Cortisone Injection (cont.)

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What are the disadvantages and side effects of cortisone injections?

Disadvantages of cortisone injections are the necessity of piercing the skin with a needle as well as potential short- and long-term side effects. It should be emphasized that though each of these side effects is possible, they usually do not occur.

Short-term cortisone injections complications are uncommon but include

  • shrinkage (atrophy) and lightening of the color (depigmentation) of the skin at the injection site, introduction of bacterial infection into the body (such as a joint infection), local bleeding from broken blood vessels in the skin or muscle,
  • soreness at the injection site,
  • aggravation of inflammation in the area injected because of reactions to the corticosteroid medication (post-injection flare).

Increased pain after the injection is typically due to a post-injection flare because true allergies to cortisone are very rare. Tendons can be weakened by corticosteroid injections administered in or near tendons. Tendon ruptures as a result have been reported. Facial flushing may occur in up to 40% of cases but lasts only briefly. Sweating and insomnia are uncommon side effects. Nerve damage is a very uncommon side effect.

In people who have diabetes, cortisone injections can elevate the blood sugar level. In patients with underlying infections, cortisone injections can suppress somewhat the body's ability to fight the infection and possibly worsen the infection or may mask the infection by suppressing the symptoms and signs of inflammation. Generally, cortisone injections are used with caution in people with diabetes and avoided in people with active infections. Cortisone injections are also used cautiously in people with a bleeding disorder.

Long-term complications of corticosteroid injections depend on the dose and frequency of the injections. With higher doses and frequent administration, which increases total systemic exposure to the corticosteroid, potential side effects include

Are there special side effects that can occur with cortisone joint injections?

Cortisone injections into a joint may have side effects in addition to those described above. Unique side effects of joint injections involve injury to the joint tissues, particularly with repeated injections. These injuries include thinning of the joint cartilage, weakening of the ligaments of the joint, increased inflammation in the joint (arthritis) due to a reaction to a corticosteroid that has crystallized, and introduction of infection into the joint.

Medically Reviewed by a Doctor on 8/11/2015

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