Side effects are actions of drugs that patients don’t wanna experience, they may be an ordeal however, sometimes, they can’t fend them off. Medications are prescribed for certain therapeutic purposes, for example, to treat eczema or other conditions. All other consequences of the medicine are classified as adverse events. Some of them are mild (a headache, stomach upset, heartburn). Others, such as liver damage or long-term fever, can be severe.
Side effects of steroids may be remorseless because these drugs are hormonal in nature. Breaking the hormonal balance in the body can lead to unpleasant outcomes. Below, we describe the side effects of cortisone, a drug belonging to the “cartel” of corticosteroids.
Cortisone Shot Side Effects (from Injections in the Elbow, Back, Knee, etc.)
Systemic undesirable side effects in the 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 inconsequential amount of the solution is carried throughout the body via the bloodstream. Here are some examples of cortisone shot side effects depending on the site of the shot:
- Elbow. These may include pain & swelling around the injection site and hives.
- Knee. Swelling and pain are possible.
- Wrist. Pain, swelling, and on rare occasions, nerve damage.
In addition, some patients may notice that the skin around the shot zone becomes paler.
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 the spine can also develop adverse events. These include all the above-mentioned inimical actions plus a pounding headache relief from which is only obtained by lying down. Another example of side effects from a shot in the back is fluctuating blood sugar levels, but this is largely insignificant. 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 sweat gland ducts);
- 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 noted that during her juvenile years she used a moisturizing cortisone cream. As a result, her skin became thinner and blood vessels began to be visible.
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 body. Adverse events can also be systemic.
Elevated blood glucose levels are the most typical response, which is more common in diabetic individuals. Therefore, diabetes sufferers should carefully monitor the sugar levels in their blood during the therapy. This medicine can temporally increase them, requiring an adjustment in 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 a 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 this 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 ulceration. However, this myth “still survives amongst general practitioners”.
According to experimental studies, corticosteroids don’t appear to cause ulcers directly but can prevent the process of the healing of an ulcer originally 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 researchers, the myths about steroid ulcers are still preserved, although they are 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 and as prescribed.
In case of prolonged use, don’t cease your therapy suddenly. If the administration lasts over 14 days, it is advisable to lower the dosage gradually tapering to the point of complete discontinuation. This will facilitate the recovery 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 eating to protect your stomach lining and intestines from potential harm (although cortisone isn’t a noted direct cause of ulcer development). The possibility of stomach diseases is higher if you take NSAID meds together with cortisone, or drink alcohol. Your physician may recommend additional remedies for protecting the stomach mucosa and averting both ulcers and gastritis.
People who are treated with cortisone are more likely to face infectious disorders and conditions because the drug compromises the immune system. Bear this in mind if you have any chronic infection like viral herpes.
Continuous 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 will enhance your appetite. The result is obvious: you eat more and gain excess pounds. Throughout the treatment period, it’s precautionary to have regular blood tests to monitor sugar levels. See an ophthalmologist once a year, as long-term therapy can create impairment of vision and other eye diseases. Children should visit a specialist for early detection of any delay in maturation.
Local cortisone infusions are usually perfectly safe. Unwanted effects typically develop when therapy involves tablets or systemic body steroid injections. If a patient experiences a serious negative reaction, his/her doctor can replace cortisone with other medicines, for instance, NSAIDs. Cortisone is now generally being superseded by hydrocortisone, a substance with a similar chemical structure, which has not dissimilar side effects but suppresses inflammation more intensively and effectively.