Understanding Cortisone Flare: What to Anticipate

A cortisone flare, also known as a “steroid flare,” is a temporary, painful reaction following a cortisone injection. This occurs when the cortisone irritates the joint where it is injected.

Cortisone injections are widely used to treat osteoarthritis by reducing inflammation within joints, which often leads to significant pain relief.

Typical injection sites include:

• Knee
• Shoulder
• Wrist
• Foot

After receiving a cortisone injection, you might experience intense pain at the injection site, particularly within the first 24 to 48 hours. Understanding the potential side effects and what to expect can help you prepare for the procedure and the recovery period.

What Causes a Cortisone Flare?

According to the Arthritis Foundation, cortisone flares result from the corticosteroid crystals in the injection. These slow-release crystals are designed to provide extended pain relief lasting several months. However, they can sometimes irritate the joint, triggering a temporary increase in pain around the injection area.

It is difficult to predict who will experience a steroid flare, and repeated injections don’t necessarily increase the likelihood or severity of flares. Although repeated cortisone shots can weaken tendons over time, this does not directly correlate with more painful injections.

Steroid flares are a recognized side effect but are manageable with proper care.

Common Side Effects of Cortisone Injections

Before your first cortisone shot, you may worry about discomfort. Typically, a topical anesthetic is applied to numb the area temporarily. You might feel some pressure or mild pain as the injection is administered, sometimes guided by ultrasound for precision.

Side effects usually appear within 48 hours and commonly include pain or soreness at the injection site, mild bleeding, and possible skin discoloration. Occasionally, the inflammation may worsen temporarily—this is the cortisone flare.

Though rare, infections can occur at the injection site. If you notice persistent bleeding, discharge, or signs of infection, contact your healthcare provider immediately.

Effective Management of a Cortisone Flare

Applying ice to the injection area is the first step to reduce inflammation and alleviate pain. Over-the-counter pain relievers like ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) can also help if icing is insufficient. Typically, flare pain subsides within a few days, leading to relief.

If significant pain persists beyond three to five days, consult your doctor for further evaluation.

Recovery Guidelines After a Cortisone Injection

Post-injection, avoid using the affected joint for at least two days. For knee injections, minimize standing and walking, and avoid swimming or soaking the area—opt for showers instead. Most patients can resume normal activities within four to five days.

Besides the corticosteroid, the injection contains a pain reliever, so joint pain usually diminishes quickly. Expect symptom improvement lasting two to three months.

It's important to space cortisone injections appropriately, generally limiting to three or four treatments per year to avoid potential complications.

Prognosis

Corticosteroid injections provide effective relief from joint inflammation for several months. Despite some possible side effects, they remain a valuable treatment for millions suffering from osteoarthritis pain.

Additional Tips for Managing Osteoarthritis

Beyond corticosteroids, consider these strategies to reduce osteoarthritis discomfort:

• For knee or hip osteoarthritis, weight loss and a doctor-approved exercise plan can improve joint function and reduce stress. Physical therapy may also be beneficial.
• Incorporate anti-inflammatory and antioxidant-rich foods into your diet, such as blueberries, kale, and salmon.
• Use ice or heat packs on affected joints to manage pain.
• Discuss with your doctor the possibility of using braces for joints like the knee or wrist.

Explore online options for knee braces.

Discover more: 4 Yoga Poses to Alleviate Osteoarthritis Symptoms »

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