Cortisone injection reactions can include soreness and bleeding at the injection site, along with facial flushing. People can also experience some unusual side effects like tissue atrophy and a phenomenon called cortisone flare, where the pain actually gets worse. Long-term cortisone use tends to carry more risks for patients, and it is important to discuss maintenance injections with a doctor to see if there are any available alternatives.
Cortisone injections usually contain a mixture of cortisone and novocaine. The novocaine works as a local anesthetic for immediate relief while the cortisone acts to suppress inflammation. Injections can be given in most areas of the body to treat muscle and joint pain if they do not respond to other means of treatment. It is important to avoid injection into the nerves, as cortisone injections do not mix well with the nervous system.
The most common reactions to a cortisone injection occur because the doctor has to break the patient's skin with a needle. Some patients notice pain, soreness, or bleeding at the injection site. They can also experience infections if bacteria manage to enter the break in the skin. This will cause the area to change color and turn warm, and the patient may notice a smelly discharge.
Repeat cortisone injections can weaken tendons, leading to loss of dexterity. Cortisone injection reactions may also cause skin depigmentation, where lighter patches of skin appear around the injection site, along with atrophy, as the underlying layer of fat disappears. This can cause the skin to turn pitted or lumpy, or may result in a situation where extremities become asymmetrical because one shrinks as a result of cortisone injections.
In patients who get repeat injections for chronic inflammation and pain, a doctor may recommend other options like physical therapy, alternative medications, icing, and changes to work habits. Doctors want to avoid giving patients too many cortisone injections, as these can increase the risk of more serious side effects.
Patients with diabetes can experience cortisone injection reactions related to their diabetes. Sometimes the cortisone causes blood sugar to rise and may endanger a patient who does not monitor and address blood sugar levels. In cortisone flare, one of the more unusual cortisone injection reactions, patients experience a flareup after the injection before the pain subsides. Some patients view the flare as a good thing, as it shows that the area is responding to the injection, and the pain should go down within a day or so.