Cortisone Injection

Your doctor will determine which type and method of corticosteroid injection is best for you based on a variety of factors. These include your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different corticosteroid injections and ask why your doctor will use a particular type for you.

Will I feel pain with a cortisone injection?

Your comfort and relaxation is very important to both you and your care team. You may feela brief pinch or prick during the needle insertion. Take a few long, deep breaths to help yourself relax. If any discomfort does not pass quickly, tell a member of your healthcare team.

Types of anesthesia that may be used

If your doctor is performing an epidural, intra-articular, or intralesional injection, he or she will most likely use a small amount of local anesthetic. The local anesthetic numbs your skin before the actual corticosteroid injection. In addition, your doctor may combine the corticosteroid with more local anesthetic for the injection. You will be awake, but kept as comfortable as possible during the procedure.

What are the risks and potential complications of a cortisone injection? 

General risks and potential complications of corticosteroid injections include:

• Adrenal suppression or problems with your adrenal gland
• Bleeding or bruising
• Cartilage or nerve damage
• Increased blood sugar
• Infection
• Injection site reactions including swelling, tenderness and warmth
• Menstrual changes
• Post-injection steroid flare, which is pain from a reaction to the crystallized structure of the steroid
• Skin discoloration and skin or fat atrophy (abnormal shrinkage)
• Sleep problems
• Spinal headache with epidural injections
• Weakened tendons, ligaments, bones and cartilage with repeated intra-articular injections

Reducing your risk of complications

You can reduce the risk of certain complications by:

• Ensuring that all members of your care team are aware of any allergies you have
• Following activity, dietary and lifestyle restrictions and recommendations
• Keeping all scheduled appointments
• Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain
• Informing your doctor if you are nursing or if there is any possibility that you may be pregnant
• Taking your medications exactly as directed

How do I prepare for my cortisone injection?

If you dread the thought of undergoing injections, you are not alone. Remember that you are a very important member of your own healthcare team. The steps you take before your corticosteroid injection can improve your comfort level and help your doctor get the best treatment results. You can best prepare yourself for a corticosteroid injection by:

• Answering all questions about your medical history and medications you take. This includes prescribed medications, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications and allergies at all times.
• Following any restrictions or recommendations about eating or drinking just prior to your procedure or treatment as directed.
• Getting any necessary testing as directed. Testing will vary depending on your age, health and diagnosis. Testing may include X-rays or other imaging tests, electrocardiography (ECG), blood tests, and other tests as needed.
• Taking or stopping medications exactly as directed. For certain corticosteroid injections, this may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.

Questions to ask your doctor

Preparing for a corticosteroid injection can be stressful. It is common for patients to forget some of their questions during a brief doctor’s office visit. You may also think of other questions after your appointment. Feel free to contact your doctor with any concerns between appointments. You should also write down your questions and bring the list to your appointment. Common questions include: