What is a Cortisone Shot? Purpose, Procedure & Results

A cortisone shot is a targeted injection of a synthetic steroid medication directly into an inflamed joint, muscle, or soft tissue area. This powerful anti-inflammatory treatment mimics your body's natural hormone cortisol, which helps reduce swelling and pain in specific problem areas. Doctors often recommend these injections when other treatments haven't provided enough relief from conditions like arthritis, tendinitis, or bursitis.

What is a cortisone shot?

A cortisone shot delivers a concentrated dose of corticosteroid medication directly to the source of your inflammation. The medication is a lab-made version of cortisol, a hormone your adrenal glands naturally produce to fight inflammation throughout your body.

Unlike oral medications that affect your entire system, cortisone shots target the specific area causing you trouble. This focused approach means you get stronger anti-inflammatory effects right where you need them most, often with fewer side effects than taking steroids by mouth.

The injection itself contains the steroid medication mixed with a local anesthetic to help numb the area during and after the procedure. This combination helps provide both immediate comfort and longer-lasting inflammation relief.

Why is a cortisone shot done?

Doctors recommend cortisone shots when inflammation in a specific area is causing significant pain or limiting your daily activities. These injections work best for conditions where inflammation is the main problem, rather than structural damage or wear-and-tear.

Your healthcare provider might suggest a cortisone shot if you're dealing with joint pain from arthritis that hasn't improved with rest, physical therapy, or over-the-counter medications. The injection can provide relief that lasts several weeks to months, giving you time to strengthen the area or try other treatments.

Common conditions that respond well to cortisone shots include several inflammatory problems. Let me walk you through the most frequent reasons doctors recommend these injections:

• Osteoarthritis or rheumatoid arthritis in knees, shoulders, or hips
• Tennis elbow or golfer's elbow from repetitive motion
• Bursitis in shoulders, hips, or elbows
• Tendinitis in various joints
• Carpal tunnel syndrome causing wrist pain
• Plantar fasciitis causing heel pain
• Trigger finger or thumb

These shots are particularly helpful when the inflammation is interfering with your sleep, work, or ability to enjoy daily activities. Your doctor will consider your specific situation and other treatment options before recommending an injection.

What is the procedure for a cortisone shot?

The cortisone shot procedure is typically quick and straightforward, usually taking just 10-15 minutes in your doctor's office. You won't need any special preparation beforehand, and most people can return to their normal activities the same day.

Your healthcare provider will start by cleaning the injection site with an antiseptic solution to prevent infection. They may mark the exact spot where the needle will go, especially for deeper joints that require precise placement.

Here's what you can expect during the actual injection process:

1. Your doctor will position you comfortably, often lying down or sitting
2. They'll clean the skin thoroughly with antiseptic
3. A thin needle will be inserted into the affected area
4. You might feel pressure or mild discomfort as the medication is injected
5. The needle is removed and a small bandage is applied

For deeper joints like the hip or shoulder, your doctor might use ultrasound or fluoroscopy (real-time X-ray) to guide the needle to exactly the right spot. This imaging helps ensure the medication goes precisely where it's needed most.

The injection itself usually takes just a few seconds, though the entire appointment might last 15-30 minutes including preparation and aftercare instructions.

How to prepare for your cortisone shot?

Preparing for a cortisone shot is relatively simple, and most people don't need to make major changes to their routine. Your doctor will give you specific instructions, but generally, you can eat normally and take your regular medications before the appointment.

If you're taking blood-thinning medications like warfarin or clopidogrel, let your doctor know ahead of time. They might ask you to temporarily stop these medications to reduce bleeding risk, but never stop them without medical guidance.

There are a few practical steps that can help make your appointment go smoothly:

• Wear loose, comfortable clothing that allows easy access to the injection site
• Bring a list of all your current medications and supplements
• Tell your doctor about any allergies, especially to local anesthetics
• Mention if you have diabetes, as steroids can temporarily affect blood sugar
• Ask someone to drive you home if you're nervous about the procedure

Most people feel comfortable driving themselves home after a cortisone shot, but having support can be reassuring. The procedure itself rarely causes significant discomfort that would interfere with normal activities.

How to read your cortisone shot results?

Understanding your response to a cortisone shot isn't about reading lab results, but rather noticing how your symptoms change over time. The medication works gradually, so don't expect immediate dramatic improvements right after the injection.

Most people begin to notice pain relief within 24-48 hours, though the full anti-inflammatory effects can take up to a week to develop. The local anesthetic in the injection might provide some immediate numbness, but this wears off within a few hours.

Here's what to expect during your recovery timeline:

• First few hours: Some temporary numbness from the local anesthetic
• 24-48 hours: Initial pain relief as inflammation starts to decrease
• 1 week: Full anti-inflammatory effects should be noticeable
• 2-6 months: Duration of pain relief varies by person and condition

A successful cortisone shot typically provides significant pain reduction and improved function that lasts several weeks to months. You should be able to move the affected area more comfortably and perform daily activities with less discomfort.

If you don't notice improvement within two weeks, or if your pain returns quickly, let your doctor know. This might indicate that inflammation isn't the main cause of your symptoms, or that you need a different treatment approach.

How to manage after your cortisone shot?

Managing your recovery after a cortisone shot involves following some simple guidelines to maximize the benefits and minimize any potential complications. Most people can return to normal activities within a day or two, but taking care of yourself helps ensure the best possible outcome.

For the first 24-48 hours after your injection, it's important to rest the treated area without completely avoiding movement. Gentle activity is usually fine, but avoid intense exercise or heavy lifting that might stress the injection site.

Your doctor will likely recommend these post-injection care steps:

• Apply ice to the injection site for 15-20 minutes if you experience soreness
• Take over-the-counter pain relievers if needed, but avoid anti-inflammatory drugs
• Keep the injection site clean and dry for 24 hours
• Avoid strenuous activity for 24-48 hours
• Monitor for any signs of infection like increased redness or warmth

Some people experience a temporary flare-up of pain in the first day or two after injection. This is normal and usually indicates that the medication is working to reduce inflammation in the area.

Once you start feeling better, gradually return to your normal activities. The goal is to use the pain-free period to strengthen the area through gentle exercise or physical therapy, which can help prevent future flare-ups.

What are the risk factors for cortisone shot complications?

While cortisone shots are generally safe, certain factors can increase your risk of complications or make the injection less effective. Understanding these risk factors helps you and your doctor make the best decision about whether this treatment is right for you.

People with diabetes face a higher risk of temporary blood sugar spikes after cortisone injections. The steroid medication can raise glucose levels for several days, requiring closer monitoring and possibly adjusted diabetes medications.

Several medical conditions and circumstances can increase your risk of complications:

• Active infection anywhere in your body
• Bleeding disorders or use of blood-thinning medications
• Diabetes or pre-diabetes
• Weakened immune system from medications or medical conditions
• Previous allergic reactions to steroids or local anesthetics
• Pregnancy (though injections may be used in specific situations)

Having multiple cortisone shots in the same area also increases risk. Most doctors limit injections to no more than 3-4 per year in any single joint to prevent potential tissue damage or thinning.

Your age and overall health don't necessarily prevent you from getting cortisone shots, but they do influence how your doctor approaches the treatment and monitors your recovery.

What are the possible complications of cortisone shots?

Most people experience cortisone shots without any significant problems, but like any medical procedure, complications can occasionally occur. Understanding these potential issues helps you know what to watch for and when to contact your healthcare provider.

The most common side effects are mild and temporary. You might experience some soreness at the injection site, similar to how you might feel after receiving a vaccination. This discomfort usually resolves within a day or two.

Common, generally mild complications include:

• Temporary pain or soreness at the injection site
• Slight bleeding or bruising where the needle was inserted
• Temporary increase in pain (cortisone flare) lasting 24-48 hours
• Mild swelling around the injection area
• Temporary elevation in blood sugar levels, especially if you have diabetes

These common effects are usually manageable with rest, ice, and over-the-counter pain relievers. They indicate that your body is responding normally to the injection.

Less common but more serious complications require immediate medical attention. While rare, these can include:

• Infection at the injection site with increased redness, warmth, or pus
• Allergic reaction causing difficulty breathing or widespread rash
• Nerve damage causing numbness or weakness (extremely rare)
• Tendon rupture if injected directly into a tendon
• Skin discoloration or thinning at the injection site

Contact your doctor immediately if you develop fever, severe pain that worsens instead of improves, or any signs of infection. These serious complications are uncommon but need prompt medical evaluation.

When should I see a doctor for cortisone shot concerns?

Knowing when to contact your healthcare provider after a cortisone shot helps ensure any problems are addressed quickly. Most people recover smoothly, but certain symptoms warrant immediate medical attention.

Call your doctor right away if you develop signs of infection, which can occur within a few days of the injection. Infection symptoms include increasing redness, warmth, or swelling at the injection site, especially if accompanied by fever or pus.

Here are specific situations that require prompt medical evaluation:

• Fever above 101°F (38.3°C) within a few days of injection
• Severe pain that gets worse instead of better after 48 hours
• Pus or unusual discharge from the injection site
• Red streaks extending from the injection site
• Difficulty breathing or widespread rash suggesting allergic reaction
• New numbness or weakness in the treated area

You should also contact your doctor if you don't experience any improvement in your symptoms within two weeks of the injection. This might indicate that inflammation isn't the main cause of your problem, or that you need a different treatment approach.

For people with diabetes, monitor your blood sugar levels more closely for several days after the injection. Contact your healthcare provider if your glucose levels remain significantly elevated or if you have trouble managing them with your usual medications.