How Long Does Dizziness Last After a Steroid Injection?

Dizziness after a steroid injection is common, and for most people it is a short-lived reaction to the procedure, not to the steroid itself. It usually fades within minutes, often before you leave the clinic, though a faint off-balance feeling can stay with you the rest of the day.1Acibadem Hospitals Group. Intratympanic Steroid Injection Side Effects: What to Expect How long it lasts depends mostly on where the needle went and what was in the syringe, so a shot in the ear behaves differently from one in the knee or spine.

Typical Timelines by Type of Dizziness

Steroid effects that spread through the body, such as raised blood pressure and blood sugar, tend to be temporary.7Johns Hopkins Arthritis Center. Corisone Shots and High Blood Pressure The feeling can also fade at the clinic and come back when you get up, climb stairs, or stand in the heat of a shower later that day. Each return should be milder and shorter than the last; if returns get stronger, call. If you had a shot somewhere other than the ear and the spinning persists, call the clinic rather than assuming it is normal.

Why Back, Neck and Joint Shots Can Make You Lightheaded

The most common cause is the body’s fainting reflex, triggered by the stress, pain or sight of the needle. It was the most common immediate side effect of lower-back epidural shots, affecting about 4 in 100 people.8PubMed. Adverse events associated with fluoroscopically guided lumbosacral transforaminal epidural steroid injections After ultrasound-guided joint injections it affected about 2 in 100, most often with shoulder, hand and foot shots.9PubMed Central. Vasovagal reactions in ultrasound guided musculoskeletal injections: A study of 2,462 procedures Women and people under 65 were more prone to it.10PubMed Central. Vasovagal reactions in ultrasound guided musculoskeletal injections: A study of 2,462 procedures

Lying flat usually ends it within minutes. The reflex briefly drops blood pressure and slows the heart, so less blood reaches the brain while you are upright. Lying down puts your head level with your heart, and blood reaches the brain again without any medicine. That is why staff lay you down and raise your legs, and why standing up too early can bring the spell right back.

On the table, it often starts with warmth, sweating, nausea and tunnel vision before you feel faint. It passes and doesn’t mean the injection went wrong.

It can hit people who aren’t afraid of needles, too. Pain, the pressure of the procedure, or lying in an unfamiliar position can set it off. Having fasted or being dehydrated makes it easier for blood pressure to dip, so a calm person can still feel faint.

The numbing medicine adds its own effect. Most steroid shots also contain a numbing drug such as lidocaine. If enough of it reaches the bloodstream, it can cause dizziness, ringing ears and a numb mouth.11PubMed Central. Adverse events associated with local anaesthetic use in musculoskeletal injection therapy: a scoping review In neck epidural shots, about 7 in 100 people noticed some dizziness, with no serious problems.12PubMed Central. Effectiveness of a multimodal pain management concept for patients with cervical radiculopathy with focus on cervical epidural injections

Nerves can amplify all of this. Anxiety alone can produce dizziness, nausea and fast breathing within two hours of a needle, as seen after vaccinations.13PubMed Central. Anxiety-related adverse events following immunization (AEFI): A systematic review of published clusters of illness Being nervous about a shot can therefore make the dizziness feel worse or last longer.

Slower Effects From the Steroid Itself

Injected steroid can enter the bloodstream and raise blood pressure, usually only briefly.14Johns Hopkins Arthritis Center. Corisone Shots and High Blood Pressure In people with diabetes, blood sugar rose by about 64 mg/dL the day after the shot, but it was back to baseline by day 2.15PubMed Central. Changes in Blood Glucose Level After Steroid Injection for Musculoskeletal Pain in Patients With Diabetes If you have diabetes, you may feel off for a day, so check your sugar more often than usual. Thirst, tiredness or wooziness alongside high readings suggests high sugar may be part of it. If readings stay very high or keep climbing past two days, call your doctor or diabetes care team.

A short rise in blood pressure may cause no symptoms at all, so many people never notice it. When it is noticeable, it can feel like a pounding head, a flushed face or a fluttery heartbeat. If you already have high blood pressure and a home cuff, checking it for a day or two after the shot gives you real numbers instead of guesses.

Other signs that the steroid is responsible include flushing, a racing heart or trouble sleeping on the same day, or a headache with raised blood pressure. These usually ease within one to two days.

The body’s own stress hormone can also dip. In a small group of athletes, a single joint injection left 9 of 10 with low cortisol two days later, and cortisol was still lower than normal at two weeks.16PubMed. High risk of adrenal insufficiency after a single articular steroid injection in athletes Lingering fatigue or lightheadedness over the following days may be worth mentioning to your doctor. Repeated shots can also add up their effects on cortisol, so talk to your doctor about how often you get injections.

Ear Injections Cause Longer Spinning

An ear injection puts steroid through the eardrum, close to the balance organ. Spinning often starts within a minute or two because the inner ear reacts to the fluid’s temperature.17Acibadem Hospitals Group. Intratympanic Steroid Injection Side Effects: What to Expect For that reason, clinics warm the solution and have you rest before standing.18Acibadem Hospitals Group. Intratympanic Steroid Injection Side Effects: What to Expect

True vertigo can come later and last hours. Some people develop it 20 to 30 minutes after the shot, especially when they get up. It can last from 40 minutes to 5 hours, with jerky eye movements.19PubMed Central. Assessment of complications due to intratympanic injections About 4 in 100 people treated for sudden hearing loss had vertigo after these shots.20PubMed. Complications and prognosis associated with intra-tympanic steroid injection to treat sudden sensorineural hearing impairment

It feels like you or the room is turning, often with nausea. It is usually worse when you move your head or stand quickly, and eases when you lie still with your eyes closed. Keeping still is the right response, since moving tends to feed it.

Arrange a driver before the appointment, keep your head still, and stand up slowly. If the clinic advises it, lie with the treated ear up. Spinning that lasts into the next day should be reported.

Warning Signs That Need Urgent Care

Rarely, a neck nerve-root shot can send slow-release steroid particles into an artery and cause a stroke in the brainstem or cerebellum.21Spine. Cervical Transforaminal Epidural Steroid Injections: More Dangerous Than We Think? Particulate steroids such as Depo-Medrol and Kenalog contain particles, while dexamethasone does not.22PM&R KnowledgeNow. Steroids and Corticosteroids This complication is rare and linked to neck nerve-root shots, not to ordinary joint shots or most back injections. Dizziness with slurred speech, double vision, weakness, numbness or trouble walking needs 911. Stroke-type dizziness comes with other changes, like trouble walking in a straight line; the added symptoms are what make it an emergency.

If warning signs appear, call 911 rather than driving yourself or asking someone to drive you, because paramedics can start care on the way. Note the time symptoms began, since that affects which stroke treatments are possible. Tell the responders you recently had a spinal or neck injection, which points them to the likely cause.

An epidural needle can puncture the spinal sac, causing a headache that worsens when standing.23PubMed Central. Inadvertent Dural Puncture Causing Low Pressure Headache and Peripheral Vestibular Bilateral Damage In one reported case this came with balance problems.24PubMed Central. Inadvertent Dural Puncture Causing Low Pressure Headache and Peripheral Vestibular Bilateral Damage A headache that worsens when you stand and eases when you lie down deserves a call to the clinic the same day.

  • Dizziness that worsens instead of easing
  • Fainting after you’ve left the clinic
  • Chest pain, a racing heart or trouble breathing
  • Seizure, confusion or slurred speech

When you call, say where the injection was and which medicine was used, when the dizziness started and how it has changed, and whether you have any headache, vision or hearing changes.

What to Do While It Passes

Lie or sit down at the first sign of lightheadedness. Afterward, sit up for a minute before standing. Your blood vessels need a moment to adjust, so sitting lets blood pressure settle before you take your weight. Standing in stages, lying, then sitting, then standing with a hand on something steady, makes a repeat faint less likely. If the room tilts when you sit up, lie back down and try again after a few more minutes.

Drink water and eat a small snack if you fasted. If you have diabetes, follow your usual meal and medicine plan and check your sugar rather than relying on a snack alone. Skip driving and climbing ladders for the rest of the day.

Before your next injection, tell staff if you fainted before so they can treat you lying down. Eat beforehand unless told not to, and bring a driver. For neck shots, ask whether a non-particulate steroid is an option.