What You Need to Know About Getting a Cortisone Shot

No, they're not used just for arthritis. Here's how cortisone shots can help ease inflammation—and pain—in your joints.

A tennis player with elbow pain in front of cortisone shots
Photo: didesign021/Yulia Reznikov/Getty

Just like your mattress or your car, your body is going to experience some wear and tear over time. Your bed might lose its initial bounce in the spot you sleep in every night, and your knees might slowly begin to ache after years of trail running and marathon training. Your sweet ride might not take off as fast as it used to, and your shoulders could start gnawing with pain, thanks to all those push-ups you've been doing in the gym for the past 10 years.

But unlike your valued possessions, there's no replacement option or warranty for the joints. So what can you do to make your joints feel like they're brand new again? Get a cortisone shot.

What Is a Cortisone Shot, Exactly?

Think back to your high school health class, and you'll remember that your body naturally produces cortisol, a steroid hormone responsible for controlling the body's blood sugar levels, influencing blood pressure, and most importantly (in this case), acting as an anti-inflammatory.

The cortisone shots your doctor injects, however, aren't *exactly* the same as the cortisol found in your body. Instead, they're made from a mix of corticosteroid medications (man-made drugs that closely resemble cortisol—cortisone is a type of corticosteroid) and a local anesthetic that acts as a numbing agent, according to the Mayo Clinic. This blend is typically injected around inflamed tissue (think: red, swollen, and tender areas) with the goal of decreasing the inflammation, which usually causes pain, says Charles Kim, M.D., a physiatrist and pain management specialist at the Joint Preservation & Arthritis Center at NYU Langone Health. Inflammation that's treated with a cortisone shot typically occurs in the tendons, joints, and nerves, adds Dr. Kim, though you can also use a cortisone shot in the bursa (fluid-filled sacs between joints, tendons, and bones), according to Cleveland Clinic. (

And while cortisone shots are often used to relieve arthritis symptoms in old, creaky joints, that's not their only use case. For example, cortisone shots in the heels can help treat plantar fasciitis, injections in the thumbs can treat tendonitis (aka trigger thumb), and shots in the knees can ease pain from marathon training, says Janette Nesheiwat, M.D., a family and emergency medicine doctor and the medical director for CityMD. Simply put, anywhere you're dealing with inflammation, you can use a cortisone shot to ease your gnawing pain. "Think of [a cortisone shot] as taking a water hose and spraying out a tiny fire," says Dr. Nesheiwat. "You're reducing inflammation."

Just because cortisone shots can help ease a ton of conditions doesn't mean they should be used all the time and are 100 percent safe for everyone, though. For starters, they're not the first-resort treatment, says Dr. Nesheiwat. "[Cortisone shots are used] after conservative measures have not provided significant relief of symptoms," she explains. So before you head to the doctor to treat some one-time knee pain with a quickie injection, you'll first want to try taking a break from running, icing the sore area, compressing the area, and taking ibuprofen to ease the aches, she says.

If you're seriously ill, have a weak immune system, an active infection, uncontrolled diabetes, or an underlying medical condition that you're treating with other medication, a cortisone shot could do more harm than good. The reason: Steroids like cortisone can further weaken the immune system and increase blood sugar, and some medications can interfere with the cortisone and cause adverse side effects, says Dr. Nesheiwat. For example, cortisone and other steroids can actually exacerbate the thinning of the blood to unsafe levels in people who take blood thinners. That's why it's a good idea to first talk to your doctor and together determine the best management and treatment plan for you, she says.

And FYI, shots are just one of the many ways you can get the benefits of corticosteroid medications. You can get cortisone eye drops to deal with inflammatory conditions in the eye like uveitis (inflammation of the eye's middle layer), cortisone oral rinses to treat ulcers in the mouth, and even cortisone pills to treat, in combination with antibiotics, external ear infections with swelling, says Dr. Nesheiwat. (Not to mention, dermatologists often use or recommend OTC cortisone cream for a number of skin issues, from acne to rashes.)

What’s It Like to Get a Cortisone Shot

Once your doctor gives you the OK and you decide to go ahead with the cortisone shot treatment, you'll want to do some light prep work before you arrive for your appointment. Make sure the affected area and skin is free of body lotion and perfumes, which can potentially cause a bacterial infection if it gets inside the body during the injection, says Dr. Nesheiwat. You also want to make sure you don't have a sunburn, which means the skin is already extra sensitive and could make it more prone to injury, she adds. (Not to mention, sunburned skin already kills if you just look at it the wrong way.)

At your appointment, your doctor will first sterilize the area with a topical antiseptic to help prevent infection. Then, they'll refer to an x-ray, ultrasound, or CT scan to see that the needle goes into the exact right spot, most commonly for hip or spine injections, or they'll insert the needle "blindly," or without any of these references, explains Dr. Kim. (Your doctor will know what's necessary depending on the site and situation.) They'll swiftly inject the cortisone shot and voilà—you're good to go, says Dr. Nesheiwat.

If you tear up every time you get your annual flu shot, don't fret: Cortisone shots are relatively painless, with Dr. Nesheiwat describing them as uncomfortable at the worst. "It's just like a pressure," she explains. "Since it's mixed with numbing medicine, you might feel discomfort for one or two seconds, but the benefits definitely outweigh those few moments of discomfort." You might also feel a bit of tingling, but Dr. Nesheiwat stresses that it's completely normal and will go away.

Later on, you could feel a little sore at the injection site, and you'll want to keep it dry for about 24 hours (i.e. no baths or swimming for you) and avoid strenuous activities, says Dr. Kim. As the aches and pains melt away, you'll probably be tempted to get back to the tennis courts or your high-impact workout routine. If you choose to do so, take it easy and use your pain-free period as an opportunity to re-establish proper movement patterns that won't aggravate your joints and tendons in the future. But know that this isn't a free-for-all: Overdoing these repetitive motions can put you right back where you started, says Dr. Nesheiwat.

"Some people feel better, and then they go back to regular activities without being mindful, and then they forget that what they're doing caused the discomfort in the first place," says Dr. Nesheiwat. "So even if you're feeling better, still be careful not to overdo it...and be mindful of anything that you know exacerbates your joints." After all, cortisone shots aren't a silver bullet. Yes, they temporarily ease swelling and pain by decreasing the production of chemicals that cause inflammation, but they're often just one part of your greater treatment plan to achieve long-lasting pain relief and fix the root of your problems.

What Are the Cortisone Shot Side Effects?

Just like that buzzy feeling you get when you drink one too many lattes, you might feel flushed and a little jittery right after getting a cortisone shot, but that feeling is totally normal and temporary, says Dr. Nesheiwat. While uncommon, it is possible to see some bleeding or bruising at the injection site, says Dr. Kim. And bacterial infections can happen if the skin is dirty, adds Dr. Nesheiwat. Those with diabetes may experience a slight rise in blood sugar—another reason why it's super important to discuss cortisone shots with your doc before you follow through with one.

The potential cortisone shot side effects get a little riskier if you start getting them too frequently. Cortisone injections take place in a very small area of tissue, and while most of the medication is absorbed by the body, it does leave a little bit of residue that can cause irritation to the tendons and ligaments, and potentially bone damage, if you have too many injections, says Dr. Nesheiwat. "You always want to do the minimum; the most minimal amounts to get the job done," she says. "We don't want potential secondary side effects like cartilage damage or nerve damage." That's why Dr. Nesheiwat recommends getting just a few cortisone shots a year. (Some doctors recommend that patients do not get more than three cortisone shots per lifetime in the same spot, but most of these limitation claims are not fully validated by research, says Dr. Kim.)

How Long Does a Cortisone Shot Last?

How quickly the cortisone shot kicks in varies from person to person, but if your doctor mixes the medication with a numbing agent, you could feel relief within minutes. Otherwise, you could notice a difference in pain levels within a few hours or a few days, says Dr. Nesheiwat.

The same goes for how long cortisone shots last. For Dr. Nesheiwat, who got a cortisone shot herself in her elbow and continued to ice the area after she got the injection, the relief lasted roughly eight months. But, again, everyone is different, and a cortisone shot may last a few months in some people or a year in others, she says.

Alternatives to Cortisone Shots

If the big, scary needles of your childhood check-ups still haunt you, know that cortisone shots are just one of many tools in the shed. The biggest and best alternative: non-steroidal anti-inflammatory drugs, aka NSAIDS, says Dr. Nesheiwat. These drugs—including over-the-counter varieties such as aspirin and ibuprofen—help reduce inflammation, and thus pain, just as cortisone shots do. Plus, there are NSAID prescriptions used specifically to treat arthritis, bursitis, and tendonitis—common inflammatory conditions that can be treated with cortisone shots, according to the Mayo Clinic.

Despite their ease of use, NSAIDs do come with a few drawbacks. They can relieve pain within a few hours, but it can take up to two weeks for the drug to reduce any swelling and inflammation in the joints, according to the Arthritis Foundation. And if you don't take the NSAID with food, even just for a few doses, you could develop a stomach ulcer, says Dr. Nesheiwat. To combat this, she recommends patients who are taking an NSAID for an entire week or who have significant inflammation and are using a high-dose NSAID also take an over-the-counter stomach protector such as Pepcid.

Innovative medical treatments and traditional practices are also being explored. Some doctors are using platelet-rich plasma (PRP) and stem cell injectionsto treat the same conditions as a cortisone shot would. "These are derived from one's own blood and tissue [in order] to isolate concentrated 'healing' chemicals that our own bodies produce," says Dr. Kim. With a PRP treatment, platelets are removed from the blood and injected into the affected area. The growth factors within the platelets release at the site and stimulate the tissue to heal itself. On the same token, stem cells (aka the cells that produce all other cells with specialized functions) can be injected. The stem cells will generate certain healthy cells that will eventually repair damaged tissue, according to the Mayo Clinic. The downside: These treatments are typically expensive, many insurances don't cover them, and research is still lacking to fully back them up, he says.

You can also try acupuncture, which is believed to work by stimulating your body's own healing mechanisms, explains Dr. Kim. Recent research has been positive and supportive in favor of its anti-inflammatory effects, and an increasing number of insurance plans are covering the procedure, he says.

For a more bread-and-butter approach, turn to RICE—rest, ice, compression (i.e. wearing a brace or ACE wrap), and elevation. This treatment is pretty temporary (no one expects you to ice your joints every time you play tennis for the next few decades), but it will give you enough relief and time to come up with a longer-term game plan with your doc. And remember, preventing the inflammation in the first place is always your best bet. "The key is to take care of your body and not overdo it," says Dr. Nesheiwat. "Then try to take action early if you're feeling some pain, rest that area, ice it, consider a wrap, and maybe a little anti-inflammatory to keep you out of the doctor's office."

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