lasts for a few hours, providing an initial sense of significant relief. As the anesthetic wears off, a temporary increase in pain and inflammation, known as a “cortisone flare,” often begins.
This flare occurs because the corticosteroid is a suspension of fine crystals, and the body reacts to these crystals settling in the bursa. This reaction is normal, affecting approximately one in five patients, and typically manifests within the first 48 hours. Management involves limiting activity and applying ice to the injection site for 15 to 20 minutes at a time.
Patients must avoid strenuous activity, heavy lifting, or running for the first two days to allow the medication to settle effectively. It is also advised to avoid soaking the hip in water, such as in a bathtub or hot tub, for two days to minimize the risk of infection. The discomfort from a cortisone flare usually resolves within two to three days.
The Timeline for Pain Reduction and Maximum Effect
The immediate pain relief experienced right after the injection is solely due to the local anesthetic component. This effect is short-lived, generally wearing off within a few hours. The true therapeutic benefit comes from the steroid, which takes time to reduce inflammation on a cellular level.
Noticeable pain relief typically begins three to seven days after the injection. This is when the anti-inflammatory properties of the drug start to take effect. Maximum relief is often achieved one to two weeks post-injection, as swelling continues to subside.
The duration of this relief can vary widely, lasting from several weeks to a few months. On average, patients experience a reduction in pain for about 6 to 12 weeks. If no noticeable improvement is felt after two weeks, a follow-up appointment with the provider is necessary to reassess the diagnosis and treatment plan.
Common Localized and Systemic Side Effects
While the cortisone flare is an expected, temporary reaction, other side effects are possible. Localized reactions occur near the injection site and can include temporary changes to the skin. Patients may notice hypopigmentation (lightening of the skin color) or fat atrophy, appearing as a slight dimpling or depression at the site.
Systemic side effects affect the entire body because a small amount of the steroid is absorbed into the bloodstream. These are typically transient and can include facial flushing or a feeling of warmth in the chest and face. Corticosteroids can temporarily elevate blood sugar levels, a concern that must be closely monitored by patients with diabetes for up to a week.
Patients may also experience transient mood changes or difficulty sleeping in the days following the shot. Serious complications such as infection are rare, but symptoms like fever, persistent severe pain, or drainage should be reported to a healthcare provider immediately.
Integrating the Shot into a Long-Term Recovery Plan
The cortisone injection treats symptoms, not the underlying cause of hip bursitis. The primary goal is to provide a pain-free window of opportunity to address the factors that led to the inflammation. Therefore, the injection should be integrated into a comprehensive, long-term recovery strategy.
Physical therapy (PT) is a central part of this plan, focusing on stretching the iliotibial (IT) band and strengthening the hip abductor muscles. Utilizing the pain relief allows the patient to participate fully in PT exercises without the limitation of chronic pain. The therapy addresses poor biomechanics or muscle imbalances that often contribute to bursitis development.
To minimize the risk of tissue damage, healthcare providers generally recommend limiting the number of injections to three or four per year. The shot facilitates rehabilitation, but sustained recovery depends on long-term changes, including exercise and activity modification. If pain returns a few months after the injection, it signals that the underlying issue needs further attention.