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Cortisone injections are often used to treat orthopedic conditions such as arthritis and tendonitis. Cortisone is a powerful medication that can help reduce swelling and inflammation. This, in turn, can decrease pain. Cortisone shots usually take effect in about five days.

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Cortisone shots start to work very quickly. Still, it's different for each person. Some people report immediate relief and others say it takes a few days. For some, it can take weeks for symptoms to improve.

This article provides details about cortisone shots, how they work, and common side effects. Understanding these facts can help you know what to expect if you get a cortisone shot.

How Cortisone Works

Cortisone shots work by decreasing inflammation. In people with conditions like tendonitis, bursitis, and arthritis, pain is caused by inflammation. Once the inflammation subsides, pain relief follows.

A cortisone shot starts to work immediately. Inflammation usually improves within a few days. Pain relief can come within a few days to a few weeks, depending on how quickly the inflammation settles. Most people who have had a cortisone shot say the pain gets better over a span of days to weeks.

The amount of inflammation, the type of injection, and other factors can all affect how quickly you feel relief. If your inflammation is severe, or if it's been around a long time (chronic), the shot may take longer to work. In some cases, you may need more than one dose.

Cortisone shots are effective for lots of common inflammatory conditions. But not all people respond to them.

If your shot hasn't worked after a few weeks, let your healthcare provider know so you can discuss the next steps in treatment.

Click Play to Learn What to Do If a Cortisone Shot Doesn't Work

How Cortisone Is Given

Different types of cortisone vary in terms of how strong they are, how long they last, and how well they dissolve in water.

Cortisone can be taken as an oral medication. It can also be injected into a muscle or joint. For bone and joint conditions, cortisone shots are given in the specific spots where there's inflammation.

Cortisone is often mixed with a local anesthetic (a numbing medication). The anesthetic can help to relieve pain. It also makes getting the shot itself a little less uncomfortable.

Your healthcare provider will clean the skin over the area being injected. Then your healthcare provider will inject the medication where it is needed—often a joint or tendon sheath. Your healthcare provider can be sure they have the needle in the proper place if it meets the right amount of tension.

After the injection, the needle is removed, and a simple Band-Aid is placed over the site. You might have a tiny amount of bleeding. If you're taking a blood thinning medication, you may have a little more bleeding at the injection site.

When Relief Is Quick

Cortisone typically takes a few days or longer to begin to take effect. Even so, many patients report almost immediate relief after an injection.

There are two possible reasons why pain relief is quicker for some people. The most common reason is that the healthcare provider has mixed an anesthetic medication, such as lidocaine or marcaine, with the cortisone.

These local anesthetics work right away. In fact, many healthcare providers will use this effect as a test to make sure the medication went into the right spot. If the problem was numbed by the injection, then your healthcare provider can be confident the cortisone was delivered to the proper location.

The other reason why some people feel better faster is that sometimes the healthcare provider also removes fluid from a swollen joint. For example, many patients with a swollen knee have the fluid drained from the joint just before the shot. Having the fluid removed from the joint can bring dramatic pain relief.

Side Effects

Some patients react to the injection with what is called a cortisone flare. A cortisone flare is a condition where the injected cortisone forms crystals. This can cause a brief period of pain that is worse than before the shot. The discomfort usually lasts a day or two. It can be treated by icing and resting the injected area.

Other side effects are possible but uncommon. These could include skin color changes, increased blood sugar, allergic reactions, and more.

Most patients find cortisone helpful in treating orthopedic conditions, but it doesn't work for everyone.

Summary

Cortisone shots can reduce inflammation, a common cause of joint and tendon pain. For many people, relief begins immediately, but the length of time it takes to experience pain relief may vary from days to weeks.

If your healthcare provider mixes a local numbing agent in with the cortisone, you could feel relief immediately. Relief may also be quicker if your doctor drains fluid from a swollen joint. On the other hand, your pain could temporarily get worse if you have a reaction called a cortisone flare. If that happens, ice and rest will help.

A Word From Verywell

If you haven't experienced pain relief, it's possible you haven't given the shot long enough to take effect. It could also mean the cortisone isn't relieving enough of the inflammation. After a few weeks without relief, call your healthcare provider to see what the next steps should be in your treatment plan.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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2. Nuelle CW, Cook CR, Stoker AM, Cook JL, Sherman SL. In vivo toxicity of local anesthetics and corticosteroids on supraspinatus tenocyte cell viability and metabolism. Iowa Orthop J. 2018;38:107-112.

3. Bhatia D, Bejarano T, Novo M. Current interventions in the management of knee osteoarthritis. J Pharm Bioallied Sci. 2013;5(1):30-8. doi:10.4103/0975-7406.106561

4. Fawi HMT, Hossain M, Matthews TJW. The incidence of flare reaction and short-term outcome following steroid injection in the shoulder. Shoulder Elbow. 2017;9(3):188-194. doi:10.1177/1758573217693808

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.

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Source: https://www.verywellhealth.com/cortisone-injection-effects-2549712

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