In the US, prevalence of arthritis is relatively high, with an estimated 54 million adults reportedly being diagnosed with the condition. This accounts for almost 23% of the adults in the US, which means that one out of every 5 adults are diagnosed with the condition. Among the various treatment options, cortisone shots are considered as a good choice to help relieve inflammation. Known as corticosteroids, the shots are typically a synthetic formulation of the cortisol hormone. Medications, intended for various desired outcomes, come with the possibility of side effects and cortisone is no exception. Here is a detailed look at the side effects of cortisone shot and measures to prevent or mitigate the same.

Overview and side effects of cortisone shot

The steroid is not to be confused with pain killers or relievers. The mechanism of action of the steroids or corticosteroids are different and the outcome is relief from pain. The primary mechanism of action of the corticosteroids is reduction in inflammation. When there is a reduction in the inflammation in the joints, this results in a reduction in pain, thereby offering relief. However, cortisone shots are not to be classified as pain relievers. The shots are typically administered to manage inflammation in specific areas of the body. For instance, inflammation of the joints or tendons. In certain instances, the shots are also intended to treat inflammation that extends to various parts of the body. This is typically, when inflammation is the outcome of allergic reactions, such as asthma or rheumatoid arthritis.

Before we look at the side effects of cortisone shot it is necessary to understand the specific conditions that are treated or managed with the injections. This will help identify the situations when individuals are likely to experience side effects o undesirable effects of the shots. Cortisone injections are administered when patients experience various conditions such as tendinitis, or bursitis, or gout. Other conditions that are managed with cortisone shots include back pain, osteoarthritis and rheumatoid arthritis. The injections are known to offer swift relief from inflammation and the ensuing pain associate with the conditions. The injections are administered on the joints that are inflamed. In addition to the above conditions, cortisone injections are also recommended for managing reactive arthritis and psoriatic arthritis.

Commonly reported side effects of cortisone shot

The possibility of patients experiencing side effects of cortisone shot is higher among individuals who are required to take heavier doses. This risk is also elevated for patients who are required to take the corticosteroids for a longer duration. It is important to note that all patients receiving cortisone shots will not necessarily experience side effects. Some patients may experience side effects and the intensity of the side effects r the duration may actually differ from person to person depending on various parameters.

Side effects of cortisone shot that are frequently reported include damage to the nerves and in many instances, there are infections of the joints experienced by patients. Other adverse effects include damage to the cartilage, and there are instances of individuals ending up with a sudden and temporary increase in inflammation in the joints. This sudden inflammation in the joints where the injection is administered, may also cause pain to the individuals. This may be temporary in nature and is known to subside naturally without the need for any particular intervention. A rise in blood sugar levels is another possibility that is attributed to the use of cortisone shots, as the mechanism of action of the corticosteroid triggers a spike in blood glucose. This is also temporary in nature and will resolve naturally.

Other commonly reported side effects of cortisone shot include a possible impact on adjacent bone. The bone adjacent to the site of injection is sometimes known to be affected severely, resulting in bone death. In certain instances, while bone death may not actually occur, it may result in osteoporosis – the condition where the bone density is significantly reduced. A weakening of the tendons is another eventuality and this could also result in a rupture of the tendon, after a period. The area around the site of administration of the cortisone injection may also witness a thinning of the skin. This is also known to impact the soft tissue around the site of administration of injection. In addition to the above possible undesirable effects, individuals are also known to experience flushing in the face, which is again temporary in nature and will resolve naturally. In certain instances, there is the possibility of a slight lightening of the skin around the site of administration of the injection. The area around the injection site may appear whiter than other areas of the body, as a result of the lightening of the skin.

Side effects of cortisone shot that are experienced by women alone

One of the unusual outcomes of the injections are side effects of cortisone shot that are experienced by women alone. Men are not typically known to experience any of side effects that are listed out in this section. The most common side effect that is experienced by women includes irregular menstruation which can impact routines of women in certain professions. Similarly, women who are nursing infants are likely to experience changes in lactation that may impact breast feeding. This needs medical attention as it involves the health of the child.

Other side effects of cortisone shot that are exclusive to women include a sudden and abnormal excessive growth of hair that is not attributed to other reasons. Similarly, flushing of the skin is another possible experience among women. These side effects may not necessarily impact all women, but may be limited to a small section of women on the medication. Similarly, these undesirable effects may not impact all breast-feeding women or menstruating women. Importantly, these side effects are not common in nature, but are remote possibilities that have been observed and documented in a smaller number of individuals on the injections.

Tips to avoid side effects of cortisone shot by limiting the number of shots

As listed out above, the side effects of cortisone shot include damage to the cartilage and other undesirable effects. It is therefore necessary to ensure that the number of injections to the joints are limited. This will prevent adverse effects that are attributed to heavy dosage or frequent use of cortisone shots. Typically, cortisone injections are not to be administered more than thrice or four times per year. Similarly, the frequency or duration between two injections should be more than six weeks. It is essential to understand that the frequency between two injections should not be considered as a method of calculating number of injections per year. The maximum number of cortisone shorts per year should not exceed 4, while the gap between two consecutive shots should not be less than 6 weeks.

Precautions to avoid side effects of cortisone shot

In addition to the above measures that are necessary for avoiding side effects of cortisone shot, there are other precautions that need to be followed. For instance, individuals on blood thinners are advised to discontinue the blood thinners for a particular period prior to taking the cortisone shots. This is mainly for the purpose of preventing bleeding or to prevent the risk of bruising that is possible as a result of the interaction or mechanism of action. Similarly, certain supplements also work like blood thinners and this exposes the individual to the risk of bleeding or bruising when cortisone injections are administered. As mentioned in the above section, the area around the site of injection thins and the skin is likely to turn soft. This exposes the individual to risk of bleeding and bruising. When an individual on blood thinners takes cortisone injections, this could cause adverse effects. For instance, bleeding will be difficult to control if the thin skin bruises. To avoid risk of bleeding and bruising, it is necessary to seek medical opinion about the medications that need to be avoided. It is necessary to also inform the treating specialist about consumption of supplements and herbal formulations.

Possibilities during the actual administration of cortisone shots

Patients taking cortisone injections are to be prepared for certain possibilities. For instance, individuals with diabetes are likely to witness a spike in blood sugar levels immediately after the injection. Others are likely to experience some kind of warmth on the chest and face. Additionally, individuals may also experience a discernible flushing in the face and chest, that could turn slightly red. To avoid some of the side effects of cortisone shot mentioned in section above, it is necessary to follow certain practices or precautions, that will minimise the risk of certain effects. To avoid bruising or bleeding, a simple precaution is to avoid lifting heavy objects and to stay away from activities where the site of injection may be exposed to heavy strain.

The use of cold compress or ice is recommended to reduce the pain experience at the site. It is important to note that the use of hot packs is to be avoided. Many individuals are known to apply warm or hot packs on injection sites to relive pain. This is not to be used on cortisone injection sites. By extension, it is necessary for patients who have received cortisone shot to avoid bathtubs and jacuzzi or any other relaxation/cleansing option that uses heat. The 48-hour period immediately after the administration of injection is the period that requires utmost care. During this window, it is necessary to be on the lookout for swelling, or pain stimuli or flushing. This will indicate the onset of side effects of cortisone shot.

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