Steroid Injections

Medically Reviewed by Jabeen Begum, MD on June 18, 2024
Written by Matt McMillen
9 min read

Steroid injections, sometimes called cortisone shots, are injections of man-made drugs called corticosteroids that can help ease pain and inflammation (swelling) in specific areas of your body. Corticosteroids are similar to cortisol, a hormone your body makes in your adrenal glands. They are not the same as the hormone-related steroid compounds that some athletes use.

Your doctor may suggest you have a steroid injection to treat inflammation in your joints, or other inflammatory conditions such as rheumatoid arthritis, lupus, bad allergies, and asthma. There are different types of corticosteroids, including prednisone, methylprednisolone, and cortisone.

How do steroid injections work?

When you get ill or injured, your immune system responds by sending out inflammatory cells that aid in the healing process. As you get better, that immediate inflammation goes away. However, some types of injuries and diseases cause longer-lasting or chronic inflammation, which can mean ongoing pain.

Like the cortisol your body makes, the corticosteroids delivered by steroid injections temporarily calm your immune system. That reduces inflammation so that you feel less pain. While steroids don’t offer any healing properties of their own, they can make you feel well enough to engage in rehabilitation -- such as physical therapy -- that can help repair what’s wrong with your body.

You will get your injection via a needle. The procedure varies depending on the purpose of the shot. Your doctor typically inserts a needle under your skin at the site of the pain. In some cases, you’ll get a local anesthetic to numb the spot where your doctor gives you the steroid injection.

But some injections require a more complex process. Your doctor may use imaging technology, such as a CT scan or ultrasound, to guide the needle to the part of your body that needs treatment. Once it’s in the right position, you’ll get an anesthetic to numb the site, followed by the steroid injection.

Steroid injections may also be given via an IV infusion. In this type of procedure, a health care provider inserts a needle into your vein, and the steroid enters your bloodstream over a certain period determined by your doctor. You’ll have an IV infusion in the hospital or an outpatient infusion center.

Steroid injection sites

Often, you'll receive your steroid injection directly into the part of your body that it’s meant to treat, such as a painful joint. Common injection sites include:

  • Feet
  • Hands
  • Hips
  • Knees
  • Shoulders
  • Spine

If you are getting an IV steroid injection, the injection site likely will be a vein in your arm. That will allow the steroid medication to move through your bloodstream to the parts of your body affected by inflammation.

Systemic steroids

When inflammation occurs throughout your body, you may need systemic steroids, which circulate in your bloodstream in order to reach various places. Diseases such as lupus and systemic vasculitis (inflammation of your blood vessels) require systemic steroids. They are administered in a few ways:

  • Intravenously
  • Injected into a muscle
  • Orally, via pills

Local steroids

Local steroid injections treat specific areas of inflammation. For example, if you have painful arthritis in a toe, you will receive a local steroid injection directly into that toe. When possible, doctors choose local steroids over systemic steroids to reduce the side effects of treatment.

Steroid injections bring temporary relief for a variety of health conditions. They ease pain and reduce inflammation.

Steroid injections for sciatica

Sciatica is a painful condition that develops when something, such as a bulging, or herniated, spinal disk, presses against a nerve root in your spine. This triggers pain and inflammation in your sciatic nerve, which stretches from your butt down both of your legs. Steroid injections can reduce this pain. They’re given up to three times a year.

Steroid injections for plantar fasciitis

Plantar fasciitis happens when connective tissue on the bottom of your foot (called plantar fascia) becomes inflamed. This can cause intense stabbing pain and tenderness in your heel. Steroid injections into your heel relieve pain for about a month and also significantly reduce inflammation.

Steroid injections for keloids

Keloids are raised scar tissue that can develop after skin injuries due to surgery, body piercings, trauma, acne, and other causes. Steroid injections into the keloid can reduce their size and the irritation they cause. Sometimes, doctors recommend steroid injections before surgery to prevent keloids from forming at the incision site.

Steroid injections for bursitis

Bursae (the plural of bursa) are fluid-filled sacs that provide cushioning and reduce friction between tendons, ligaments, bones, and skin. Bursitis is the painful inflammation of a bursa. It usually occurs in your shoulders, knees, elbows, and hips. Steroid injections, delivered to the area surrounding the affected bursa, both ease pain and reduce inflammation.

Steroid injections for tendinitis

Tendinitis is inflammation of the tendons, the connective tissue between your muscles and bones. Often caused by injuries due to overuse or strain, it commonly affects shoulders, elbows, and knees. Tennis elbow is one of the most common types of tendinitis. Your doctor will give you a steroid injection directly into the affected tendon to quickly reduce pain and swelling.

Steroid injections for arthritis

Arthritis involves painful inflammation in one or more joints. Steroid injections can quickly ease that discomfort in your ankles, hips, elbows, knees, shoulders, hands, feet, spine, and wrists.

Other conditions

Your doctor may recommend steroid injections for pain and inflammation caused by other health conditions, including:

  • Autoimmune diseases, such as lupus and multiple sclerosis
  • Back pain and inflamed spinal nerves, which can cause pain in your legs and arms
  • Cervical radiculopathy, caused by a pinched nerve in your neck, which triggers pain in the neck, shoulders, arms, and hands
  • Carpal tunnel syndrome, which is a pinched nerve in your wrist
  • Trigger finger and trigger thumb (these cause a feeling of locking when you move your affected finger)

Steroid injections provide safe and effective, though temporary, relief from pain and inflammation. The result — you’re better able to participate in your normal day-to-day activities.

Steroids taken in pill form or via IV go into your bloodstream and travel throughout your body. Sometimes, that’s necessary, such as when treating flare-ups of autoimmune diseases that affect several parts of your body -- such as multiple sclerosis. But doctors prefer steroid injections whenever possible, as they deliver steroid medication right where it needs to go. The medication does enter the bloodstream, but you likely won’t notice any side effects from it.

That depends on a few factors:

  • The condition being treated by the steroid injection
  • How long you’ve had that condition
  • The part of your body being treated

In general, if a steroid injection successfully reduces your pain and inflammation, you can count on about 3 to 6 months of relief -- or longer. If your discomfort returns sooner, it can be a sign of other health conditions complicating your treatment, which may require a different approach. Ideally, your steroid injection will remain effective long enough for you to become more physically active and complete rehabilitation, which should bring long-lasting pain relief.

While steroid injections can bring quick and lasting relief to pain and swelling, they do have some potential side effects to consider. 

Common side effects of steroid injections include:

  • Pain at the site of the injection
  • A temporary increase in swelling
  • Bruising
  • A temporary rise in blood sugar. If you have diabetes, check your blood sugar more often for 5 days after your injection.
  • Redness or discoloration at the site of the injection
  • Lightened or paler skin where the needle went in
  • Insomnia and feeling hyper, like you’ve had too much caffeine, for 1-3 days
  • Flushing in your face for a few days

Rare side effects include:

  • Infection at the site of the injection
  • High blood pressure (hypertension)
  • Increased swelling and fluid retention
  • Hiccups

Risks of long-term or too frequent use of steroid injections:

  • Reduced bone density (osteoporosis), leading to weakened bones
  • Adrenal gland suppression, which can cause weakness, dizziness, fatigue, muscle pain, and shock

Some health conditions and circumstances make steroid injections less safe. Before you receive a steroid injection, your doctor should thoroughly review your medical history. They will likely advise you to avoid steroid injections if:

  • You have a broken bone. Steroids can interfere with healing.
  • You have surgery scheduled. Steroids may impact both the outcome of your surgery and how your surgical wound heals.
  • You have a serious condition, such as a spine injury causing numbing or weakness. Easing the pain could hide symptoms that show your condition is getting worse and needs treatment such as surgery.
  • You have an infection. Steroid injections suppress your immune system and weaken your body’s ability to fight infection.

Steroid injections can increase your risk of bruising and bleeding. For that reason, you should be cautious about them if you take a blood thinning medication (anticoagulant) or if you have a bleeding disorder, such as hemophilia. Talk to your doctor about your health conditions and the medications you take for them, as well as any supplements you take.

Make sure your doctor knows about any recent steroid injections you’ve had. In general, you should wait at least 3 months between shots and get no more than 3 shots per year. Frequent steroid injections raise your risk of osteoporosis, which causes a loss of bone mineral density and weakened bones.

Depending on your case, your doctor may give you steroid injections along with pain medications, anti-inflammatory drugs, physical therapy, occupational therapy, or devices such as canes and braces.

For example, if you don’t have any other health problems, a local steroid injection might be all you need for tendinitis. But if you have a condition such as rheumatoid arthritis, injections will be only one part of your treatment plan.

Steroid injections offer effective but temporary relief from pain caused by inflammation. For most people, they are a safe treatment. However, frequent steroid injections raise your risk of serious side effects, and they don’t mix well with certain health conditions or medications. Before you have a steroid injection, talk with your doctor about your health history and any current medications or supplements you take.

Is a steroid injection painful?

It can be. Your doctor may give you a local anesthetic before your steroid injection to prevent pain. You might experience a temporary increase in inflammation after your injection, which can be painful. This should go away within 24 hours as the steroid begins to work.

What is the downside of getting cortisone shots?

There are a few. The shot can be painful. You may experience side effects, though serious side effects rarely occur. Also, steroid injections offer only temporary relief. They do not treat the cause of your pain.

How many epidural steroid injections are safe in a lifetime?

There’s no set safe number of epidural steroid injections that you can have over your lifetime. Your doctor likely will limit the number to two to three per year to lower your risk of serious side effects, such as weakening the bones in your spine as well as the muscles near it.

What should you not do after a steroid shot?

You likely won’t need to put many limitations on your activities after a steroid injection, but it will depend on what part of your body was treated. Steroid injections in your spine, for example, may require you to avoid a lot of activity or exercise for up to a week. You likely will be able to do basic things such as grocery shopping and household chores. Steroid injections in other parts of your body typically have much shorter periods of restriction. Your doctor will outline the types of activities to avoid and for how long.

How long should you rest after a steroid injection?

After a steroid injection, you should be able to return to your normal routine the day after. However, take it easy and gradually increase your activity level. Ice or cold packs can provide relief if you feel discomfort.