One of the most common treatments for joint pain, inflammation, and allergic reactions in a specific area of the body is to receive cortisone injections. Cortisone is a steroid which can be taken orally, applied to the skin, or injected. Because cortisone injections provide near-instant relief and can last for months, they have become the go-to treatment for arthritis and other inflammatory joint conditions. However, these injections can have horrible side effects, making them a somewhat risky endeavor.
Cortisone belongs to a broad class of medications known as corticosteroids. These medications and other steroids have been found to cause a variety of mood changes in some individuals. While these mood changes are usually minor, sometimes they can be quite serious. Typically mood-related side effects include irritability, anxiety, memory loss, and difficulty concentrating. In some rare cases, however, more serious effects have been reported including paranoia, delusions, or depression. The risk and severity of any mood changes depends on the dosage of cortisone administered.
Insomnia is one of the most common side effects of cortisone, as reported by forty to fifty percent of cortisone patients in some studies. Steroids such as cortisone can have a strong effect on the adrenal glands, responsible for regulating the body’s level of adrenaline. Too much adrenaline can cause sleeplessness and restlessness, a common cause of insomnia for many individuals on corticosteroids. To avoid insomnia associated with cortisone injections, injections should be scheduled as early in the day as possible.
Acne, Dry Skin, Or Other Skin Issues
Steroids commonly cause a variety of skin problems such as rashes or adult acne. In fact, during the height of steroid abuse by professional athletes and bodybuilders, adult acne was one of the indicators that a particular athlete was abusing steroids. Corticosteroids such as cortisone injections are no exception to this facet of steroid medications. Many individuals who receive cortisone injections report thinning skin, dry skin, acne, or other irritating skin flare-ups during the course of their cortisone treatment.
Pain Or Inflammation Flare-Ups
Cortisone injections are commonly prescribed to treat joint pain and inflammation associated with arthritis, orthopedic injuries, or various inflammatory illnesses. In a small percentage of patients, however, cortisone injections actually have the opposite effect and can increase the level of pain or inflammation individuals experience. These flare-ups are temporary for most individuals but can be long-lasting in some rare cases. In many cases, these temporary flare-ups are due to allergic reactions to cortisone or other corticosteroids.
Osteoporosis or Osteonecrosis
Since cortisone injections are most commonly used in the treatment of arthritis, most of the individuals who receive these injections are seniors or middle-aged. Bone health is an important factor of older age health, yet unfortunately, cortisone injections can cause osteoporosis, a weakening of the bones, or even osteonecrosis, the death of bone tissue, in some individuals. Some senior citizens, particularly women, are already at a high risk for developing osteoporosis, making cortisone injections all the more risky for older patients.
All injections run a small risk of creating bruises, but cortisone injections lead to bruising more often than other medications due to their pharmacology. Corticosteroids can stimulate blood flow, making bruises worse and even leading to subcutaneous bleeding. Some individuals report bruising more easily after cortisone injections, and not just on the areas of the body in which injections were administered. Any bruising or discoloration of the skin following cortisone injections should be reported to a doctor immediately.
Infections have become one of the most serious health risks and side effects associated with any type of internal medicine, including cortisone injections. Any time the skin is pierced, no matter how small the injection site, bacteria, and other germs can find their way in. Given that so many antibiotic-resistant bugs are popping up in hospitals around the world, individuals should avoid cortisone injections – or injections of any kind – if their immune systems are compromised in any way.
One of the most serious risks associated with getting cortisone injections is the possibility of nerve damage. A small percentage of individuals who receive cortisone injections develop numbness, pain, or even partial paralysis due to the injection of corticosteroids into their joints. Because the joints of the limbs contain so many nerves, injecting anything into the joints has a risk of causing nerve damage. Even though these cases are rare, they should not be taken lightly. Individuals considering cortisone injections should talk with their doctors about the possibility of nerve damage before receiving injections.
Hyperhidrosis is when an individual experiences excessive sweating to the point where moisture may drip from their hands, face, or other body parts, and can be caused for no discernable reason or can be related to a medical condition or medications, such as cortisone injections. Naturally, the sweat glands produce perspiration that is carried to the skin’s surface when the air temperature rises, or if an individual is exercising, experiencing anxiety or stress, or are sick with a fever. However, with hyperhidrosis, the sweat glands do not properly turn off and affects one to two percent of the population.
There are two types of hyperhidrosis: primary and secondary. Primary hyperhidrosis causes excessive sweating in the face, hands, underarms, and feet with no apparent cause, whereas secondary hyperhidrosis causes excessive sweating all over the body and can be caused by excessive heat, a medical condition, or medication, such as cortisone injections.
Headaches And Dizziness
Just like other medications, cortisone injections can have numerous side effects, including dizziness and frequent headaches. As a safety precaution, individuals who are receiving cortisone injections should not drive, operate machinery, or perform any activities that require alertness and mental focus until the individual’s headache or dizziness has subsided. If a patient receives a cortisone injection in the head, neck, spine, or shoulders due to inflammation from arthritis or other inflammatory conditions, and as result of the injection, can experience pain, swelling, or redness around the area, which can travel further into the brain. This can cause a headache, migraine, or dizziness due to the location of the injection being so close to the brain, especially for those who receive an injection in their spine.
Weight Gain And Swelling
Another negative side effect of cortisone injections is, unfortunately, weight gain and abdominal swelling. If a patient is receiving cortisone or any steroid injections for a lengthy period of time, then yes, they will more than likely experience weight gain and bloating. Typically, a patient is only given two to three injections a year to avoid any negative side effects, however, in serious cases where the patient is experiencing severe, debilitating pain with very little pain relief from other treatments, a physician may give them multiple shots throughout the year. If done persistently, it can lead to significant weight gain. If a patient is undergoing cortisone or steroid injections, it is recommended that they decrease their caloric intake and exercise more consistently to prevent any substantial weight gain from occurring. Following a low-fat diet that includes lots of water can also help to control one’s weight while receiving cortisone shots as well.
Developing A Cortisone Allergy
Unfortunately, and just like any other medication, a patient may develop an allergy to cortisone. If a patient begins to have a reaction after receiving their shot that is not a known side effect, they should seek emergency medical treatment if they are experiencing any signs of anaphylaxis, a severe allergic reaction. These signs may include hives, difficulty breathing, or swelling of the face, lips, tongue, or throat. It is believed that an allergic reaction to cortisone could be a reaction to the local anesthetic that is added to the injection, as allergic reactions to cortisone are rare, as cortisone itself is a synthetic version of cortisol, a steroid that is naturally produced within the body. Although it is uncommon, it can happen to anyone, therefore, it is beneficial to know the signs of an allergic reaction.