What is the side effects of cortisone shots

Steroid injections, also called corticosteroid injections, are anti-inflammatory medicines used to treat a range of conditions.

They can be used to treat problems such as joint pain, arthritis, sciatica and inflammatory bowel disease.

Steroid injections are only given by healthcare professionals. Common examples include hydrocortisone, triamcinolone and methylprednisolone.

How steroid injections are given

Steroid injections are usually given by a specialist doctor in hospital.

They can be given in several different ways, including:

  • into a joint (an intra-articular injection)
  • into a muscle (an intramuscular injection)
  • into the spine (an epidural injection)
  • into the blood (an intravenous injection)

The injections normally take a few days to start working, although some work in a few hours. The effect usually wears off after a few months.

If you're having an injection to relieve pain, it may also contain local anaesthetic. This provides immediate pain relief that lasts a few hours.

You should be able to go home soon after the injection. You may need to rest the treated body part for a few days.

Side effects of steroid injections

Possible side effects of steroid injections depend on where the injection is given.

Side effects of injections into the joints, muscles or spine can include:

  • pain and discomfort for a few days – paracetamol may help with this
  • temporary bruising or a collection of blood under the skin
  • flushing of the face for a few hours
  • an infection, causing redness, swelling and pain – get medical advice as soon as possible if you have these symptoms
  • a loss of fat where the injection was given – this can cause dimples in the skin and may be permanent
  • paler skin around the site of the injection – this may be permanent
  • if you have diabetes, your blood sugar level may go up for a few days
  • if you have high blood pressure, your blood pressure may go up for a few days

Epidural injections can also occasionally give you a very painful headache that's only relieved by lying down. This should get better on its own, but tell your specialist if you get it.

Side effects of injections given into the blood tend to be similar to side effects of steroid tablets, such as increased appetite, mood changes and difficulty sleeping.

You can report any suspected side effect to a UK safety scheme.

Who can have steroid injections

Most people can have steroid injections.

Tell the doctor before having treatment if you:

  • have had a steroid injection in the last few weeks – you usually need to wait at least 6 weeks between injections
  • you've had 3 steroid injections in the last year – doctors usually recommend no more than 3 injections in the same area in the space of 12 months
  • have had an allergic reaction to steroids in the past
  • have an infection (including eye infections)
  • have recently had, or are about to have, any vaccinations
  • are pregnant, breastfeeding or trying for a baby
  • have any other conditions, such as diabetes, epilepsy, high blood pressure, or problems with your liver, heart or kidneys
  • are taking other medicines, such as anticoagulants

Steroid injections may not always be suitable in these cases, although the doctor may recommend them if they think the benefits outweigh any risks.

How steroid injections work

Steroids are a manmade version of hormones normally produced by the adrenal glands, 2 small glands found above the kidneys.

When injected into a joint or muscle, steroids reduce redness and swelling (inflammation) in the nearby area. This can help relieve pain and stiffness.

When injected into the blood, they can reduce inflammation throughout the body, as well as reduce the activity of the immune system, the body's natural defence against illness and infection.

This can help treat autoimmune conditions, such as multiple sclerosis (MS), which are caused by the immune system mistakenly attacking the body.

Steroid injections are different from the anabolic steroids used illegally by some people to increase their muscle mass.

Page last reviewed: 26 February 2020
Next review due: 26 February 2023

Q. I'm in my late 70s and have been getting about four cortisone shots a year for the past several years for the arthritis in my left knee. They really help with the pain, but I've heard that, long-term, there could be bad side effects. Should I be worried?

A. Cortisone is one of the many corticosteroid drugs. The corticosteroids are powerful anti-inflammatories that can do a lot to relieve pain, but the side effects are a drawback. As pills, they deplete bone and have other systemic effects. Injected cortisone, which is often combined with lidocaine, a short-acting pain reliever, sometimes clumps into crystals and may worsen pain rather than relieve it. Repeated shots can eventually damage skin and other tissues. Small amounts of cortisone that have been injected into a joint can get into the rest of the body and have hormone-like effects that make diabetes harder to control. There's also the slight risk of the shots leading to an infection of the joint.

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

How long does a cortisone shot stay in your system?

The effects of the injection usually last up to 2 months, but sometimes longer. Cortisone can reduce inflammation that damages joints. Your doctor also may recommend other treatments to address joint pain resulting from another condition such as obesity, tendon or ligament damage, or an autoimmune disorder.

Do cortisone injections have side effects?

The most common side effects of steroid injections include: pain around the injection site, also called a cortisone flare. bruising or dimples at the injection site. pale or thin skin around the injection.

What are the long term effects of cortisone injections?

Repeated shots can eventually damage skin and other tissues. Small amounts of cortisone that have been injected into a joint can get into the rest of the body and have hormone-like effects that make diabetes harder to control. There's also the slight risk of the shots leading to an infection of the joint.

Does a cortisone shot affect the whole body?

Cortisone injections are extremely safe. But like any drug, there are possible side effects and complications that can occur with a cortisone shot. Some side effects impact the area of the injection site, while others are systemic, meaning they affect the whole body.

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