How do I know if I need a cortisone injection? > News > Yale Medicine

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Allergic reactions are rare, says Dr. Halim. But, as with any treatment, there can be side effects, which for cortisone injections include flushing and headaches. There may also be fat necrosis, which looks like a divot in the skin, and hypopigmentation [an area of pale skin] at the injection site, says Dr. Halim.

“You may also get temporary elevations in blood sugar. Typically, this lasts about a week. And I’ve seen that it’s mostly only problematic with diabetic patients,” she says.

“There is a risk of injuring a tendon with repeated injections, so we are careful about how often we give them,” says Dr. Halim. “My approach is to space them out by at least three months. And if I inject around a tendon, I don’t do more than three for the same tendon.

Another possible risk is infection. “This can happen if you don’t use good sterile technique and make sure the skin is clean before giving the injection,” says Dr. Halim. “It is important to note that if you have surgery too soon after an injection, there is an increased risk of surgical site infection because the steroid suppresses the immune system. Most total joint surgeons will not do surgery within two months of a cortisone injection into that joint.

Overall, cortisone injections carry less risk than oral steroids, adds Dr. Halim. These, if used long term, can cause osteoporosis, diabetes and weight gain. “Cortisone shots don’t cause the same systemic problems and won’t cause weight gain,” she says.

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