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Cortisone injection side effects?
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Cortisone injection side effects?

I apologize that this will be kinda long - want to give as much info as I can so everyone can hopefully give me some advice/input.

First, a little bit of background - I suffer from several chronic pain issues, including fibromyalgia, lupus, severe osteoarthritis.  For the past month or so I've been having a major issue with my right hip and lower back (mostly the hip) - it began with pain in the groin/inside hip area and has now totally encompassed the entire hip and does also affect the lower back (although not all the time).  the best way I can describe the pain is like a horrible, horrible toothache that does not go away. it also radiates down my leg into my knee and sometimes all the way down my leg with some shooting/burning pains into my foot.  I first went to my PCP about this (she handles all my health issues, including my pain management) and she gave me dilaudid and flexeril (to replace my normal lorcet plus) and immediately made me an urgen appt with an orthopedic doc.  She also sent me that day for xrays, which I took with me to the ortho appt (the ortho was actually one of their PA's, but that's fine with me).  Anyway, the ortho said I did have ddd, at least one bulgin disc with pinched/trapped nerve/s.  She put me on a 6 day tapering course of medrol-dose pack and told me to call her the following week and let me know how I was doing - if I wasn't at least 50% improved she would more than likely wnat to get an MRI.  I did not have much, if any at all, improvement, so I called her that following week and told her how I was feeling.  They scheduled me for an MRI - I made it another point to tell them that majority of my pain was in my hip, so to be sure that they also looked at the hip durign the MRI.  The nurse that was scheduling it said she would mention it to the PA.  Unfortunately, the day before the MRI was scheduled for, I ended up having to put my car in the shop and was without any transportation for about a week, so I had to reschedule it (and my follow-up appt with the ortho).  I finally had the MRI this past Wed (8/4) -- even though I had made sure to tell the ortho that majority of my pain was in my hip, she STILL only requested the MRI to be done of my lumbar spine - her feeling was that the pain was actually comign from my back. i didn't balk at it - figured she knew what she was talking about.  Had the MRI - no problems with that except of course I was hurting more afterward simply from laying on that horribly hard table for so long!  Friday (8/6) was my follow-up with the ortho -- MRI findings did show bulging at L3, L4, L5 with some nerve impingement, however, it was not severe impingement.  The radiologist also stated there was a tear at L3,L4 -- anyone know what that means - the PA didn't seem to and kind of skipped over it when I asked her what that meant.

Now, of course, the PA has finally decided to listen to me when I tell her that the majority of my pain is in my hip and not all in my back - yes the back does act up, but I think at least part of that is because of me adjusting my positions, gait, etc, to accomodate the hip pain.  Yesterday when I was there, she gave me a cortisone injection to see if it would help - I do have a LOT of pinpoint pain when she pressed on certain areas so she though possibly a bursitits?  Again, she told me that if I didn't see vast improvement by the beginning of next week, to call the office and she would want me to see their hip specialist - either before getting an MRI of the hip or possibly getting the hip MRI first and then seeing him (why the heck she didn't listen to me before and do the hip at the same time as the other I'll never know!)

The injection was VERY painful - I've had cortisone injections before in my shoulder (have since had that shoulder replaced) and also in both knees at different times in my life, so I'm not a stranger to them.  This one was absolutely HORRIBLE though.  i dont' know if it was simply because the area she injected was already so painful or if something wasn't right.  She did tell me that I could experience some MILD increase in pain last night as a result of the injection and to use ice packs for the next couple of days (I had been switching between heat and ice before this but she said to stick with the ice only for a few days).  Well, I'll tell you - what I experienced last night and even this morning is in no way MILD increase in pain - I am totally and completely miserable!!  About three hours after the injection, I also began sweating a LOT (yes it's hot here in Va, but I was in the a/c), had some dizziness and nausea.  I do sometimes get some nausea when my pain levels are high, but not usually dizziness or sweating.

this morning, after a horrible night of trying to sleep, I'm no longer dizzy, but my stomach is still quite queasy, I have a nasty headache (I tend to get bad headaches whenever I'm on prednisone or any steroid) and I've got body aches all over - no fever or sore throat, so I dont' think it's a virus.  Of course, too, the hip pain has not settled down at all.

If it hadn't been after hours when the sweating and nausea started yesterday, I would have called the ortho office to see if they felt it was a "reaction" or side effect of the injection (I've never had this with my other cortisone injections - some localed increased pain, yes, but nothing like this).  And of course, it is now the weekend, so I can't call.

Has anyone else ever experienced these types of things with a cortisone injection?  Is it somethign I should be really worried about or could I just try to wait it out and call their office on Monday?

I'm so very frustrated not only with my pain right now, but also with the doctor's office - why is it they don't always listen to their patients when they tell them where and how their pain is?  is it simply because they are the ones with the degree so they think they know it all?  I beg to differ if that's the case - WE are the patients - WE know how we are feeling.

Sorry, I guess I also needed to vent.

If anyone has ANY suggestions, anythign would be greatly appreciated.
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16 Comments Post a Comment
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Avatar_f_tn
Oh, I feel for you.  I have almost the exact same thing going on.  Though my hand issues are now overriding everything else.  I have (from over 20 years ago) a herniated disk at L5S1, which is common.  Mine came from a fall.  It's been manageable and it only acts up every few years (though when it does flare-up, it does it 3 times in a row.)  My right hip, though, is brutal.  There are times I have to crawl up the stairs with it.  My guess is it's arthritis since I have it so bad in other spots.  Even the ortho and hand specialist assume that's what it is and given my history figure I'll need a hip replacement at some point.

I find in addition to my narcotics for my hand, I need Advil as well.  The hip pain sort of overrides everything.  I also alternate heat and ice and basically I just deal with it.  They did give me these lidocaine patches for my hand and I tried it on my hip and it gave me some real relief.  I have not done he cortisone shots on my hip yet.  That was one of the things they did to my hand and they did too many which made a bad problem in my hand even worse.  But the hip can really be bad.  I know mine wakes me up, can't get comfortable sitting, lying or standing.  I put pillows between my legs.

One thing I did notice that helped is using an elliptical machine.  No idea why.  I was trying to walk on a treadmill when i was at the gym.  No way can I do it.  Causes my hip to throb that night in the the worst way.  But the elliptical actually makes it feel better.  I don't know if it's the motion or what, but it makes a difference.  Also some gentle exercises in the pool is helpful as well.  And sitting in a jacuzzi.

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Avatar_f_tn
The side effects I had from the steroids was hot flashes, facial flushing, increased night sweats and weight gain. I sweat a lot normally. I'm on Wellbutrin and it's one of the side effects but while I was getting the injections it was horrible. I'd sweat for no reason just sitting in my office chair. My night sweats got 10x worse. Everything has finally calmed down now 2 months after my last injection. I gained 10lbs in a month and I'm still trying to get rid of it.6 to go. The weight gain alone is enough to make me never have another steroid injection.
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Avatar_f_tn
I never got weight gain from a steroid injection.  I did get a big weight gain from Lyrica ... 15 pounds in two weeks. Plus a few other side effects. When I came off it, the weight came off too, except for a pound or two.

When my daughter did an oral course of steroids for asthma, she GAINED a ton for a little kid.  She got that "moon face"look (so did my mom when she was on it.)  She was constantly hungry ...nothing would fill her up.  Poor little thing. I remember her asking me why.

I also remember that even when the taper was done, it took a bit longer for the weight to come off but it did eventually.
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Avatar_f_tn
When I was taking oral steroids I couldn't stop eating.  I worked in the seafood dept of a grocery store and we had pre-cooked coconut shrimp.  I was popping those things like candy, lol.  I probably gained about 20 lbs over the course of a few months.  Whenever I think of steroids, I also think of coconut shrimp.
As far as the shot goes, you are describing my symptoms exactly.  That's why I didn't go back for a third.  On the second the doctor prescribed percoset (previously I had no BT meds) for the time after the shot.  It helped a lot, compared to just the methadone at the time.  The first night after the first shot I was in so much pain and restless, I wish I would have gone to the ER.  I just paced around in the hot shower for hours until I could take my nighttime meds and go to sleep.  I do consider that some of the worst pain of my life and sort of compare any pain I go through to that.  
I hope you feel better soon.  If you are still feeling awful, I would go to the ER.
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Avatar_f_tn
thank you all for your kind words and suggestions.  It's a relief to know that more than likely what I'm experience is pretty "normal", even though I've never had this type of thing happen with my past cortisone injections.  I guess it's like anything else, sometimes things just affect you differently.

I usually do get the weight gain and moon face when i'm on oral steroids - I've been on them a Lot in my life - both for the arthritis, lupus and I also have pretty severe asthma that requires the steroids quite often.  I never have notice much of a weight gain with the cortisone shots in the past, but with this one affecting me so differently, it wouldn't surprise me if it did!  UGH!!

Unfortunately, i cannot take any type of anti-inflammatories - they not only tear up my stomach BIG time, even with stomach meds on board, but they also tend to raise my BP.  I don't have any trouble with my BP normally, unless I take anti-inflammatories.  So I tend to avoid them like the plague.

I actually would LOVE to sit and soak in a jacuzzi, however, it is impossible for me to get down into a tub and also back up again, so that's out of the question.  I am finding the ice does numb the hip for a while, but of course, as soon as it starts to "warm up" again, the intense pain returns with a vengeance.

I am taking my normal Lorcet Plus - I still have a couple of the dilaudid left that my PCP prescribed when I first went to her with the hip problem, so when it's med time again, I think I may try one of those and see if it helps any better than the lorcet.

I also forgot to mention the HORRIBLE, HORRIBLE insomnia last night!!!  I always have a lot of trouble sleeping anyway, and especially when I;m on steroids, but once again, never had it be even worse after a cortisone injection - until this time!!  I'm sure a good bit of it was because of the pain and not being able to get comfortable, but even when I was able to find a semi-comfortable position for at least a short time, I found myself just staring at the ceiling because I wasn't really even sleepy - and this was after taking my nighttime Ambien.  I think I got a total of about 1 1/2 hours all night - that could also be adding to my body aches today - hadn't really thought about that until just now.

Fortunately, the dizziness from yesterday has passed and the sweating is a good bit more under control - at least it's not jsut pouring off of me like it was yesterday afternoon/evening/night.  Now if I could just get the pain and nausea under control I'd be happy.  Hoping to be able to get a nap in a bit later.

Again, thank you all for your suggestions and if you have any others, I'd be happy to hear them!
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Avatar_f_tn
Please have them check the hip area if you are still having issues at the beginning of the week.If you are a long term(even on and off)steroid therapy patient it does put you at a higher risk for necrosis of the bone and the beginnings are not painful pain starts when necrosis has begun.The most common sites are hips,knees and shoulders.

Please mention it to the dr and not the PA especially after she did not adequately address your questions when expaining the test results.

I am not saying thats what this is but want you to be aware that it COULD be an issue that may need to be explored especially due to long term steroid use over the years.

I hope you feel better soon and get some solid answers.
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Avatar_f_tn
Thank you for your suggestion - I'm definitely calling the ortho office the beginning of the week and setting up and appoitnment with the hip specialist.  I haven't received any relief at all from the injection and teh side effects have been horrible this time.  A friend and I went out to dinner last night - he was trying to get me out as a diversion from the pain, bless his heart - but anyway - I ended up eating my meal doing the sit down/stand up dance - I'd sit for a couple of minutes until the hip became unbearable and the I'd have to stand for a while (which I also can't do for too long not only becuase of the hip, but also the arthritis in my knees).  I was so embarassed for having to be up adn down so much, but I also didn't want to just pack up our meals and leave - that would have actually made me feel worse - at least my friend was able to eat him meal in relative peace and enjoyment, even while laughing at me for getting up and down so much!  

I do know that long term (and like you said, even sporadic) use of steroids is not good for the bones and the docs have told me that that is one reason my arthritis is not only as severe as it is, but also why it has hit me at such a relatively young age (I'm 47 now but was first diagnosed with teh arthritis about 8 years ago)  I've already had one shoulder replaced, have been told I need to have both of my knees replaced and I also have an ankle that will also need to be done probably in the next several years - I broke it about 3 years ago - while on prednisone - and it has never quite healed properly and now the arthritis has settled in it.

I did ask the PA if perhaps my knee situations could at least be adding to the hip problem and she did say it was an absolute possibility.  Fortunately, the hip specialist that I'll be seeing is also their knee specialist, so hopefully can address that idea/possibility further with me.  Her comments to me about it when I asked was that yes, because with my knees being bad, my gait is different than what it used to be - adjusting for the pain and weakness in the knee, so it could very well be makign the hip move differently also, which could have damaged it.  Soooooo, there is a possiblity that I'll be having the knees done sooner than I had hoped - I was trying to put it off as long as possible - again because of my relatively young age, so hopefully I could avoid having to have them redone at a later date.

So yes, I definitely plan on going to see the hip doc and hopefully he will be able to give me more information/advice on what is going on and most importantly, LISTEN to me when I tell him where my pain is mostly located.

Thank you again - I hadn't really thought about the prednisone use over the years possibly being an issue (even though I know they can and are - my mind just didn't "go there" this time).
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547368_tn?1332173665
Hi Geminigrl,

I apologize to my tardy response. Your post is very well written and contains a lot of good information. Thank you.

I have had repeated bouts of trochanteric (hip) bursitis. It is so painful. I have been fortunate that an injection of steroids has always relieved my painful bursitis symptoms. I've experienced a bit of increased pain in the 24 hours following the injection but never as extreme as yours. I have also noted nausea and some perspiring but again not to any great degree or for any extended length of time.

I do have insomnia after an injection. My system seems to be very sensitive. If anything can cause insomnia in ppl, it most certainly will for me. I am sorry that this seems to be true for you also.

When similar hip, low flank, gluteal and leg pain was not relieved by a steroid injection it was finally diagnosed as SI Joint Dysfunction.  This took a number of years and my repeatedly saying this is not the same as the bursitis pain before I was properly diagnosed.  Has your SIJ ever been considered as a possible source of for your pain?

As suggested, steroids can cause bone necrosis. This can occur with one dose or may never occur after large amounts of steroids, even over an extended period of time. Why this happens in one and not another it not certain. However the pain is very debilitating and extremely painful. In my opinion this should also be considered and investigated. It's not difficult to diagnosis.

A physician that listens is priceless. They can be hard to come by. I hope you are able to get her "ear."  If not do not hesitate to look else where.

Some new joints are now lasting thirty years and more. Every few years that time frame increases. My sister is about your age and is holding out for the same. Some days she is ready to take the chance and have the surgery. I am sure you know how she feels. It is possible that even a unconscious change of gait is effecting you hip pain. Our body is really one unit and functions as such.

I hope you will find a resolution to your increased pain and symptoms. You've had more than enough to deal with. Your strength is admirable. Please continue to keep us posted. I'll be thinking of you. :)

~Tuck
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Avatar_f_tn
Thank you, Tuck, for your wonderfully kind words.  I'm glad to hear that somebody thinks I have some strength, for I certainly do not feel like I do right now.

I did ask about the SI Joint at my first appt with the ortho (at your suggestion from my initial post about the hip pain several weeks ago), but she did not feel it was that - she said the pain from the SI joint is typically more localized in the SI joint area (back of the hip is where she was pointing) and my pain is not that localized.  I will, however, approach the subject again with the hip specialist when I get in to see him - especially now that the PA that I saw doesn't seem to really know what is going on and didn't really listen to me when I was telling her where my pain was the worst (hip as opposed to lower back).

I've also been doing some research over the weekend on hip pain and one thing I came across that I had thought about initially, but then didn't think about it much more until I read more about it this weekend is a labral hip tear.  Do you by any chance know anything about this and if, in your opinion, it might possibly be a cause for my hip problems?  from what I've been reading, the pain I'm experiencing does sound quite a bit like what those with a tear have.  The main thing I'm wondering, though, is, that I've not had an injury or fall that could have caused a tear, so I honestly don't know how a tear would/could have occurred.

I'm sorry to hear of your sister's ortho problems also.  I can relate to what she is going through, yes.  I just recently saw an ad on tv for a relatively new knee replacement that is supposed to last 30 years or more, so I think I will also ask the hip specialist (who is also their knee specialist) about it.  By all means, if getting my knees done now will help my hip situation and possibly help me avoid having teh same situation come up with my other hip, I'll definitely go for the surgery sooner rather than later.  Obviously I'd like to avoid major surgery if I can, however, I also feel that if it's inevitable down the road, I'd be better off getting it done soon before I get too bad and then it would only make my recovery all that much harder.

It is very comforting, not only to have all my MH friends here to talk to, but also to know that the side effects I've had from the injection seem to be somewhat "normal" - it's always scary when you begin to experience something different from what you've experienced before, even with the same type of therapy/medication.  I still had some insomnia last night - still more than my norm - but it wasn't quite as severe as Friday night, so hopefully that will also begin to go away - I certainly can do without any additional sleep issues!

I'm going to place a call to the ortho office tomorrow morning and see about getting in to see the hip specialist and also ask if they think it's best to get the hip MRI before seeing him or after - my thoughts are it would be best to get it done beforehand and then hopefully whenever I do see him, he'd have the appropriate films in hand to hopefully be able to give me a correct diagnosis and begin treatment.  But, of course, I'll have to go by whatever they say.

Thank you all again for everything.
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Avatar_f_tn
I had never heard about steroids causing problems like that before this post.  I am so glad to know it.  I haven't taken much for steroids in a long time, but for a while there it seemed like all the time.  
I really hope you start to feel better soon, Gemini!  It's awful when something we hoped would make us feel better actually makes us feel worse for a while.  Every time I get an injection I start complaining and my husband says "You always feel that way, why do you bother getting them?".  Really he should speak up before I go in for them, then. LOL
I've only had 2 or 3 though, and I have heard that sometimes if you don't get relief from the first you do from the second.. yada yada.. I know when we are desperate we'll try anything, sometimes I guess we just have to decided when is enough.
I think you have a great idea that if the knee replacements last 30 years they might save you a hip replacement down the road.  It's kinda sad when we have to pick one replacement over another, but I imagine the hip replacement is more complicated and I think you are right about the recovery time being better.
I hope you feel better soon and get to the bottom of this!
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Avatar_f_tn
Thank you Bree for your well wishes - they really are appreciated greatly.

You're absolutely right - when the pain makes you desperate enough, you are pretty much willing to try just about anything and that's one reason I did not hesitate when the PA suggested giving the cortisone injection a try - I also figured I had been through them before with my knees and my shoulder, so I THOUGHT I knew what to expect, but I guess I was definitely wrong in this case.  Because of this strange "reaction" that I've had this time, I doubt I will give another one a try if it's suggested - if I had gotten at least SOME relief from it, then my thoughts might be different, but since I haven't, and because of the "reactions", I definitely think I'm going to steer clear.

I also have heard that hip replacements are much harder to recover from and a much riskier surgery.  If I could get 30 years out of a knee replacement that would possibly also help the hip, then I definitely feel it would be worth it.

How are YOU feeling?  Is the dilaudid helping any more than it was?
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Avatar_m_tn
It could very well be a labral hip tear.  The labral is the "cushion" that lines the inside of the hip socket to prevent bone one bone friction of the "ball" of the femur and the "socket" of the acetabulum.  This could have been caused from anything from an injury, (possibly even and unknown injury) excessive use, repetitive motion, etc.  especially in more active individuals.  There could also be a cam, pincher or mixed hip impingement that caused a labral tear over time.

A cam impingement the femoral head is not round, a "bump" has either formed or could have been there since birth, this prevents the ball from rotating smoothly and grind the labrum inside the socket.

A pincher occurs when extra bone extends out over the normal rim of the acetabulum and the labrum can be basically crushed under that rim over time.

A mixed impingement is when you have both of the above, (which is what I had)

The medically accurate term for this is a Femoroacetabular Impingement or FAI for short.

More people probably have this and may not know it.  Less active individuals do not experience the labral tear until much later in life and  may end up having a hip replacement, which in this day of advanced medical techniques is much easier recovery than the next option, but since any joint REPLACEMENT doesn't usually last forever the newer procedure that a select few specialized surgeons are recommending for their younger, active patient who wish to continue, or resume their active lifestyle is arthroscopic surgery where they can repair the labral tear (these tears unlike a muscle tear, will not heal on their own) and reshape or shave off the boney spurs of the femur, acetabulum or both.

Google Femoroacetabular Impingement or FAI.  There are lots of good articles, pictures, etc. Not a lot of Doctors are aware of this procedure and therefore don't think of it when a patient comes to them with hip pain.

I hope this has helped,  Good luck - believe me, I feel your pain!
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Avatar_f_tn
I know I'm three years late, but I just found these postings and I'm going through EXACTLY what you did geminigirl1963. EXACTLY. :(
I had my first SI injection seven weeks ago and had been pretty much pain free up until a few days ago. Now my pain level is getting to be back where it was before the injection (which is severe) and it's depressing the hell out of me.
I see my doctor in a few days to schedule another injection (btw, it took them almost a year to figure out what was wrong with me)
In short, thanks for sharing your experience.
Are you feeling better?
I just can't believe how painful this is.
Oh, and when they did the first injection I practically screamed it was so painful. At least I knew they hit the right spot.
Thanks again and I'd love to hear how you're doing now.
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Avatar_f_tn
I know I'm three years late, but I just found these postings and I'm going through EXACTLY what you did geminigirl1963. EXACTLY. :(
I had my first SI injection seven weeks ago and had been pretty much pain free up until a few days ago. Now my pain level is getting to be back where it was before the injection (which is severe) and it's depressing the hell out of me.
I see my doctor in a few days to schedule another injection (btw, it took them almost a year to figure out what was wrong with me)
In short, thanks for sharing your experience.
Are you feeling better?
I just can't believe how painful this is.
Oh, and when they did the first injection I practically screamed it was so painful. At least I knew they hit the right spot.
Thanks again and I'd love to hear how you're doing now.
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Avatar_f_tn
I have being experiencing Hip pain and lower middle back pain since June of this year. Cut along story short I have the depo- medrone injection into my hip joint Wednesday last week and omg the pain in the back is even worse . Groin pain has gone hip is tender but I am suffering with my back I'm in tears it really hurts and pain killers are not doing a damn thing for me at all . Does this mean the steriod hasent worked ? And why is my back feeling worse than it was before I had the injection ?
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3112530_tn?1342559764
For informational purposes ask your orthopedic doctor about the Piriformis muscle or if this is related. Do so research on the Piriformis muscle syndrome. Find a doctor who has experience in this field and this can be treated with shots (not steroid). That is what I have and that is what I am getting for this piriformis syndrome. The shots help calm down the nerves.
Check into this and find a specialist in this area. It may help...can't hurt to find out more information...can it?
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