The People's Perspective on Medicine

Cortisone Injections Can Have Devastating Effects

People who receive cortisone injections into joints for pain relief may also experience systemic psychological side effects such as insomnia or anxiety.
Anaesthetist injecting patient with anaesthetic in hospital ward emergency room operating theater.

What will the doctor offer you if you have a stubborn pain in a joint? Frequently, physicians turn to cortisone injections to ease the pain for a while. Before you agree to such treatment, make sure you are aware that it can cause devastating body-wide side effects. One reader learned that the hard way.

Side Effects of Cortisone Injections:

Q. I had cortisone injections, one in my neck and one in my back, within a month of each other. A few days later I developed severe insomnia. After being awake for nearly 40 hours, I was almost delirious.

Then I developed more symptoms: panic attacks, blurred vision and two weeks of diarrhea. I could not focus during the day. Because I felt foggy, I was unable to study or drive.

I went to the ER three different times. Twice I was diagnosed as having anxiety and palpitations. They didn’t want to hear I am very fit and have never had anxiety. Even my PCP said it was anxiety. So did the sports medicine doctor who administered the cortisone injections.

Finally, I went to the ER where I had worked as a trauma nurse before retiring. The ER doctor said, “You are having an adverse reaction to your steroid injection.” The neurologist she consulted agreed. I was not treated like I was some fruit loop who suffered from anxiety.

Don’t let any doctor tell you cortisone injections can’t cause such side effects, because they do! I will never have a cortisone injection again.

Correcting Misconceptions:

A. People may think steroid injections are localized: that the medicine goes into the joint and stays there. However, blood and lymph circulate around every joint and throughout the body. Your story illustrates that such medications can affect the entire body, including the nervous system. Insomnia, anxiety, high blood pressure and trouble controlling blood sugar are just a few of the reactions people may experience from corticosteroids, including cortisone injections. 

Anyone contemplating such injections may want to read about the latest research. In exchange for possible short-term pain relief, cortisone injections can speed the progression of arthritis and lead to loss of cartilage (Osteoarthritis and Cartilage, June 2019). As a result, the patient might need a joint replacement sooner.

Rate this article
star-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-empty
4.2- 74 ratings

Today's Newsletter Reading List

    About the Author
    Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
    Tired of the ads on our website?

    Now you can browse our website completely ad-free for just $5 / month. Stay up to date on breaking health news and support our work without the distraction of advertisements.

    Browse our website ad-free
    Citations
    • Zeng C et al, "Intra-articular corticosteroids and the risk of knee osteoarthritis progression: Results from the Osteoarthritis Initiative." Osteoarthritis and Cartilage, June 2019. DOI: 10.1016/j.joca.2019.01.007
    Join over 150,000 Subscribers at The People's Pharmacy

    We're empowering you to make wise decisions about your own health, by providing you with essential health information about both medical and alternative treatment options.

    Showing 19 comments
    Comments
    Add your comment

    I was on Norco for years with lower back pain radiating down one leg. Finally went to a pain Dr who prescribed two spinal steroid shots. He followed that by putting me on Gabapentin. I am off the Norco and have my life back. Nothing works for everybody, and there are risks to all medical procedures. But for some there are great benefits.

    I was very saddened to see this question and answer in my local newspaper. So much has been done to reduce the stigma of anxiety and depression. These words “fruit loop suffering from anxiety” did not need to be put in print. Where are your editors? Do the writers agree with this? If so, shame on you. Anxiety is not a sign of weakness, it is a true illness that can be treated. Many people do not seek treatment because they don’t want to be judged like this.
    Retraction, please.

    I also have anxiety disorder and did not appreciate the “fruitloop with anxiety” comment. I thought we had come further in recognizing mental disorders and the shaming that goes with it.

    I have anxiety disorder and do not appreciate the comment “some fruitloop with anxiety.”

    I had cortisone knee injections and did not have any increase in anxiety. My mood was improved because my quality of life was greatly improved. Without pain I was able to resume activities I enjoyed and chores too. Still can’t kneel without some pain and have the occasional twinge but overall much improved.

    Everyone reacts to medication differently. Now here’s my SUCCESS story. Finding out finally that the pain, plus not being able to walk distances or even stairs, was due to a torn meniscus in my knee, I sought out an orthopedic surgeon. Because I was of the age that he considered a senior (and having read about cortisone shots vs surgery in elderly people), he suggested the shot. And if I can recall, he told me I could have at least two more shots that year if needed. Well, I DIDN’T need another shot and have not for years! In fact, the night of that one shot, I was able to participate in a mile walk in a parade. I have had slight twinges in the knee since, but I can walk distances again (as well as take the stairs in my house). If need be, I will DEFINITELY go the cortisone shot route again. Thankfully, it’s been years.

    Had a bad experience in Oct 2017 with a shot in my knee. Within a couple of hours, I had hot flashes that morphed into cortisone flush so hot that I actually used ice packs on my face. Next day, woke with vertigo, nausea, ringing in my ears, high BP and spike in blood sugar. Called dr, but the receptionist had never heard of such a thing. Made a follow-up appt for a few days later. During that time, I remained dizzy; my stomach felt on fire; knee swelled, ached; still had BP & blood sugar problems, and my period started (I was 67). I immediately saw gynecologist (possible uterine tumors) and lost 7 pounds.

    When I finally saw orthopedic DR, he confirmed all the above was a reaction. He also said to have uterine sonogram instead of the biopsy I was scheduled to have, as I didn’t have tumors. He was right. I’ve had about 20 injections of cortisone over a 25-year period (including the lumbar done each month for pain management) and usually got the “flush.” Never anything so severe again. This bad reaction took 5 weeks before I was normal but has left me with occasional vertigo and constant tinnitus, kind of a high-pitched hissing. Had one injection in my hand for a trigger thumb since. No reaction, probably due to such a small amount injected, and that injection did not work! Now I do weeks of physical therapy for pain management when one shot used to take care of it within hours. Wonderful drug, but not for me.

    I had several steroid (real steroid, not just cortisone, starts with D) some years ago here in Delray Beach by an MD who does nothing but injections at $250+ per shot which I paid out of pocket. Did nothing, but perhaps that is why I very seldom sleep more than 3-4 hrs a night.

    Thanks for the article. It would be helpful if the nurse had told us if she and her new doc found a REMEDY or some
    kind of help to counteract the cortisone affects. The “miracle” drug these days seems to be prednisone
    with more side effects in tow.

    Have had 4 shots. No problems. One in hip did not help. Ones in knee like a miracle drug. Saved me from replacement for years. So grateful for this intervention. Also exercise regularly doing exercises recommended by
    PT.

    I’ve had corticosteroid and hyaluronic acid injections into knee joint – both with good results. Doc, of course, wants to limit steroids, and I agree with that.

    Question: Can hyaluronic acid injections be used repeatedly (my doc recommends no more frequently than 6 months) without harm?

    In this case, the cure can be worse than the cause. Had a friend who died last spring. The death certificate listed the cause as suicide, but it could have also listed a secondary cause as medical irresponsibility. He was a person with whom doctors found it easier to just give in and give him a shot or prescribe a new medicine to eliminate his pain (easier since he had insurance) than to try to and get him to change his behaviors that would have reduced his back pain without medicine. He received at least several steroid injections, and the side effects listed here were among his complaints. The side effects of treating the resulting high blood pressure didn’t help either.

    Doctors need to have a back bone too. His didn’t.

    The article does not state dosage and form of steroid or how many to be avoided, like in knee, back, neck, sacroiliac joint, etc. to cause appreciable bone damage. I have taken the shot twice in my knee, three times sub epidural in the last 3 years. I had no adverse action and also got relief. So attacking insomnia anxiety must be exceptional, agreed But multiple injections are to be avoided.

    I’ve had several injections over the last 20 years with good success: a foot, both knees with torn meniscus and ACL, a shoulder, and 2 epidurals this year for a back injury. That is improving.

    Over the years my husband has had cortisone injections for his shoulders and severe back issues. After a injection a number of years ago, he developed hiccups. When I mentioned this recently to an orthopedic doctor who was doing a series of cortisone injections in his back, the doctor’s comment was that he had never heard of such a thing. Sure enough, with the last two injections, he has had over 7 hours of hiccups each time. Upon research on the Internet, over seven pages of comments confirmed the hiccup issue. Fortunately, several of the suggestions, q-tips up the nose to induce sneezing and sucking ice cubes, stopped the hiccups.

    As someone who suffers from joint pain as well as anxiety, I take offense at the comment, “like I was some fruit loop who suffered from anxiety.” As a retired nurse, she should know that you are not a “fruit loop” when you suffer from this disorder.

    Of course some amount of steroid is going to enter your system. Now that you know you react so adversely, you can avoid them. My reaction is less severe (and I’ve never had back to back injections) but every time I’ve taken them, I have some degree of agitation and sleeplessness. Careful dosing and tapering is vital. Steroids are miracle drugs….and powerful ones at that.

    Steroid shots and pills can cause long-lasting damage and many undesirable side effects. Honest doctors will tell you that steroids should not be used except for a last ditch life-saving effort. And never used in a joint. But doctors charge up to $2,000 for joint injections, so that is why they are pushed on patients. Physical therapy is usually the best approach for joint pain.

    Can repeated cortisone injections lead to fibromyalgia?

    Didn’t give enough info.

    I wonder if they can also cause something called Bell’s Palsy. I had this after an injection in my wrist for carpal tunnel.

    * Be nice, and don't over share. View comment policy^