Arthritis and other joint conditions cause inflammation and pain, often affecting one’s ability to perform daily activities. While many treatments are available, not all work for everyone. For many people, corticosteroid injections are a good option for managing joint pain and discomfort.
What Are Corticosteroid Injections?
Corticosteroids, also known simply as steroids, are anti-inflammatory drugs. They are designed to be similar to cortisol, a natural anti-inflammatory hormone made in the adrenal glands’ cortex or outer layer. Corticosteroids are not the same as anabolic steroids, which athletes sometimes use to build muscle and improve performance. A corticosteroid injection contains an anti-inflammatory steroid, similar to our native cortisol, along with a numbing agent to decrease pain at the time of the injection.
When Do Providers Prescribe Corticosteroid Injections?
Providers often use corticosteroid injections to treat patients who have rheumatoid arthritis, an autoimmune disease that causes painful inflammation in the joints. Some patients who have osteoarthritis, in which cartilage in the joint has broken down over time, can also benefit from corticosteroid injections. These shots can be carefully administered in joints all over the body, including the hands, wrists, knees, hips, elbows and spine.
In most cases, corticosteroid injections are a temporary treatment for patients who are experiencing severe pain or a flare-up of symptoms. Topical and oral corticosteroids are other options available for some people. Providers often use corticosteroids in conjunction with other treatments, such as long-term drugs for rheumatoid arthritis, which can take time to take effect and improve symptoms.Â
Your provider might also recommend other treatments, such as:
- Heat or cold therapies
- Diet and exercise changes
- Physical therapy and strengthening of the muscles around the affected joint
Often, your provider will try these treatments first before administering corticosteroid injections, or your provider might suggest doing them at the same time. Most providers will use corticosteroid injections when signs of osteoarthritis are seen in an X-ray or sometimes as a diagnostic tool to determine whether the joint is the primary source of your pain.
Benefits and Risks
For most people, corticosteroid injections provide safe, effective relief from joint pain. The relief usually lasts for about a month after the injection.
However, depending on the type of corticosteroid, there is a range of possible side effects. The risk of these side effects goes up the longer you take the medication and the higher the dose.
Side effects of corticosteroids include:
- Allergic reaction
- Bleeding in the joint
- Damage to the nerves near the joint
- Increased blood glucose level for several days after the injection in patients with diabetes
- Infection
- Pain and bruising at the injection site
- Skin discoloration and irritation of the skin at the injection site
- Swelling
- An increase in blood pressure, especially for those with brittle hypertension (frequent and rapid fluctuations between normal and high blood pressure)Â
- Damage to the body’s natural cartilage and soft tissue
Additionally, repeated corticosteroid injections can weaken the tendons and ligaments around the joint. To reduce the risk of side effects, your provider will administer the injections only for the shortest amount of time necessary. In most cases, the injections will be spaced apart by months to maximize the anti-inflammatory benefit and minimize side effects. Most providers will avoid steroid injections in younger patients, whose cartilage is mostly intact.
What to Expect When You Get a Corticosteroid Injection
Before getting an injection, you will meet with your provider to discuss the benefits and risks. Be sure to tell your provider about any:
- Allergies you have
- Health issues you are concerned about
- Medicines you take, including prescription and over-the-counter drugs
- Previous injections you’ve had in the joint, and the length of time you experienced relief
If you have been diagnosed with diabetes, tell your provider about your blood sugar management and any problems you have had.
The procedure itself takes very little time, and you can go home right after. It’s a good idea to avoid any strenuous activity on the day you receive the shot. You might also have mild swelling and redness around the injection site. If this occurs, apply an ice pack for 15 to 20 minutes two to three times per day.
For the first few hours after the shot, you may notice a decrease in pain. This is due to the numbing medicine in the corticosteroid shot. However, after this wears off, your pain may return and last for a few days. But within three to seven days, the steroid will begin to take effect, and your pain will likely decrease or disappear.
If you have diabetes, your provider will likely recommend you check your glucose level more frequently for up to five days. This is because the steroid can cause blood sugar levels to rise, but usually only by a small amount.
If you notice any symptoms that concern you, such as worsening pain, swelling or fever, which can be a sign of infection, contact your provider right away.
More to Read
- Supplements for Joint Pain: Helpful or Harmful?
- The Connection Between Diabetes and Arthritis
- Osteoarthritis Treatments: Today and Tomorrow
- Arthroscopy and Arthroplasty: Providing Relief from Joint Pain
Medically reviewed by David T. Schroder, MD.
