A cortisone shot is a common medical procedure used to deliver a powerful anti-inflammatory medication directly into a painful, localized area of the body, such as a joint, tendon, or bursa. This medication works by suppressing the immune system’s inflammatory response. Cortisone shots often include a local anesthetic for immediate pain relief, but the therapeutic effect of the steroid itself can take a few days to fully activate. Because the injection process can cause temporary discomfort, patients often have questions about how to best manage the site immediately afterward.
Immediate Post-Injection Care: The Role of Icing
Icing is generally recommended for immediate post-injection care for the first 24 to 48 hours. The primary purpose of applying ice is to manage localized pain and minor swelling resulting from the needle insertion. Ice works by causing temporary vasoconstriction, which helps to numb the tissues and minimize soft tissue trauma from the procedure.
For effective pain relief, ice packs should be applied for 15 to 20 minutes at a time, followed by a break of at least 45 minutes to allow the skin temperature to normalize. Always use a thin towel or cloth barrier between the ice pack and the skin to prevent injury. Avoid using heat on the area during this initial period, as increased blood flow could potentially disperse the concentrated medication away from the target area.
Understanding the Cortisone Flare
A temporary increase in pain, swelling, and irritation can occur hours or days after the procedure, known as a cortisone flare. This reaction is a common side effect caused by the body reacting to the microcrystals of the corticosteroid medication deposited into the tissue. The crystals can attract immune cells, leading to a temporary inflammatory response that mimics the symptoms the injection was meant to treat.
A cortisone flare is usually short-lived, typically peaking within the first 24 hours and resolving completely within one to three days. This temporary setback is a normal part of the process. Continuing to use ice on the injection site remains the standard recommendation for managing the discomfort associated with this self-limiting flare-up. This temporary worsening of symptoms is distinct from a rare infection, which would progressively worsen beyond 48 hours.
Beyond Icing: Other Post-Injection Guidelines
In the days following the injection, it is important to protect the treated area to allow the medication to settle and reduce the risk of tendon or tissue damage. Healthcare providers typically recommend avoiding strenuous activity, heavy lifting, or high-impact exercise involving the injected joint for at least 24 to 48 hours. This period of relative rest allows the corticosteroid to concentrate at the site of inflammation and begin its therapeutic action. Excessive strain on the joint too soon could potentially compromise the injection’s effectiveness.
For continued pain management, over-the-counter pain relievers such as acetaminophen are generally permitted. However, patients should confirm the use of nonsteroidal anti-inflammatory drugs (NSAIDs) with their doctor.
Patients must also monitor the injection site for signs of a serious complication, such as infection, which is extremely rare but requires immediate attention. Symptoms that warrant contacting a healthcare provider include:
- A fever.
- Significant drainage from the site.
- Redness and swelling that increase or persist beyond 48 hours, indicating a potential problem beyond a simple cortisone flare.
Additionally, diabetic patients should be aware that corticosteroids can temporarily elevate blood sugar levels for several days, requiring careful glucose monitoring.