Cortisone injections are used for the treatment of many different orthopedic problems including arthritis, tendonitis, and bursitis. Cortisone is an anti-inflammatory medication, not a pain killer. However, by reducing inflammation, pain often subsides. Cortisone injections are very safe to perform. Side effects tend to be rare and minor. However, there are a few potential side effects of a cortisone injection that patients should know about.
In addition, often doctors are not keenly aware of the side-effects of cortisone as these tend to be limited (they resolve in a short amount of time) and your doctor may not see these effects as they tend to occur long after the patient has left the office. Many patients feel as though their doctor doesn't care about these sometimes significant consequences of cortisone. Therefore, it's important that patients be aware of the possible side-effects of any medication they take, and inform their doctor if these occur.
Systemic Side Effects
Systemic side effects occur as a result of a small amount of the cortisone entering the bloodstream and affecting your entire body, not just the location where the cortisone was given.
Systemic side effects of a local injection of cortisone are rare and usually minor. Unlike taking oral steroids, or having cortisone injected directly into the bloodstream, only a small amount of a local injection is absorbed by the body. And since the body actually produces cortisone naturally, most people do not experience systemic effects. Those who do may experience:
- Elevated Blood Sugar
The most common systemic reaction is seen in diabetic patients. Patients with diabetes should carefully monitor their blood sugar as cortisone can cause a temporary rise in their levels. Patients taking insulin should be especially careful, checking their blood sugar often and adjusting the insulin doses, if necessary.
- Facial Flushing
Patients may experience flushing sensation and redness of their face. This reaction is more common in women and is seen into up to 15 percent of patients. This can begin within a few hours of the injection and may last for a few days.
Local Side Effects
Local side effects are those that are only experienced in one area of the body. The local side effects of a cortisone injection are also rare.
Whenever there is a break in the skin, like when a needle is used to administer cortisone, there is a chance of infection. Your doctor will sterilize the skin to minimize the risk of infection.
- Skin Pigment Changes
Patients with darker skin should also be aware that cortisone may cause skin around the injection site to lighten. This is not harmful.
- Loss of Fatty Tissue
High doses of cortisone can have detrimental effects on some tissues in the body. When injected into fatty tissue, cortisone can lead to a problem called fat atrophy. Fat atrophy causes loss of fatty tissue, which can lead to dimpling of the skin or the thinning out of fat. Patients who get cortisone injections in the heel to treat plantar fasciitis may find walking painful as fat that usually cushions their steps may thin out.
- Tendon Rupture
Cortisone can also cause weakening of tendons. This is one reason your doctor may limit the number of cortisone injections administered. Cortisone can also lead to tendon rupture, as is the case when cortisone is injected for Achilles tendonitis.