What should you know about safety and timing?

Cortisone shot side effects: what might happen afterward?

Brief soreness or a rise in blood sugar can occur. Flushing means your face may briefly feel warm and look red. Skin near the shot may also become lighter or thinner. Infection and tendon injury are less common but more serious concerns.

Increasing heat, swelling, severe soreness, or fever needs prompt medical care. Before leaving, get clear instructions for the first day. Know which soreness is expected and whom to call. Keep the clinic number with your procedure record.

What changes when you have diabetes?

Blood sugar may climb briefly after a cortisone shot. Tell the clinician how steady your blood sugar has been. Ask how often to check and what reading calls for help. Only the person managing your diabetes should change insulin or other medicine.

How often can you get cortisone shots?

There isn't a single yearly number for all people. A shorter spell of relief after each shot calls for another exam. The joint, your health, the reason for care, and future surgery all matter. Ask what would make the next shot worth repeating or stopping.

What if joint surgery is already being planned?

A cortisone shot in the same joint within three months before replacement was linked with higher infection risk. Tell the surgeon which joint was treated, what was put into it, and the date. You can find the treatment name on your visit papers or ask the clinic. QC Kinetix medical providers perform regenerative treatments by collecting blood or marrow, making it more concentrated, and putting the fluid inside the treated joint.

Sources

1. A review of ten studies found single local corticosteroid injections caused a significant but TRANSIENT rise in blood glucose in patients with diabetes, with no adverse reactions or complications reported, and concluded such injections are most likely safe in people whose diabetes is well controlled.

   Waterbrook AL, et al. — Blood Glucose Levels After Local Musculoskeletal Steroid Injections in Patients With Diabetes Mellitus: A Clinical Review.. Sports Health, 2017. DOI: 10.1177/1941738117702585.

2. A meta-analysis found ipsilateral intra-articular corticosteroid injection within 3 months BEFORE joint arthroplasty was associated with increased periprosthetic joint infection risk, and the authors recommend against performing arthroplasty on a joint injected within that window - while injections given at any time overall showed no such association.

   Lai Q, et al. — Prior Intra-articular Corticosteroid Injection Within 3 Months May Increase the Risk of Deep Infection in Subsequent Joint Arthroplasty: A Meta-analysis.. Clin Orthop Relat Res, 2022. DOI: 10.1097/CORR.0000000000002055.

3. A 2024 AJR review of corticosteroid injection side effects lists local effects (post-injection flare, skin hypopigmentation and atrophy, infection, tendon rupture, accelerated osteoarthritis progression, osseous injury) and systemic effects (adrenal suppression, facial flushing, hypertension, hyperglycaemia, osteoporosis), and calls for targeted pre-injection counselling for specific populations.

   Kamel SI, et al. — Local and Systemic Side Effects of Corticosteroid Injections for Musculoskeletal Indications.. AJR Am J Roentgenol, 2024. DOI: 10.2214/AJR.23.30458.

4. A meta-analysis of 10 RCTs of RECURRENT intra-articular corticosteroid injections (2-8 injections per patient) found they often gave inferior or non-superior relief compared with hyaluronic acid, PRP, saline or orgotein at 3 months and beyond, and no benefit over placebo in pain or function at 12-24 months.

   Donovan RL, et al. — Effects of recurrent intra-articular corticosteroid injections for osteoarthritis at 3 months and beyond: a systematic review and meta-analysis in comparison to other injectables.. Osteoarthritis Cartilage, 2022. DOI: 10.1016/j.joca.2022.07.011.

5. In a controlled cohort of 1,471 patients injected in the hip, 106 (7.2%) developed rapidly progressive idiopathic arthritis; compared with controls they were older, had narrower joint spaces and higher Croft scores before injection - so pre-injection joint severity, not the injectate or the anaesthetic, marked the at-risk group.

   Boutin RD, et al. — Rapidly progressive idiopathic arthritis of the hip: incidence and risk factors in a controlled cohort study of 1471 patients after intra-articular corticosteroid injection.. Skeletal Radiol, 2021. DOI: 10.1007/s00256-021-03815-7.

6. The 2015 Cochrane review of 27 trials (1,767 participants) found intra-articular corticosteroid better than sham for knee OA pain (SMD -0.40, 95% CI -0.58 to -0.22; NNTB 8), but the benefit decayed with time: moderate at 1-2 weeks, small at 13 weeks, and no evidence of any effect at 26 weeks. All outcomes were graded LOW quality.

   Jüni P, et al. — Intra-articular corticosteroid for knee osteoarthritis.. Cochrane Database Syst Rev, 2015. DOI: 10.1002/14651858.CD005328.pub3.

7. A 2021 JAMA review of hip and knee osteoarthritis places intra-articular steroid injections as providing SHORT-TERM pain relief within a management model whose cornerstones are exercise, weight loss if appropriate and education, complemented by topical or oral NSAIDs, with joint replacement reserved for advanced symptoms and structural damage.

   Katz JN, et al. — Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review.. JAMA, 2021. DOI: 10.1001/jama.2020.22171.