Side effects are actions of drugs that patients don’t wanna experience (they may be a ordeal); however, sometimes, they can’t fend them off. Medications are prescribed for certain therapeutic purposes, for example, to treat eczema or other condition. All other consequences of the medicine are adverse events. Some of them are mild (a headache, stomach inquietude, heartburn). Others, such as liver damage or long-term fever, can be severe.
Side effects of steroids may be pitiless because these drugs are hormonal in nature. Breaking the hormonal balance in the body can lead to unpleasant outcomes. Below we describe side effects of cortisone, a drug belonging to the “cartel” of corticosteroids.
Cortisone Shot Side Effects (from Injections in Elbow, Back, Knee, etc.)
Systemic undesirable effects in case of local (intra-articular) cortisone intermuscular injections are occasional and insignificant. Most of the negative reactions are triggered by oral administration of steroids, but if the substance is injected into the inflamed area (e.g., joint), only an unimportant amount of the solution is carried throughout the body with the blood flow. Here are some examples of cortisone shot side effects depending on the site of shot:
- Elbow. These may include pain & swelling around the injection area, and hives.
- Knee. Swelling and pain are possible.
- Wrist. These imply pain, swelling, and nerve damage (rarely).
In addition, some patients may notice that the skin around the shot zone becomes lighter.
It’s interesting: “Side Effects” is a psychological thriller by Stephen Soderbergh. It’s about a woman taking experimental drugs after her husband is released from prison.
Spinal Cortisone Injection Side Effects
Epidural steroid injection in spine also may cause adverse events. Thus, they include all above-mentioned inimical actions, and a pounding headache that is only relieved while lying down. Another example of side effects from shot in back is fluctuating blood sugar, but it’s inconsequential. Other side effects may be as follows:
- Facial flushing.
- Local pain increase.
Cortisone Cream & Lotion Side Effects
Undesirable reactions caused by cortisone-based creams are:
- redness of skin, irritation;
- male-pattern hair growth;
- cutaneous atrophy;
- red, itchy rash;
- skin maceration;
- miliaria (skin changes induced by clogged duct of sweat gland);
- systemic action (long-lasting treatment, covering a large surface, to injured skin, or under a tight bandage increase the risk).
The same holds true for lotions. One female patient has noted that during her juvenescence she used a moisturizing cortisone cream. As a result, her skin became thinner and blood vessels began to be viewable.
Side Effects of Cortisone Pills & Systemic Injections
The main drawback of tablets and general injections is that they may have a systemic effect on the organism. Adverse events can also be systemic.
Elevated blood glucose rate is the most typical response, which is more common in diabetes individuals. Therefore, persons suffering from diabetes should carefully monitor the sugar level in the blood during the therapy. This medicine can temporally increase it. Persons administering insulin need to frequently check their glucose levels and adjust the insulin dosage (if the necessity exists).
In addition, acne, dry skin, and excessive hirsuteness or hirsutism (which is also a common side effect of prednisolone) may occur. These reactions are more widespread in women, their prevalence is about 15%. They may appear 1-2 hours after the shot, and last for 3-4 days. Administration of cortisone may also trigger downgrade of natural hormone secretion by the adrenal glands.
There are suspicions that corticosteroids can lead to a stomach or duodenal ulcer. Some scientists of the mid-20th century described cases of ulceration as an outcome of cortisone therapy. Is it true? What does science say about this now? If we look at modern studies, for example, the article “Steroid ulcers: Any news?” (World J Gastrointest Pharmacol Ther. 2013) by Italian scientist Mario Guslandi, we’ll see that most likely cortisone isn’t a direct cause of the process of becoming ulcerated. However, this myth “still survives among general practitioners”.
According to experimental studies, corticosteroids don’t appear to cause ulcer directly, but prevent the process of healing ulcer provoked by other meds, namely nonsteroidal anti-inflammatory drugs, like aspirin, ibuprofen, and naproxen.
Nevertheless, as Guslandi points out, due to a lack of interest on the part of modern research, the mythos about steroid ulcers is still preserved, although it’s based on numerically insignificant clinical data (for example, on studies that have described cases of ulcers only in small groups of patients).
How to Avoid or Minimize Side Effects of Cortisone?
Here are some tips:
- Do not change the dosage yourself, take the drug properly.
- In case of prolonged use, don’t terminate your therapy suddenly. If the administration lasts over 14 days, it’s advised to lower the dosage gradually until the complete discontinuation of cortisone administration. This will provide recovering of the endogenous production of hormones.
- Don’t start cortisone treatment again without a doctor’s prescription.
To reduce the risk of side effects, consume cortisone-based preparations with a meal or after it to secure your stomach and intestines from potential harm (although cortisone isn’t a visible direct cause of ulcer development). The possibility of stomach diseases is higher if you take NSAID meds together with cortisone, or drink alcoholic beverages. Your physician may recommend you additional remedies for protecting the stomach mucosa and averting the ulcer and gastritis.
People who are treated with cortisone are more likely to face inflectional conditions, because the drug compromises the immune system. Bear this in mind if you have any chronic infection like viral herpes.
Durable administration can disrupt the process of natural hormone emission. If you take the medication in the morning the possibility of this snag is lower.
Consult a licenced specialist about your nutrition during the therapy since the drug boosts appetite. The result is obvious: you eat more and gain excess pounds. Throughout the treatment period it’s advised to take a blood tests to monitor sugar levels. See an ophthalmologist once a year, as a long-term therapy can provoke impairment of vision and other eye diseases. Children should visit a specialist for early detection of delay in maturation.
Local cortisone infusions are usually safe. Unwanted effects typically develop when one uses tableted drugs or systemic body steroid injections. If a patient experiences a serious negative reaction, his/her doctor can replace cortisone with other meds, for instance, NSAIDs. Cortisone is now gradually replaced by hydrocortisone (a substance with a chemical structure similar to it), which has resembling side effects, but suppresses the inflammation more intensively.