Corticosteroid injections (cortisone shots) are common medical procedures used to reduce localized inflammation and pain in joints, tendons, and bursa. This powerful anti-inflammatory medication provides significant relief for conditions like arthritis or tendinitis. Although primarily targeting the injection site, a portion of the medication is absorbed into the bloodstream, causing systemic side effects. A frequently reported side effect is a temporary mood disturbance, often manifesting as anxiety.
The Mechanism Behind Mood Changes
The anxiety experienced after a steroid injection is a physiological response resulting from the medication’s effect on the body’s stress system. Corticosteroids are synthetic versions of cortisol, a hormone naturally produced by the adrenal glands. Introducing a synthetic steroid temporarily elevates the body’s overall level of this stress hormone, a known regulator of mood.
This sudden increase in steroid levels influences the hypothalamic-pituitary-adrenal (HPA) axis, the central command system for the body’s stress response. The injected steroid temporarily overwhelms this regulatory process, which normally works to maintain balance. These powerful hormones can cross the blood-brain barrier and directly impact brain chemistry. The steroid interacts with receptors that modulate key neurotransmitters, such as norepinephrine and serotonin, leading to symptoms like a racing heart, insomnia, and feeling on edge.
Expected Duration of Post-Injection Anxiety
The anxiety symptoms associated with a corticosteroid injection are generally short-lived, reflecting the time needed for the drug to clear the system. For most people, acute effects, including heightened anxiety or insomnia, begin within the first 24 to 48 hours following the procedure. This is when the systemic concentration of the absorbed steroid is at its peak.
The anxiety usually starts to subside significantly after the first few days. A typical resolution timeline for these mood disturbances is within three to seven days of the injection. This duration is highly variable, depending on factors like the specific type of steroid used, the dosage, and the individual’s metabolic rate. Steroids like methylprednisolone or triamcinolone have varying half-lives, influencing how quickly systemic effects resolve.
While most patients return to their baseline mood within a week, mild symptoms may linger slightly longer. If anxiety or other mood changes persist beyond two weeks, it is atypical and warrants a follow-up conversation with the prescribing physician.
Immediate Steps for Managing Anxiety Symptoms
While waiting for the steroid to leave your system, several non-medical strategies can help mitigate anxiety. Since the symptoms are often physical, focusing on calming the body is effective. Simple techniques like deep, controlled breathing can help regulate the nervous system, such as inhaling for four counts, holding for four, and exhaling slowly for six.
Strategies for Relief
- Practice mindfulness and progressive muscle relaxation to reduce the physiological stress response.
- Maintain a consistent and restorative sleep schedule, as the steroid can disrupt natural sleep patterns.
- Reduce or eliminate caffeine and other stimulants to prevent the worsening of anxiety and jitters.
- Engage in gentle physical activity, if medically permitted, as a healthy outlet for nervous energy.
When to Seek Medical Attention
While mild anxiety is a common side effect, certain severe or persistent symptoms require immediate contact with a healthcare provider. Any sign of extreme mood change, such as profound depression, intense euphoria, or thoughts of self-harm, should be reported without delay.
Symptoms involving a break from reality, such as hallucinations, paranoia, or delusional thoughts, indicate a rare but serious reaction requiring urgent medical assessment. Additionally, if anxiety prevents basic functioning—such as driving, working, or maintaining adequate nutrition—it should be considered a medical concern. If intense insomnia lasts for more than a few days, or if mood symptoms persist well beyond the two-week mark, seek reassessment from your doctor.