Side Effects

Cortisone Injection Side Effects

Cortisone injections can cause both local and systemic side effects, which may be immediate or delayed in onset[6].

  • Short-term (local) side effects commonly include:
    • Pain during and after injection (“cortisone flare”)[2]
    • Swelling or bruising at the injection site[1]
    • Redness, discoloration, or lightening/whitening of the skin around the site[4]
    • Skin hypopigmentation and atrophy (thinning)
    • Facial flushing and warmth[1]
    • Insomnia for a day or two[3]
    • Temporary rise in blood glucose levels (especially in people with diabetes)[1]
    • Hiccups (rare)[3]
  • Serious or rare side effects include:
    • Infection at the injection site[6]
    • Tendon damage or rupture[1]
    • Cartilage damage or accelerated progression of osteoarthritis[6]
    • Nerve damage[4]
    • Osseous (bone) injury, including death of nearby bone tissue (avascular necrosis)[4]
    • Allergic reactions
    • High blood pressure
    • Increased swelling or fluid retention[1]
  • Long-term or repeated injections may cause:
    • Tendon rupture and sustained tendon weakening[4]
    • Adrenal suppression or insufficiency (Addison’s disease)[1]
    • Thinning of skin and soft tissue at injection site
    • Osteoporosis (bone thinning)[1]
    • Cushing’s syndrome (infrequent, primarily with frequent or high-dose steroid use)[5]
  • Cautions: More severe side effects become more likely with higher doses or frequent injections. The number of cortisone shots into one joint is usually limited to minimize these risks[4].
  • Management: Most side effects are minor and temporary, but consult a healthcare provider if you experience signs of infection, severe joint pain, allergic reaction, or persistently elevated blood glucose[2].

References

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