With hydrocortisone injections, the medicine is placed directly into the painful or swollen joint. It does not travel through the rest of your body. That means, it's less likely to cause side effects. Sometimes, though, hydrocortisone from a joint injection can get into your blood.
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.
Risks / Benefits
Doctors monitor blood sugar levels to make sure they are stable before delivering a cortisone injection. Cortisone may also (more rarely) cause osteoporosis (low bone density), fluid retention (swelling of the limbs and congestion in the lungs), high blood pressure, and alterations in mood.
Cortisone injections are most commonly delivered to joints, including those in the hip, knee, shoulder, spine, or wrist, to tamp down inflammation and pain—with the goal of getting people back to their everyday activities.
You can only have three cortisone injections in a lifetime
Generally, if the first injection doesn't work, the second and third probably won't either. Moreover, you should limit yourself to 2-3 injections in one area over 3-6 months.
Many people are curious about what differentiates a steroid injection from a cortisone shot. When discussing steroid and cortisone injections for orthopedic related conditions, the two terms are referring to the same injection product.
Q: What are the possible side effects of cortisone shots? A: While cartilage damage, bone death, joint infection and nerve damage are possible, if the shot is done by an experienced doctor, those complications are exceedingly rare.
Enter – PRP, or platelet-rich plasma. PRP injections offer a viable alternative to corticosteroid injections, without all of the nasty side effects.
However, the effects aren't permanent; they can last anywhere from a few weeks to six months. In that sense, cortisone does not represent a cure, merely a temporary way to mitigate pain and swelling.
Rest Up!
While some people experience relief right away, the full effects of the injection may not be noticeable for 1-3 days after the procedure. If patients feel pain at the injection site during this time, we recommend using an ice pack or taking pain medication until it subsides.
Arrhythmias: Studies have shown that the use of corticosteroids, particularly in high doses, is associated with a greater risk of heart arrhythmia known as atrial fibrillation. In this abnormal heart pattern, the heart beats irregularly, and the blood flow to the brain can be impaired, increasing the risk of stroke.
A corticosteroid injection will usually take 3 to 7 days to begin to have a positive effect. It may take up to two weeks for the medicine to decrease the inflammation to a point where pain is improved. The full benefit of the corticosteroid may not be felt until 6 weeks after injection.
Repeated shots can eventually damage skin and other tissues. Small amounts of cortisone that have been injected into a joint can get into the rest of the body and have hormone-like effects that make diabetes harder to control. There's also the slight risk of the shots leading to an infection of the joint.
Weight and physical appearance
Description: corticosteroids are known to frequently cause weight gain in patients. This gain is is usually moderate, consisting of 1 to 2 kilograms of added mass.
You should not use cortisone if you are allergic to it, or if you have a fungal infection anywhere in your body. Steroids can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have.
As a general rule, patients advised receiving a steroid injection into a joint are cautioned against any heavy lifting or exercise. But after 10 days to two weeks, they are encouraged to start gentle range-of-motion exercises and to remain active as tolerated.
During a “flare-up,” the cortisone crystallizes in the joint, causing a lot of pain. Icing the area after the injection can reduce the “flare-up” within a day or two. The cause of this flare up is through the corticosteroids that are injected into the joint during the procedure.
Studies show hyaluronic acid injections may work better than painkillers for some people with OA. Other studies have shown they also may work as well as corticosteroid knee injections. Hyaluronic acid injections seem to work better in some people than others.
Short-acting products such as hydrocortisone are the least potent. Prednisone and methylprednisolone, which are intermediate-acting products, are four to five times more potent than hydrocortisone.
You may be able to have a hydrocortisone injection into the same joint up to 4 times in a year. The number of injections you need depends on the area being treated and how strong the dose is. If you have arthritis, this type of treatment is only used when just a few joints are affected.
The use of corticosteroids is strongly associated to the development of psychiatric/neurological side effects. These effects are due to the wide expression of GR in the brain, and their long-term modulation can lead to functional and anatomical alterations, which might be responsible for the observed side-effects.
Adverse effects such as paraplegia, quadriplegia, spinal cord infarction, and stroke have all been reported from epidural glucocorticoid injections.
Typically, corticosteroid injections are not given more often than every six weeks, and usually not more than three or four times a year. But these are only guidelines. A patient's situation dictates the timing and frequency of treatment.
Some patients may experience a “cortisone flare” after their injection. This happens when the cortisone crystallizes and causes pain for a day or two. The pain may be worse than what you were living with before the shot. This is not a dangerous side effect, but it is uncomfortable.