Do Cortisone Shots Hurt?

If you have an upcoming cortisone injection to help with pain and swelling due to inflammation, you may wonder if it will hurt. You may also want to know if you can do anything to make this procedure more comfortable.

Cortisone shots can cause some pain, but it varies depending on where on your body they're given.

This article explores what happens during a cortisone shot, how painful it may be, and how long the effects might last. It will also discuss ways to manage the injection pain.

How Painful Are Cortisone Shots?

Shots vary in the amount of discomfort they may cause. Some factors that impact the level of pain a shot may cause include the location of the injection and the size of the needle. Not surprisingly, larger needles tend to cause more pain than smaller ones.

For some cortisone shots, healthcare providers can use ultrasound so that they can more easily visualize the area where the injection should go. In general, injections that are ultrasound-guided are less painful than those which are not. Whether a cortisone shot is guided by ultrasound or not depends on the location of the shot.

What Happens When You Get a Cortisone Shot?

Cortisone is a powerful medication that may be injected directly into the area of your body experiencing discomfort. These shots may be helpful for various short- or long-term conditions that impact the bones, joints, or muscles. They work by reducing the inflammation in the area and, therefore, your body's pain response to inflammation. Decreased inflammation often means decreased pain.

The shot appointment may take five to 30 minutes. Depending on the location of the shot, you might receive a smaller injection of the numbing medicine lidocaine, followed by a few minutes of delay while the medicine takes effect. Other times, a spray that has a cooling effect is used on the skin where the shot will be given, alleviating any pain.

In the hours immediately after the shot, pain may seem to decrease. This may be due to the numbing medication used during the injection. Pain relief is usually felt about a week after the cortisone shot.

Where Do Cortisone Shots Hurt the Most?

Certain cortisone injections will hurt more than others based on their location. Injections into the palm of the hand and sole can be especially painful. Injections tend to hurt most when the cortisone is delivered to a small space.

Managing Pain from a Cortisone Shot

If you're worried about the pain from an injection, let your healthcare provider know. They may be able to reduce your discomfort.

• Ask if they can use a smaller needle if possible. In some cases, it can be traded out. But, in others, like if the medication is very thick, it can't.
• Ask if you can have a numbing agent. Numbing cream or spray applied to the skin can help reduce the feeling of the injection.
• Avoid rushing. If you are extremely nervous, let your healthcare provider know. Sometimes, discussing the procedure may help you feel more in control of the situation.
• Practice mindfulness. Take slow, deep breaths. If possible, ask your healthcare provider if you can get the injection lying down. Try to remind yourself that this procedure will only take a few minutes.

What to Expect After a Cortisone Shot

While you may feel pain during the actual injection, there can also be discomfort afterward. One of the most common side effects is called a cortisone flare, which is when pain increases in the area being treated. The cortisone flare may occur within hours or days after receiving a cortisone shot. Some studies show that about one in five patients will experience a pain flare.

While the pain will often decrease on its own, there are some effective ways to reduce the symptoms more quickly, including:

• Resting the part of the body that is in pain
• Avoiding hot showers and baths
• Applying ice to reduce inflammation
• Taking nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) or Aleve (naproxen)

You should rest for one to two days after an injection and gradually increase activity. The length of time it takes before a cortisone injection starts relieving pain can vary depending on where the injection is located, but it can be anywhere from three to five days to up to a week. Keep in mind that some individuals may need just one shot to experience relief, while others will need multiple injections.

Other Side Effects From Cortisone Shots

Cortisone shots can have other side effects besides a flare-up in pain. They include:

• Insomnia
• Increased flushing
• A rise in blood sugar among diabetics
• Hiccups
• Reduced bone density over time
• Adrenal gland problems

Most side effects are not serious. More serious side effects like bone density changes and adrenal gland problems are rare and mostly tend to occur when people get too many cortisone shots.

When to Call a Healthcare Provider

Infections are uncommon following a cortisone shot. However, call your healthcare provider if you develop a high fever over 100.4 F, have severe pain, increased swelling, a bloody discharge, or a deep red or purplish skin color.

If you are experiencing a significant increase in pain after your cortisone injection, ask your provider for strategies to mitigate pain and make sure everything is as it should be. Speak with your healthcare provider before taking an NSAID, especially if you are currently taking other over-the-counter or prescription medication.

Summary

Cortisone is an anti-inflammatory medication that may be given as an injection to treat pain and swelling. The size of the needle and the location of the injection can impact the level of pain and discomfort these shots may cause.

Keep in mind that there are ways to reduce the pain associated with these shots, and it's best to speak with your doctor before the procedure if you're worried about it.