Are Cortisone Injections Painful?

Doctors Can Help to Ensure They Are Not Painful

Cortisone injection
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Cortisone injections are a treatment option for areas of localized inflammation in the body. The injections can also be used to treat inflammation that is more widespread in the body. Localized injections are given into the affected joint (intra-articular injection). Systemic injections are usually given in the buttocks.

Some patients say cortisone injections are painful. Most doctors say they shouldn't be.

Plus, there are patients who have had several cortisone injections over time who would tell you that some were painful, others not so much. Confused? What should you really expect when getting a cortisone injection? It's actually somewhat subjective. If you think a cortisone injection is painful, it is. But, in reality, doctors take steps to ensure that cortisone injections cause little to no pain.

What Doctors Do to Minimize Pain Associated With Cortisone Injections

In describing how he minimizes the pain when giving cortisone injections, rheumatologist Scott J. Zashin, MD said, "I freeze the skin with ethyl chloride and I take my time." Aside from topical anesthetics used to freeze the skin before giving injection, other numbing medications, such as lidocaine, can be injected with the cortisone. Using a small (thin) needle instead of a larger (thicker) one helps to alleviate discomfort, too.

However, if your doctor wants to remove fluid from the affected joint in addition to injecting cortisone, he will likely opt for the larger needle.

My Personal Experience With Cortisone Injections

To treat localized pain and inflammation associated with my rheumatoid arthritis, I have had several cortisone injections over the years.

There was only one time when the injection caused me to inadvertently curse at my orthopedic doctor. Perhaps he didn't take his time, freeze the skin or wait until it was numb. I can't really say why that one injection was so much more painful than any other I received.

It is normal to feel pressure as the needle is inserted into the affected joint. As the medication is released into the joint, it is normal to feel a slight sensation. After the injection, be careful as you first put weight on a weightbearing joint because it can feel "different" as the freeze spray and lidocaine wear off.

The Bottom Line

You won't be given a guarantee that a cortisone injection will be pain-free. Most often, the experience is not bad though. The pain is usually minimal, but there can be that rare exception.

Don't be shy. Ask your doctor to briefly explain the procedure he will use when giving you the cortisone injection. If you hear words like freeze spray, lidocaine, and small needle, you're likely in good hands.

The next step is for you to relax. Tensing up will work against you.

After the injection is done remember to avoid strenuous activity for about 24-48 hours. You can apply ice to the injection site if you have any discomfort. Most importantly, observe the joint for signs of infection, pain that is increasing rather than decreasing, or redness and swelling that persists for more than 48 hours. Call your doctor if you observe anything of concern.


Cortisone Shots. What You Can Expect. Mayo Clinic.  August 13, 2013.

Steroid Injections. Tests and Procedures. Cleveland Clinic. March 16, 2015.

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