What to expect after a cortisone shot

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How long does it take for a cortisone shot to work: Important FAQs

We use cortisone injections for arthritis and tendonitis. Commonly asked questions include how long does it take for a cortisone shot to work. We answer the most common questions on cortisone injections in this blog.

Why do we use cortisone? 

Diseases of joints and tendons produce inflammation. When inflammation makes joints and tendons painful and activities difficult, we use a cortisone shot to help with treatment. However, you should understand that the effect of a cortisone shot is only temporary. Generally, a cortisone shot does not cure arthritis or tendonitis, but reducing pain can improve the impact of rehab.

Will a cortisone shot hurt? 

Usually, you will feel some discomfort during a cortisone injection. However, most people tolerate these injections well. Also, using ultrasound reduces pain by ensuring the cortisone goes directly to the target. Dr. Masci performs a nerve block for some injections, such as plantar fasciitis, to make a painful injection much more comfortable.

You need to tell your doctor about your medical history

Overall, cortisone shots are very safe. However, some medical diseases, such as diabetes, cancer, or HIV, can interact with cortisone. So you should tell your doctor. Also, if you are taking a blood thinner such as Warfarin, you may need to stop the medication for a short time. Warfarin and cortisone injections could increase your risk of bleeding.

How long does it take for a cortisone shot to work?

People often ask this question: how long does a cortisone shot take to work? This fact is essential to know when you have an upcoming event, such as a marathon or a sports final. Choosing the best time to have a cortisone shot could be the difference between success and failure.

Generally, a cortisone shot takes 4-5 days to start working. However, we often say you should leave about a week before an event for the cortisone shot to work. Also, you need to be aware that cortisone can cause a flare of pain in the first few days. Therefore, you must rest for a few days after the cortisone shot to prevent the flare from worsening.

How long does a cortisone injection last?

The effect of a cortisone shot can last anywhere from 6 weeks to 6 months. As cortisone reduces inflammation, it can make you feel great. However, this effect is temporary as cortisone does not cure the disease. Nevertheless, this window of pain relief can help with rehab. In addition, combining a cortisone shot with exercise can provide more significant pain relief. Also, lifestyle factors such as weight loss, muscle strength, and footwear can help.

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.

My cortisone shot didn’t work – what does this mean? 

Failure of a cortisone shot may occur for several reasons. Firstly, the correct diagnosis is essential. A cortisone shot will not have a positive effect if the wrong site is injected. Secondly, correct needle placement is critical. Using ultrasound improves the accuracy and, therefore, the effectiveness of a cortisone shot. Finally, the failure of proper rehabilitation after a cortisone shot is another important reason.

What are the side effects of a cortisone shot? 

Generally, cortisone shots are very safe if used for the right reasons.

However, like any medical treatment, there are always side effects. These potential side effects include:

• Allergic reaction (rare)

• infection (1/100000)

• Skin thinning and discoloration. We can reduce this side effect by using ultrasound.

• Bleeding into joints.

• Temporary increases in blood sugar in people with diabetes. This increase lasts for two weeks.

• Cortisone flare causes increased pain for the first few days (see below).

• Some worry about long-term side effects such as weakening tendon strength or further joint damage. For example, recent studies suggest that repeated cortisone injections can damage cartilage. Moreover, a cortisone injection can weaken tendon strength for a few weeks. But we can reduce these concerns by using cortisone shots sparingly and for the right reasons. Also, using ultrasound to direct the injection into the right spot reduces the chances of a poorer result.

Pain after cortisone injection: what does it mean?

Generally, pain after cortisone injection is the most common side effect. We call this reaction a cortisone flare.

Usually, a cortisone flare starts after 6 hours and lasts up to 5 days. One study suggested that a cortisone flare can last up to 4 days.

If you develop a cortisone flare, we recommend rest from activities, including sports, until the pain settles. However, you can continue exercise that doesn’t make your pain worse. In addition, try regular ice packs for 10 minutes every 6 hours and regular ibuprofen 400mg thrice a day.

Can I take ibuprofen after a cortisone shot? 

Yes. Ibuprofen or other anti-inflammatories will help settle a cortisone flare. Ibuprofen is a safe and effective way to settle a flare after an injection. We suggest immediate treatment with regular ice (every 3 hours) and ibuprofen to prevent flaring.

How many cortisone shots can you have?

There are no hard and fast rules on the maximal number of cortisone injections. But there are concerns about repeated injections into one area. This is because the effect of cortisone varies among patients. Generally, if the first shot doesn’t work, we may inject the same area again after 6-8 weeks. However, if a second shot doesn’t work, we don’t recommend the third shot. But, you can have multiple cortisone shots in different parts of your body.

Can you drive home after a cortisone injection? 

Firstly, you should wait at least 15 minutes after a cortisone shot before going home. Sometimes, injections make you feel dizzy or lightheaded. This effect is short-lived and settles after a few minutes.

Many insurance policies have strict rules on driving after a medical procedure. They require you to be able to apply an emergency brake when driving. So, as a general rule, we advise against driving after a cortisone injection into the hip, knee, or foot. However, cortisone injections into the shoulder, elbow, or hand can also stop you from driving properly. We suggest a friend or family member drive you home, or you take the tube or Taxi.

Is a cortisone shot safe during pregnancy or breastfeeding? 

As a general rule, cortisone is safe in pregnancy. However, we don’t like to inject cortisone in pregnant women unless needed. Also, we suggest to pregnant women that they speak to their obstetrician. Breast-feeding is not an issue as the amount of cortisone absorbed in breast milk from one injection is very small.

Other common questions about a cortisone shot:

Can cortisone shots affect your periods? 

Yes. Cortisone can stop your periods for a short time or can cause bleeding or spotting for a few weeks. However, a change in your periods can be due to another cause.

Do cortisone shots cause weight gain?

While cortisone can increase appetite and weight, we only see this effect when taking high doses of tablets for many weeks. Usually, one to two cortisone shots over a few months are unlikely to cause a significant change in appetite or weight.

Hiccups and cortisone injections: Is there a link? 

Yes. Cortisone injections can cause hiccups. However, we don’t know exactly why. The good news is that hiccups usually settle after one to two days.

Can I drink alcohol after a cortisone injection? 

Yes. However, drinking alcohol will increase blood flow and bleeding after a cortisone injection. Therefore, we suggest you avoid alcohol at least a few days after a cortisone shot.

Flushed cheeks after a cortisone injection: Is it common? 

Yes. This effect of facial flushing is more common in women. Fortunately, it only lasts from 1-2 days.

Can a cortisone shot cause insomnia? 

Yes, but it’s not common. Like flushed cheeks, cortisone can cause insomnia or sleeplessness, which is transient and lasts 1-2 days.

Can you get a cortisone injection after a knee replacement? 

As a general rule, we do not recommend you have a cortisone injection after a knee replacement. This is because injecting an artificial joint increases the risk of infection.

Do cortisone injections damage joints?

A recent study suggested that frequent cortisone injections harm knee cartilage. However, the people in this study had eight injections over two years. Generally, we think that 1-2 injections of cortisone are safe and effective in reducing pain and swelling in knee arthritis. But repeated injections into one joint can increase the risk of damage.

Can you have cortisone injections while on blood thinners? 

We used to think that taking blood thinners such as Warfarin increased the risk of bleeding after injections into large joints such as the hip or shoulder. However, a recent study showed that bleeding is not increased irrespective of the dose of blood thinner. So, we don’t think you need to stop or reduce the amount of blood thinner before performing a joint injection.

Are cortisone shots better under ultrasound?

Yes. There is good evidence that ultrasound guidance improves the accuracy and effect of a cortisone shot. If you are thinking about a cortisone shot, you should see a doctor with experience in ultrasound-guided injections. Unfortunately, not all practitioners performing injections are qualified. See this blog for the top 4 questions to ask before you have an ultrasound-guided injection. 

Glaucoma and cortisone shots: what should you do? 

We know that cortisone can increase pressures in your eye, leading to glaucoma. However, we think that this risk is minimal with a cortisone shot. Generally, if you have stable glaucoma, one cortisone shot is unlikely to cause problems. However, if in doubt, you should check with your eye specialist. However, acute vision loss is a rare side effect of a cortisone shot. We think cortisone increases the risk of a rare condition called central serous retinopathy. You must seek medical attention immediately if you develop sudden vision loss in the eye after a cortisone shot.

Are there alternatives to cortisone injections?

Dr. Masci is a specialist sport doctor in London. 

He specialises in muscle, tendon and joint injuries.

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97 Comments

1. Jackie Perry September 30, 2021 at 7:41 pm - Reply

   Answered my question & more..Rest for 2 days after..Also may be pain or flare for 2 days…

   • • Mary Christine Calderon May 19, 2022 at 6:20 am - Reply

       Im on XERALTO blood thinner, is it safe to get a cortisone injection for tendon tear

       • Yes blood thinner. I often tell patients not to take the dose on the morning of the injection although tendon injection is a lower risk. Lorenzo

2. John Lahti October 6, 2021 at 1:03 am - Reply

   Very interesting. Lots of good information. Do you have any information about a series of gel shots given in 5 days? Wondering how long this relieves the pain?

   • hi John,

     Thanks for the comment. Gel shots usually last from 6-12 months. Nowadays, I tend to use the concentrated form so you only need one shot. eg ostenil plus durolane

3. Robin kelly October 11, 2021 at 2:01 pm - Reply

   After the knee shot I’m having lot of pain coming from my thigh it hurts bad is this normal?

   • Thank you for your comment. It can be normal to have pain from a cortisone shot that extends a little from the injection site – so for the knee – pain can extend to the lower part of the thigh. However, this pain should settle after 3-5 days.

   • Stephanie December 16, 2021 at 8:46 pm - Reply

     Hi Dr Masci,

     I received a cortisone injection (December 13th, 2021) into the joint of my big toe after breaking my sesamoid bone over a year ago. I’m a professional dancer and the lack of joint movement has caused me a lot of pain. As soon as the injection was done it felt numb for about 5 mins and then started swelling and itching (the itching stopped about 15 mins later). Now 4 days later I still have on and off swelling and the joint is still very stiff and causing me pain and seems no different than before. I have read on other websites that swelling should stop after 2-3 days and effects should start to kick in and i’m worried that it’s still no different on day 4.

     • Hi, Often cortisone flare and stiffness can last up to a week. And the positive effect of cortisone can take up to 2-3 weeks to start. So i wouldn’t give up hope yet.

4. Parinitha Bhargav October 16, 2021 at 4:10 pm - Reply

   Cortisone shot is such a helpful injection to get relaxed from the pain. The information shared here is so useful to learn so much about cortisone shots. Thank you for sharing the information.

5. I got a Cortisone shot in my right hip today about 11am, when will I know if it worked?

   • Hi Steve, probably in 2-4 weeks.

6. Reg Jacobs October 21, 2021 at 9:44 pm - Reply

   I have t seen reports on back pain

   • Manuel Martinez November 22, 2021 at 1:11 am - Reply

     Can you take a cortisone shot if I have cll cancer and taking calquence medication?

     • Hi Manuel, Generally I tend to be a little more cautious about a cortisone shot if a patient is having chemotherapy – due to the concerns about the increased risk of infection. However, I still do injections if clinically indicated.

7. Ralph Dawkins October 26, 2021 at 6:42 am - Reply

   Hi, I got a cortisone shot in my shoulder 5 days ago. The shot was very painful. After the initial pain I was pain free the entire day. On the next day my resting shoulder was aching and I couldn’t raise my arm without pain. I called the doctors office and they said to rest it and ice it.

   Five days later I don’t have the range of motion I had before the shot. Before the shot I could raise my arm straight up, then I would feel pain. Now, I can’t raise my arm at all without pain.

   I’ve had two cortisone shots in the past. One I had years ago, and the other maybe a year ago. I have never felt this pain and discomfort before. The pain is not as bad as it was 4 days ago, but my should is worse off.

   Could the PA have botched to shot? I asked about using ultrasound, but she said she didn’t need it. I spoke to her today and she said that she injected into a small space, and give it some time. She mentioned injecting it into the acromial space, but I don’t remember the exact term she used.

   Does it sound like my shoulder will ever get back to at least how it was, or is my should severely limited now? I’m 65 years old. Thanks

   • Thank you for your comment. Unfortunately, despite previous successful injections, you can sometimes experience an adverse reaction to a cortisone injection. Generally, these reactions are short-lived and do not last for greater than 1-2 weeks. If you’re concerned, I’d get in touch with your PA again.

     • gaynor kim standish January 20, 2022 at 4:35 pm - Reply

       Very interesting read. May I ask a question? I am having injection tomorrow in my 3 middle toes (both feet) & wondered if I will be able to wear the footwear I go in or, should I take slippers with me ?

       • slipper would be better for a few days. Lorenzo

8. Wayne S October 27, 2021 at 11:55 pm - Reply

   How long after receiving a cortisone shot to the knee can you start Monovisc injections?

   • good question. No definite rules but I wait about 4-6 weeks before hyaluronic acid injections.

     Lorenzo

9. Gae Moore November 2, 2021 at 3:34 pm - Reply

   Hi Pain in knee 2 weeks after cortisone injection ( apart from the,odd twinge, pain free the past 2 weeks) Does that mean it’s failed to work Thanks

   • Hi Gae, i’d give the cortisone a little more time – i usually say 4-6 weeks from the time of the injection. Lorenzo

     • Gae November 5, 2021 at 4:43 pm - Reply

10. Ann Freeman November 6, 2021 at 9:53 am - Reply

    I had steroid injection 4 days ago for gluteal retinopathy and bursitis. I still have pain especially putting weight on my leg.Is this usual, should I rest it and what should I expect? Your advice would be welcome

    • Hi Ann, yes cortisone flare can last up to a week. The average is 4 dayshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5444605/

      I suggest ibuprofen and rest from activity until it settles.

11. Lisa M. November 11, 2021 at 2:14 am - Reply

    Alrhough I feel fine, I have a frozen shoulder and biceps tendinitis which have improved with PT, but it has been recommended to get a cortisone shot in my shoulder. I’m very nervous about side effects – I take 100mg spironolactone for hormonal acne, are there any adverse reactions or warnings about reducing efficacy of either? Thank you!

    • I would recommend a hydrodistention for your frozen shoulder see my blog https://sportdoctorlondon.com/hydrodistension/
      This procedure should settle both problems – you can reduce the dose of cortisone if you’re concerned about side effects – I’d suggest 20mg of Depo-medrol .

12. RITA ROACH November 21, 2021 at 12:36 am - Reply

    i have hip pain that started all at once about 2 weeks ago. Since I’m still in treatment for breast cancer, 2 more doses of Perjeta,, and the pain is going to my knee where I’ve had the joint replaced, they did xrays and a bone scan. It showed arthritis. Like I don’t have enough going on. lol She gave me 5 days of a po steroid. It didn’t help at all. She mentioned an injection. I’m terrified of that. I had several injections in my knees before the joint replacements. They didn’t help. Is the injection something you would recommend?

    • Hi Rita, If you’ve had the knee replaced with a prosthesis then I would not recommend an injection due to the increased risk of infection. The knee pain may be coming from your replaced knee joint or your hip. See this blog that outlines symptoms of hip arthritis
      https://sportdoctorlondon.com/injections-for-hip-arthritis/

13. Glenda Goodwin November 24, 2021 at 8:11 pm - Reply

    Dear Dr Masci,
    I think you are amazing to be answering all these questions. I have had some satisfaction after reading people’s questions & your replies.
    I injured my back after falling down two flights if stairs when I was young and have lower back problems & worn facet joints worse on the right. Over the past 3yrs suffering badly from bursitis with pain radiating down my thigh & around my right knee, this is effecting everything I do now.
    Three yrs ago I had a cortisone shot in the upper thigh & that did not work. Two years ago the Dr put the cortisone injection right into my hip joint and kept going in & in & I almost passed out with the pain & the nurse had to stay with me for half hour..that did not work. This year for four months now the pain is worse than ever before, I can’t do my regular walking, I can’t drive very far as can’t sit for long and the pain keeps me awake at night, so decided to go elsewhere and try another shot. This time it was ok & for first few days thought it was great, but that was almost 4wks ago and though a lot better than before, still in pain if I walk too far or drive for long & especially pain at night. Dr said to come back after 6 wks if still bad what do you think? Thankyou

    • Hi Glenda, It’s difficult to know what is driving your pain. it could be your hip or low back. The key is finding someone who can give you a better idea as to where the pain is coming from. Sometimes, however, it can be difficult.

      Lorenzo

14. Dianne Rice November 26, 2021 at 4:30 am - Reply

    Hi There – I have chronic shoulder bursitis and I had a steroid injection in my shoulder using ultrasound three weeks ago on 4th November. The pain disappeared after two weeks and I was able to use my right arm again. Unfortunately last week the pain has come back again. I am back on painkillers etc. I am not sure if I am supposed to use my arm at all until it heals or should I be able to do things with my right arm now. For the past few days I have not used my arm at all and it seems a bit better but not great. Can you give me some advice please.

    • Hi Dianne, as a general rule, you should use an injection to help with exercise. Injections are not the cure for most cases of shoulder pain. I’d suggest seeing a therapist to take you through an exercise program starting very light and progressing slowly. In general, rest will not make your shoulder pain better. Lorenzo

15. Dhruv December 1, 2021 at 8:23 pm - Reply

    Hi sir, its been 5 weeks I had steroid injection on my right shoulder as I was having supraspinatus tendinosis.
    There is no pain when I lift things, or hit hard at the pain, I get pain only when I raise my hand side wards or when I raise arm for throw (throw arm) . can you please help me what should I do here ?
    Shall I wait for few more months or ice the area with exercises or take second shot?

    • Hi Dhruv,
      I would strongly recommend you see a physical therapist or physiotherapist to help you with a strengthening program. Ice will help. I’d suggest you avoid a second shot unless you feel the pain creeping up again.

      • Julie marsh July 7, 2022 at 2:11 am - Reply

        Hi Lorenzo
        I had an injection in my knee a week ago and I am still in agony. It’s like a dull toothache. The pain comes in waves that’s the only way to describe it. In bed at night is worse. Is this normal or hasn’t the injection worked. Thank you

        • Hi Julie – a little unusual. I’d speak to your doctor.

16. Carol Orlando December 19, 2021 at 12:05 am - Reply

    Thank you so much for your great advice. Had a cortisone shot on top of my foot due to mild arthritis and tendernitis. 1st day no pain and 2nd day alot of pain. Each day pain decreases. Your article states it takes 4 to 5 days to work.Feel great now. Thank you for explaining it. I do have a bone spur on side of foot..no pain…don’t understand that.

17. Marianne December 26, 2021 at 7:30 pm - Reply

    I had a 3rd steroid injection in my shoulder 4 days ago and resting it has been difficult due to Xmas holidays. I have sharp pain down my arm when I make any movement which hasn’t yet eased, is this likely a flare? I think I only had discomfort for a couple of days previously but this is very painful during any movement now.

    • Hi Marianne, almost certainly yes. Steroid flares can last up to a week. But i would try to see a doctor if the pain doesn’t settle.

18. Ed Miles December 29, 2021 at 6:27 am - Reply

    Hi Dr. Masci, I had an injection to the tailbone part of my spine one week ago and my pain decreased starting the next day. I went back to physical therapy today and afterward the pain returned. Could the physical therapy have ruined the positive effect of the injection? Is it temporary? Should I stop PT for awhile? I would greatly appreciate your insight and advice. Ed

    • Hi Ed, I suggest you don’t exercise while you still have pain. Generally, we think that exercises during pain after a cortisone injection prolongs the cortisone flare and might lessen the positive effects of a cortisone injection.

19. Lesley GILLSON January 1, 2022 at 4:24 am - Reply

    Hello
    I hope you can help. I am a 71 year old female. My doctor has suggested an injection in my right shoulder. I’ve had an ultra sound which has revealed a torn tendon, tendinitis, and severe bursitis. I have arthritis in the shoulder as in most of my joints. Is it worth having the injection? From all the previous comments it seems a bit futile. I am very scared of injections . Should I request alternative suggestions from my doctor. I don’t think he inte ded to use ultrasound to guide the I jectiin as per the vt. I wish you a very Happy New Year and thank you for your te.

    • Hi Lesley, I’ve just written a chapter in a book (due to be released) on shoulder injections. Putting the evidence and my anecdotal experience together, I think a cortisone injection would be my preferred first option. I have had patients who have responded very well to one cortisone injeciton. if you have arthritis of the shoulder, then I’d recommend an injection into the joint (although if you have a full-thickness tear, then it doesn’t really matter where you inject the cortisone. However, I would strongly advise having it done under US guidance. Next option would be durolane (hyaluronic acid) Regards LM

20. Tony January 1, 2022 at 4:07 pm - Reply

    Hi,

    I received a cortisone shot in my left deltoid at the ER for a pulled muscle in my neck on Dec 1 that caused a lot of pain. Immediately following the shot, the neck pain went away but I lost significant range of motion in my left arm at the shoulder. No pain or tingling. I couldn’t lift my arm straight up. MRIs and EMG test done the next couple days came back negative. I’ve since been going to physical therapy and have made some, albeit slow, progress. Now when I lift my arm straight past 45 degrees up, my shoulder hunches upward to compensate for the muscle weakness. It looks like I’m shrugging on one side. Again, no pain or numbness. My PT says my rotator cuff muscles were rendered inert and I’ve been trying to get them to work again. My deltoid does feel heavy and tight constantly. Do you think this is a cortisone flare up? It’s been a long month and I just want to know if there is light at the end of the tunnel.

    Thank you and Happy New Year

    • Hi Tony, you may have developed acute brachial neuritis or parsonage turner syndrome see this blog :
      https://sportdoctorlondon.com/parsonage-turner-syndrome/
      I’m not convinced the cortisone shot was the cause.
      If it is brachial neuritis, then your prognosis is excellent – about 90% chance of full recovery.

21. Jennifer January 19, 2022 at 11:48 pm - Reply

    I’m scheduled for my first cortisone injection in my back on Friday. (22nd)
    I am really nervous and scared…
    Should I have someone to come to my appointment?

    • hi Jennifer, As a general rule, yes. Although i’m sure you’ll be fine. Lorenzo

22. Angela Wilcox February 1, 2022 at 1:56 am - Reply

    Hi,
    I had a cortisone injection 4 days ago. I have Bursitis and cuff tear? My shoulder is still sore. How long will it take for the injection to work.
    P.S. it was done under ultra sound. And I have been resting as that’s what I was told to do. Still can’t put my arm behind my back without it hurting
    Thx Angie

    • Hi Angela,
      Average flare lasts 4 days and the effect of cortisone starts in 1-2 weeks – so still time.

      LM

23. Timmy February 1, 2022 at 5:11 pm - Reply

    Hi if I get a shot in my foot will I be able to run at a tryout in a week?

    • Hi Tim, it depends on what structure you have injected. Generally, small joints should be ok after a week but you need longer if you inject a tendon – usually 10-14 days. Lorenzo

24. Manpreet February 5, 2022 at 12:38 pm - Reply

    Hi, I had a fall from electric bike 3 weeks ago and got my right arm and shoulder got injured; 11 mm calcification got build up on supraspinatus terminal which is causing me pain and restricted range of motion. I’m seeing physio too but to help with pain is it good idea to go for cortison injection because It is not chronic and also acute injury; cortison might help me to recover soon and in this time calcification will resolve too.

    • Hi, I think an injection would be reasonable. But you need to make sure you don’t have a full-thickness tear of the tendon – caused by the fall. if you do, then surgery may be needed.

      https://sportdoctorlondon.com/bursa-injection/

      Lorenzo

25. rajesh February 8, 2022 at 8:49 am - Reply

    Hi – I have had a cortizone shot in my shoulder and i have suffering from non stop hiccups. This is day 2 …. anything to be concerned? thank you in advance. all your responses are very helpful.

    • hi, yes hiccups are an uncommon side effect of cortisone. However, it should settle in the next few days and is not of concern (apart from being very annoying).
      Lorenzo

26. Anthony Schmit February 13, 2022 at 1:36 am - Reply

    Hello , I injured my finger at work a few weeks ago and now I’m told I have trigger finger . After a visit to an orthopedic surgeon , suggested by my primary care physician he prescribed me a medication and told me if the medication doesn’t work , (we’ll it didn’t work) then I will give you a cortisone injection . My questions are is this safe and how long after the injection can I return to work at 100% after receiving the injection ? How long before I can return to work because at my place of work I can not return to my job at 100% , there is no light duty at my workplace . And could the injury have caused my trigger finger ?Thank you for your time.

27. Adrian February 14, 2022 at 4:21 pm - Reply

    Hi, I had cortisone into my shoulder for bursitis 7 days ago. All has gone great but I jarred it today and my neck has stiffened up again. Do you think this will have undone the injection? Thanks for your help

    • Hi Adrian, I don’t think so. The maximal effect of cortisone injection is between 2-4 weeks. Lorenzo

28. Patricia February 18, 2022 at 11:08 am - Reply

    Hi Lorenzo. I had a fall and grabbed a handle to save myself. My shoulder took full body weight. That was September. In January I lifted my dog and hurt my back. My whole back went into spasm and twisted my spine. Doc put me on Valium which sorted out my back muscles then gave me cortisone injection for my shoulder 10 days ago. I have no idea of what damage has been done but I have a pain down my neck into my back/shoulder blade. I cannot lift arm to side past shoulder or put it up my back. I am trying to exercise when I have good days but then I am in pain the next day. Should I be resting this for a little while or am I best to keep on stretching and exercising? Doc said I can have another cortisone injection 4 to 6 weeks from last one if needed

    • I would always be supportive of exercise over rest. I think rest places you at risk of other problems such as frozen shoulder or general deconditioning.

      • Patricia February 21, 2022 at 12:07 pm - Reply

        Thank you so much for your reply. I am doing exercise 3 times a day then ice. Just wasn’t sure if I should have been doing them just now. No pain no gain right! Appreciate your advice

29. Kathleen February 22, 2022 at 12:13 pm - Reply

    Hello, I received a cortisone injection in my arthritic right hip two weeks ago. I was pain free and able to walk normally for those two weeks. I was thrilled! Now the pain (and limping) has returned. I read your responses to other patients that it may take two weeks for the steroid injection to work. Will the steroid continue to work or do you think that is all the pain relief I will experience? Thank you.

    • hi Kathleen, hard to know. As a general rule, I suggest waiting a full 4 weeks before coming to a conclusion as to whether the cortisone will continue to work.

      Lorenzo

    • Marianne Harris May 1, 2022 at 10:30 am - Reply

      Hi there,
      I had a cortisone injection for bursitis in my left hip,it was good for a couple of days,but it’s back again,can I have another injection

      • Hi Marianne, Generally, I wait about 6 weeks before injecting again. Lorenzo

30. Janet Herman February 23, 2022 at 6:16 pm - Reply

    Hi Doctor Masci,
    I had a total hip replacement 3 months ago, just winding down my outpatient PT. My knee, on same leg, slowly developed increasing pain so same doctor injected a cortisol shot. It’s 2 weeks today and I still have erratic pain in my knee, sometimes achiness to severe pain. My follow up with doc is in 4 more weeks, but I feel it’s not helping as much as I thought. Unless I take 3 ibuprofen an hour before walking I am limited in my walk. What is going on with this knee? I’m so utterly frustrated and thought that by now I’d be well on my way back to my old self.

    • I think you need to give the cortisone a little bit more time to work. The maximum effect of the cortisone shot is ususally 2-4 weeks. At 6 weeks, you’ll know whether the cortisone shot has worked. Lorenzo

31. William February 24, 2022 at 1:09 am - Reply

    I have severe pain in shoulder 2 days later from cortisone shot there, would it be ok to take a ketorolac for pain?

    • so yes – ketorolac or any other anti-inflammatory – Aleve, ibuprofen etc Lorenzo

32. Gem Young February 28, 2022 at 10:15 pm - Reply

    Dear Dr Masci, Thank you for all the above helpful information.
    I suffer with all over chronic pain , and have Lumbar and Cervical spinal Stenosis with generalized OA and Degeneration from my neck to my feet. I have had 2 Lumbar surgeries.
    I get Steroid injections approx every 4 months from my Rheumatologist. These injections are small amounts of steroid into (mostly) soft tissue/trigger points, depending on the most painful areas at the times of the appointments.
    The last 4 appointments have focused on one very painful arthritic foot, and a very painful shoulder girdle – posterior and anterior.
    Is it safe to continue getting these injections long term, as its the only short term relief I get. The foot is getting more difficult to walk on.

    • hi Gem, You need to be careful with long-term use of cortisone. I’d speak to your doctor. it depends on the dose and frequency. Lorenzo

33. Cynthia Madrigal March 17, 2022 at 7:29 pm - Reply

    Last may 2021 had both hips injections it help for 8 months now go for my 2nd injections today March 17 2022
    Help me for 8 months hope help again. I let you know…every body is DIFFERENT

    • Yes, some patients respond to cortisone better than others. The average though is only a few months. LM

34. Kathy moon March 26, 2022 at 3:10 am - Reply

    I had a reaction from a steroid injection yesterday.
    I was given an injection in both hips.
    This morning I awoke with a headache & my face was blushing. Also had a low grade fever.
    Called doctor & was told he was going to call me back but never did
    Is this to be expected?

    • so facial flushing is common, especially in women. This effect lasts for 1-2 days and then settles. It is thought to be due to a histamine-like reaction of cortisone.
      Low-grade fever is less common but could be due to a cortisone injection especially if you’ve had two injections.

      Lorenzo

35. Siobhan Gallagher March 28, 2022 at 10:27 pm - Reply

    HI Dr Masci,

    So impressed with your knowledge and responses here. I had a steroid injection last week for acute sciatica caused by ‘Small left posterolateral L5/S1 disc protrusion with likely left S1 nerve root irritation. Mild mid and lower lumbar facet joint OA’ quote from MRI report. Steroid has given me immediate relief and i am starting to be able to walk again. literally couldin’t walk over the last month.

    My question is – how do i improve and make sure i never get to that point again? what type of exercise, supplements, behaviours can help? im a 57 yr old women in a sedentary job who likes walking but is not sporty. Appreciate any guidance you can give me and pls give me a link to your book as well. Many thanks in advance

    • Thank you for your comment. I’m glad you find it useful.

      i’d suggest you adopt a healthy lifestyle – mild to moderate exercise – either Pilates or Yoga (gentle) are fantastic. Maintain a good weight and stop smoking (if you smoke). Exercise should always be progressive – start light and slowly increase to give your body time to adapt. Good luck!

      LM

36. Nancy Brzak April 12, 2022 at 5:26 am - Reply

    Thank you so much for these shared comments and answers. I had cortisone shot today with ultra sound
    I having a lot of pain and was scared 😱 but after seeing it can last around 4 days I feel more reassured I should be ok by the 22nd of April when I have surgery to reverse a colostomy and remove gallbladder! Please pray it will give me relief thank you and God Bless 🙏

37. Elisabeth April 19, 2022 at 6:02 pm - Reply

    Hello,

    I appreciate the knowledge and support that you provide on this site.

    I have Degenerative Arthritis (since my 20’s). I’ve had injections in both hips & several in the ankle w/out issue 20yrs ago. In between Ive had other replacements & surgeries.

    At 45yrs old I had 2 cortisone injections in my Lumbar Spine (L4 &L5 area) for my leg (w/ a mild flare response) that required nothing more than rest and ibuprofen & had good results. Then branch chain nerve block injections (6) in the mid-lumbar area for burning pain. They were ineffective, but caused no flare issue.

    However, in my shoulder joint (needs to be replaced), I’ve had 2 in office cortisone injections w/ sonogram. Within 2hrs of each shot, pain grew in intensity until all i could do was let out screams. Any movement/touch set off more excruciating spasms & screams of terror. The 2nd injection episode sent me to the ER.

    Do you have any idea why my shoulder joint injections would result in such a violent pain response? The first injection did finally give me relief after a week of being on high powered drugs for the reaction. It lasted 3 months. Its been a week since the 2nd injection and I’m still in pain from the initial flare response. I am not currently on any regular pain meds.

    • Hi Elizabeth, Sorry to hear about your problems.

      Your experience is a little unusual especially as you had the injections with a sonogram.

      You should ask your doctor about the type of cortisone he/she used. When using a drug called Depo-medrol, some patients develop a severe flare. Perhaps your doctor may consider using a different type of cortisone? (another option is Kenalog).

      Lorenzo

      • Donnell Reese April 23, 2022 at 7:36 pm - Reply

        Had a shot on a week ago, still in a lot of pain. And cannot put any weight on knee. This is very frustrating

38. Malorie James May 16, 2022 at 12:10 pm - Reply

39. Elise May 21, 2022 at 1:34 pm - Reply

    I have chronic back issues with stenosis and sciatica. I had a previous injection years ago to relieve pain down the back of my leg and down to the shin. That one worked beautifully. no pain for years. But had another injection at the same site recently and instead of having improved results, the shot re-initiated the pain. Why??

    • injections introduce an element of unpredictability. Sometimes, injections don’t work and in a few cases, they can make your pain worse.

40. Carol Patterson May 30, 2022 at 12:18 pm - Reply

    I’m a 60 year old female and had a hip injection by a physiatrist using ultrasound. Immediately a headache began up my neck and over my entire head and into my eyes. No pain, bruising or swelling in injected hip. Dr’s receptionist suggested I go to urgent care clinic where they asked for a urine sample. When I crouched to get the sample I experienced excruciating pain in the injected hip. Felt like something slid out of place. I slowly moved positions until searing pain decreased. This was day 2. I was given Tylenol 3 for the headache and my face began to flush and burn. Not sure if it was from the injection or codeine. I have had pain since, that radiates into my knee and groin like before the injection. This is day 7. Flushing is gone. Could I have messed with the injection by crouching and pulling something? Should I be resting by lying or sitting? Should I see a physiotherapist to work on what I did? I’m very discouraged.

    • Flushing is a common side effect after a cortisone injection. Headache is unusual.

      if the pain is not settling (or getting worse), I’d suggest contacting your doctor.

41. Marina June 1, 2022 at 11:35 am - Reply

    Hi, I’ve been suggested a cortisol injection in my shoulder for calcification- I’m
    46 and trying to get pregnant… I feel like that might be a bad idea to have the injection?

    • I would speak to your obstertican. But as a general rule, I suggest avoiding medication in the first trimester. However, if you have severe pain, I think the potential benefits outweigh the small risks.

42. Sheila Dunford-Kain June 17, 2022 at 4:20 am - Reply

    Dear Sir, l have had a cortisone injection in my knee, may l still used Ibuprofen gell on that knee please .

    • Yes you can use both treatments together. LM

43. Sandra Mikos October 19, 2022 at 5:09 am - Reply

    I read all your comments doctor and all I can say is that you may be an excellent excuse for a trip to London. You are more knowledgeable then the hundreds of drs. I have seen. I had a laminectomy in my back in2019. Have had back issues since I played professional tennis when I was young and slipped a disc going for a backhand. Ever since then it’s been chiropractor injections therapy walking. The surgery went well and nothing was put in place of the disc. No spacer no metal! Had it done at Duke University. Now May bursitis on my hip is acting up again and I took an injection today. Can only use 1/2 cc because of reaction that gives me super steroid flush and Bpressure high. The dr. Uses dextramethasone. Kenalog lasts longer but last time he used that I didn’t sleep for 2 days. My question is there is a doc that says I need to have a spacer slipped into where the one disc was removed and the go in through the side not to injure the nerves again in the back. Another dr. His parter says I need rod metal plate screws etc. I don’t think so. !!!! No way. I don’t want metal I my back . That’s when things to to go bad. It’s one surgery after that then another and another. The dr that Judy removed the ruptured disc suggest this least invasive approach. It’s been fine for 4 yrs. The dr. Today he thinks it the facet king causing the back pain and wants to try injections in there before for epidural. Also will get a new mri befor anything! Sorry so long Dr. But do you see stints ?? You have an office in Linda??very impressed with you!thanks!

    • Thank you for your comments. As a general rule, I would avoid spacers in the back – they’ve been used in shoulders and feet previously without good results.

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