Cortisone is a steroid that can be taken orally, applied to the skin, or injected. Topical cortisone, for instance, is a common treatment for eczema. One of the most common treatments for joint pain, inflammation, and allergic reactions is to receive cortisone injections.
Cortisone injections provide near-instant pain relief and can last for months. Thus, they have become a common arthritis treatment. They are also used to treat other inflammatory joint conditions. Some individuals may even receive a cortisone injection for acne. This is often reserved for severe acne, since there are side effects and many other acne treatments available. Cortisone injection side effects seem to be common when they are used as a treatment for arthritis and in high doses. This makes them a somewhat risky endeavor.
Cortisone, as mentioned, belongs to a broad class of medications known as corticosteroids. Evidence exists that shows these medications and other steroids can 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 of cortisone injections include irritability, anxiety, memory loss, and difficulty concentrating.
In rare cases, however, more serious effects have been reported. They include patients experiencing paranoia, delusions, or depression. The risk and severity of mood changes depend on the dosage of cortisone administered. Doctors typically prescribe the lowest dose that they believe will be effective for their patients. This helps minimize the risk of this side effect, along with others.
Some studies have reported insomnia as a side effect in forty to fifty percent of patients who received cortisone injections. This makes insomnia one of the most common side effects linked to such injections. Cortisone, and similar steroids, have strong effects on the adrenal glands. These glands are responsible for regulating adrenaline levels in the body. Too much adrenaline running through the body causes restlessness and difficulties sleeping. Individuals feel like they have to keep moving. As cortisone injections can cause an increase in adrenaline, many patients experience insomnia after them. However, patients may be able to minimize the risk of this side effect by receiving their injection as early in the day as possible.
Acne, Dry Skin, Or Other Skin Issues
Steroids commonly cause a variety of skin problems. Such skin issues include rashes and 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 could be misusing steroids. Corticosteroids, including cortisone injections, are no exception to this. Many individuals who receive cortisone injections have reported thinning skin, dry skin, acne, or other irritating skin flare-ups after receiving a cortisone injection. The risk of this side effect can increase if the patient must receive more than one injection.
Pain Or Inflammation Flare-Ups
Cortisone injections are commonly prescribed to treat joint pain and inflammation associated with arthritis. They will also treat inflammation and pain in the joints caused by orthopedic injuries or other inflammatory illnesses. In a small percentage of patients, however, cortisone injections actually have the opposite effect. This means that they can increase the amount of pain or inflammation that individuals experience. These flare-ups are temporary for most patients. However, rare cases have shown that they can last for quite a long time. In many cases, these temporary flare-ups are due to allergic reactions to cortisone or other corticosteroids used in the injections. Thus, patients may want to inform their doctor if they have ever had a reaction to corticosteroids in the past.
Osteoporosis Or Osteonecrosis
Cortisone injections are most commonly used to treat arthritis patients, including those who have rheumatoid arthritis and osteoarthritis. Thus, the majority of the individuals who receive these injections are seniors or are at least middle-aged. Bone health is a crucial part of overall health for seniors. However, evidence indicates that one of the horrific side effects of cortisone injections for some individuals is osteoporosis or osteonecrosis. Osteoporosis is a weakening of the bones, and osteonecrosis is the death of bone tissue. Some senior citizens, particularly women, are already at a high risk of developing osteoporosis. This makes cortisone injections a fair amount riskier for older patients, especially women.
All injections, including the flu shot or a simple blood test, run a small risk of bruising for the patient. However, cortisone injections lead to bruising more often than other injected medications or similar procedures due to their pharmacology. Corticosteroids can stimulate blood flow. This can make bruises worse and even lead to subcutaneous bleeding in some patients. Some individuals report bruising more easily after cortisone injections, and not just on the area of their body where they received the injection. Patients should always report any bruising or skin discoloration following cortisone injections to their primary doctor immediately.
Infections have become one of the most serious health risks and side effects associated with any type of internal medicine. Cortisone injections are no exception to this trend. Any time a patient's skin is pierced, bacteria and other germs can find their way in and cause an infection. It does not matter how small the injection site happens to be. Given that so many antibiotic-resistant bugs are popping up in hospitals around the world, individuals should avoid cortisone injections if their immune systems are compromised in any way. In fact, they may wish to avoid most injections whenever it is possible for them to do so.
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. As the joints contain so many nerves, injecting anything into them carries at least some risk of causing nerve damage. This includes cortisone injections. Even though these cases are rare, they should not be taken lightly. Individuals considering cortisone injections should talk to their doctors about the possibility of nerve damage before receiving injections.
Hyperhidrosis is excessive sweating to the point where moisture may drip from an individual's hands, face, or other body parts. It can be caused for no discernable reason or 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. This also occurs if an individual is exercising, experiencing anxiety or stress, or have a fever. However, with hyperhidrosis, the sweat glands do not properly turn off. This affects one to two percent of the population.
Primary hyperhidrosis causes excessive sweating in the face, hands, underarms, and feet with no apparent cause. In contrast, secondary hyperhidrosis causes excessive sweating all over the body. It can be caused by excessive heat, a medical condition, or medication, such as cortisone injections.
Headaches And Dizziness
Cortisone injections can cause dizziness and frequent headaches. As a safety precaution, individuals receiving cortisone injections should not drive, operate machinery, or perform any activities that require alertness until their headache or dizziness has subsided. A patient may receive a cortisone injection in the head, neck, spine, or shoulders due to inflammation from arthritis or other inflammatory conditions. As a result of the injection, they can experience pain, swelling, or redness around the area, which can travel further into the brain. This can cause a headache, migraine, or dizziness because the injection was so close to the brain. This is especially the case for individuals 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, 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 pain with very little relief from other treatments, a physician may give them multiple shots throughout the year. If done persistently, it can lead to significant weight gain. Thus, it is recommended that they decrease their caloric intake and exercise more consistently to prevent substantial weight gain. Following a low-fat diet and drinking significant amounts of water can also help individuals control their weight while receiving cortisone shots.
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.
Some evidence indicates that there may be a connection between cortisone injections and muscle wasting or atrophy. This research mostly applies to when patients receive repeated injections or a high-dose injection. Low-dose injections may not have this effect. Rheumatoid arthritis patients who receive corticosteroid injections to treat a flareup of their condition have reported experiencing muscle wasting.
One study from the European Journal of Rheumatology found that this muscle wasting could go up to just over four pounds. Evidence suggests that muscle wasting is more common among individuals receiving glucocorticoid injections. However, it is not currently clear why reactions such as this occur. Thus, more research is necessary to confirm the connection between cortisone injections and muscle wasting.