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You've probably heard of a professional athlete having to receive a cortisone shot to fight through an injury. You may even know a friend, a family member, or a co-worker who's undergone the procedure. But for many of us, the treatment is outside our realm of direct experience. Even though they're administered relatively frequently, cortisone shots are typically reserved for significant discomfort. In the 60-plus years since the treatment was introduced, it's helped an incalculable number of people gain relief from pain and inflammation, particularly in their joints. And even though cortisone shots are common among professional sports players, you don't have to be a hard-charging athlete to benefit from this injectable medication. Despite the effectiveness of cortisone, it can come with some considerable side effects. Let's take a closer look at the treatment, its uses, and its potential drawbacks. What Is Cortisone? Cortisone is a type of man-made steroid that mimics the effect of cortisol, a hormone naturally occurring in the body. This is what distinguishes the medicine from anabolic steroids, which mimic testosterone. Corticosteroids, as they're also called, can be extremely helpful in alleviating pain for patients suffering from a range of conditions, including:
Rarely does a physician select a cortisone shot as the initial treatment. In many cases, the doctor will first recommend less invasive steps such as weight loss, physical therapy, exercise, or over-the-counter medications like ibuprofen. If a physician does think corticosteroids are the best option, shots are typically injected directly into a particular area of the body for local relief. Shortly after a cortisone injection, the anti-inflammatory action reduces swelling and pain. Within several days, the relief can be nearly complete, even for those suffering from extreme pain. However, the effects aren't permanent; they can last anywhere from a few weeks to six months. In that sense, cortisone does not represent a cure, merely a temporary way to mitigate pain and swelling. The Downsides Cortisone shots' ability to almost fully alleviate extreme pain is extraordinary, but there are some negatives to consider. The side effects that a cortisone shot can trigger may counterbalance or outweigh its ability to reduce pain and inflammation. According to the National Institutes of Health, the side effects from cortisone shots include:
Some side effects can be serious. These include:
Side effects can vary from person to person. They could be mild or severe. They might appear with short-term use or never show up at all. Long-term, repeated administration of cortisone shots can be particularly problematic, as frequent injections in the same joint can damage it, as well as the surrounding soft tissue. It's important to remember that cortisone injections alter your immunity function, lowering the inflammatory response that your body mounts to fight injury and infection. This will reduce pain and swelling, but it can leave you open to infections and other issues. While it's true that the list of possible side effects is long, the advantages of corticosteroids can be significant. If you or someone you love is suffering from a condition that may require a cortisone shot, be sure to talk to your physician about the pros and cons. Discuss how other medical conditions you or your loved one have may affect the use of cortisone. It's an important decision, and you don't have to make it alone. Arthritis and other joint problems may be treated with cortisone injections. Like any treatment, these injections carry certain risks and side effects. Most are mild or temporary, but some can be serious or long-lasting. Patients are advised to discuss concerns about risks and side effects with their health care providers before receiving cortisone injections. Potential risks and side effects include: Pain and Swelling (Cortisone Flare)The injected cortisone medication can crystallize inside the body. The crystals can cause pain and inflammation that is worse than the pain and inflammation caused by the condition being treated. This side effect is called a cortisone flare. A flare typically lasts one or two days and can be treated with rest and intermittent cold packs. See When and Why to Apply Cold to an Arthritic Joint Skin DiscolorationPatients may notice the skin around the injection site changes color a few weeks or months after the injection.1,2 This side effect is most common in darker-skinned patients, who notice the skin becomes lighter.1 Skin discoloration may last a few weeks or months or be permanent.2 Skin discoloration is not harmful to patients' health. This side effect occurs in 1.3% to 4% of patients3 and seems to be related to the type and concentration of corticosteroid medication used.1,2 advertisement Fat AtrophyA cortisone injection may cause fat cells at the injection site to atrophy. A divot or depression in the skin may appear because the underlying fat cells have deteriorated. The skin’s appearance usually goes back to normal in 6 months but may take 2 or 3 years.2 Authors of one study estimate this side effect occurs in 0.6% (6 out of every 1000) injections.4 Elevated Blood SugarIn addition to decreasing inflammation, corticosteroids can raise blood sugar levels. A patient with diabetes should inform their doctor prior to receiving an injection and then closely monitor blood sugar levels for a day or two following a cortisone injection. The injection does not deliver cortisone directly to the bloodstream, but it can still influence blood sugar levels in some patients. In This Article:Tendon InjuryCortisone injections can weaken nearby tendons and make them more prone to tearing.5 Because of this risk, physicians take precautions to avoid placing a cortisone injection in or directly next to a tendon. Patients can reduce their risk of tendon injuries by resting the affected joint for a few days after the injection and then gradually increasing activity with recommended stretching and exercises. Cartilage LossResearch suggests cortisone injections may have a negative effect on cartilage. For example, one study6 found an association between repeated cortisone injections and 0.11 cm loss of cartilage in the knee. The same study did not find an association with increased knee pain. InfectionThough rare,7,8 infection is a serious potential side effect. People who are more prone to infection, such as those who have autoimmune diseases and who take immune-suppressing medications, should inform their health care provider. After receiving a cortisone injection, any patient who suspects an infection or runs a fever is advised to contact their doctor. Allergic ReactionPatients should tell their doctor if they have ever had an allergic reaction following an injection. While uncommon, some patients have allergic reactions to the local anesthetic added to the injection. Allergic reactions to the cortisone itself are rare because cortisone is a synthetic version of cortisol, a steroid naturally found in the body. Sex-Related Side EffectsWhile not common, women may experience9:
Unlike women, men do not seem to experience any unique side-effects.9 advertisement Doctors do not recommend cortisone injections for patients who have an existing infection, including skin infections and septic arthritis. In addition, cortisone injections may not be appropriate for patients who are taking blood thinners or who have broken bones. Some patients may be concerned about weight gain and water retention from corticosteroid use. However, these side effects are common only for patients who take corticosteroid medications orally for an extended period of time. These side effects rarely occur when the cortisone medication is injected into a joint. See What Is Cortisone? Read more articles about other types of injections in the Injections Health Center References
Can cortisone shots do more harm than good?Myth: Cortisone shots generally cause more harm than good.
While it is true that cortisone shots should not be done constantly, the majority of doctors agree that cortisone injections, when used appropriately, pose very little risk to your body.
Does cortisone stay in your body forever?How long does cortisone stay in your system? Generally, any cortisone injection will affect the body. However, this effect is small and lasts only 3-4 weeks.
What is the downside to a cortisone shot?The Downsides
According to the National Institutes of Health, the side effects from cortisone shots include: Dizziness or headaches. Skin issues, including dryness, thinness, acne, dry skin, and red or purple blotches. Fatigue and trouble sleeping.
What are the disadvantages and side effects of cortisone injections?Cortisone Shot Disadvantages and Side Effects
Infection. Bleeding from broken blood vessels in the skin or muscle. Soreness where you get the shot. Aggravation of inflammation in the area injected because of reactions to the medication (post-injection flare)
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What are the long term effects of cortisone injections
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