Yes, it's normal to feel anxious or agitated after a cortisone injection, as corticosteroids can affect brain chemistry, leading to mood changes, restlessness, insomnia, and anxiety, typically lasting a few days but sometimes longer. These neuropsychiatric effects, including anxiety, are known side effects, especially with higher doses, and are due to how steroids interact with stress response systems and neurotransmitters in the brain.
Sometimes, patients feel facial and neck flushing, anxiety, nervousness, mood swings, and trouble sleeping with the use of steroids. These symptoms most often happen within the first 24-48 hours and do not need any treatment. They should go away on their own in a week.
The neuropsychiatric adverse effects of corticosteroids are complex, unpredictable, and often severe, ranging across most categories of psychopathology. Mood lability, anxiety symptoms, cognitive impairments, behavioral disturbances, or psychotic features can present alone or in combination.
Steroid injections can cause anxiety and insomnia as common side effects. Neuropsychiatric symptoms usually appear within a day and resolve within a week.
Common side effects
The most common side effect of hydrocortisone injections is intense pain and swelling in the area where the injection was given. This usually gets better after a few days. You may also get some bruising where the injection was given. This should go away after a few days.
Restlessness. In addition to mood changes, prednisone can increase energy levels. Some people may not mind this side effect, but others may feel unpleasantly jittery. It can also make you feel like it's harder to concentrate.
For most patients, pain relief from a cortisone injection typically begins within 24-72 hours after the shot. The effects often peak within a week and can last anywhere from several weeks to a few months.
Substance-induced anxiety symptoms can last several weeks to a month. It's important to see a provider right away if your symptoms are getting worse or you're having an emergency. If your symptoms are life-threatening, call 911. It's helpful to keep a record of your symptoms to share with your provider.
However, clinicians should be aware that corticosteroid-induced mania and/or psychosis may also develop after short-term exposure with symptoms that can emerge within the first week of treatment in up to 90% of patients (Naber, 1996; Dubovsky et al., 2012; Gable and Depry, 2015; Oray et al., 2016; Sofía-Avendaño-Lopez ...
Anxiety doesn't follow a strict timeline. Some people experience occasional bouts of anxiety, which rapidly dissipate once a stressor is resolved. Others find anxiety lingers until they develop chronic anxiety disorders that require long-term management.
When you sense a threat — whether it's real or imaginary — cortisol levels go up. This rise tells your body to release more glucose (also known as sugar) to give you the energy to handle it. “These changes in blood sugar can make us feel shaky and queasy,” Eckler says.
Certain antidepressants are also used to treat anxiety disorders. An anti-anxiety medication called buspirone may be prescribed. In limited circumstances, your doctor may prescribe other types of medications, such as sedatives, also called benzodiazepines, or beta blockers.
Psychiatric adverse effects of corticosteroid treatment include depression, anxiety, delirium, panic disorder, and many other psychiatric problems. Although psychotropic medication may be required to manage these symptoms, the prognosis improves once the corticosteroids are lowered or eliminated.
Feeling nervous, restless or tense. Having a sense of impending danger, panic or doom. Having an increased heart rate. Breathing rapidly (hyperventilation).
The most common delayed hypersensitivity reaction to corticosteroids is allergic contact dermatitis, which appears following topical corticosteroid treatment [8, 12] (fig. 4). It presents more than 1 hour and up to a few days following corticosteroid exposure as local or systemic erythema/eczema [10, 12, 21, 37–39].
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.
Many different drugs can cause psychosis, especially when taken in large amounts, mixed with other substances or if used over a long period. The substances most likely to cause psychosis are: cannabis. psychedelics, such as LSD and magic mushrooms.
Clinical manifestations Early indicators of steroid-induced psychosis include confusion, perplexity, and agitation that typically occur within the first five days after initiation of treatment (6-7). Patients may go on to develop hallucinations, mania, delusions, and cognitive impairment (2).
The #1 worst habit for anxiety isn't singular, but avoidance (procrastination), poor sleep, and negative thought patterns (like catastrophizing) are top contenders, creating vicious cycles where anxiety fuels these behaviors, and the behaviors, in turn, worsen anxiety by preventing healthy coping and creating more stress. Other significant habits include excessive caffeine, poor diet, too much screen time, and social withdrawal, all disrupting the body's ability to manage stress effectively.
The 30-Second Reset: A Pause That Changes Everything
A short pause—just 30 seconds—gives our nervous system time to calm down and gives us space to choose how we want to show up in the moment. That might mean taking a slow, conscious breath. Relax your shoulders.
Worry excessively about everyday things. Have trouble controlling their worries or feelings of nervousness. Feel irritable or “on edge” frequently. Feel restless or have trouble relaxing.
Compared to cortisone injections, PRP therapy offers several advantages: Reduced risk of side effects: PRP is derived from the patient's own blood, minimizing the risk of allergic reactions or other adverse effects.
The most painful places for a cortisone shot are typically small, sensitive areas with dense nerve endings, like the palm of the hand, sole of the foot (plantar fascia), fingers, toes, or ankle joints, because they have less space for the medicine and more surface nerves compared to larger joints like the shoulder or knee. Pain is also worse if the tissue is already severely inflamed, and the needle size can play a role.