# Cortisone injections

> A cortisone (corticosteroid) injection places anti-inflammatory medicine into or around a sore joint or tendon to ease pain, swelling and stiffness. Relief usually lasts weeks to months, and it works better for some problems than others. Exercise and physiotherapy often still matter.

Guide in [Treatments](https://footanklelowerlimb.com.au/learn/topics/treatments), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/corticosteroid-injection
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026.
Next review by 27 October 2027.

- **It's an anti-inflammatory medicine** placed into or around a sore joint or tendon to ease pain, swelling and stiffness.
- **Relief is usually short-term,** lasting weeks to months, and a few people get none.
- **It suits some problems better than others:** frozen shoulder and trigger finger more than knee osteoarthritis or tendon problems.
- **Exercise and physiotherapy still matter,** especially for tendon problems.
- **It isn't for everyone,** for example if you have an infection, feel unwell or have surgery planned.

## What is a cortisone injection, and how does it work?

A cortisone injection (the clinical name is corticosteroid injection) puts a small amount of anti-inflammatory steroid medicine into or around a painful or swollen joint, or soft tissue such as a tendon sheath (the lining around a tendon) or a bursa (a small fluid-filled cushion) [1]. It calms inflammation, which can ease pain, swelling and stiffness, and it works like cortisol, a hormone your body makes naturally [2]. A local anaesthetic is often added to numb the area for a few hours [3].

## What is it used for, and how well does it work?

It's used for osteoarthritis (wear in a joint), bursitis, tendon problems, frozen shoulder, trigger finger and de Quervain disease (pain on the thumb side of the wrist) [1][4]. How well it works depends on the condition, and the best-supported benefit is short-term pain relief.

- **Frozen shoulder:** it eases pain in the short term more than physiotherapy or no treatment, and its edge may last some months [5][6].
- **Trigger finger:** it works better than a placebo (dummy) injection [7].
- **Knee osteoarthritis:** it can ease pain and improve function for a few weeks, but there's no clear benefit by 26 weeks [8]. Repeated injections over 2 years eased pain no better than saline and led to more cartilage loss [9]. Guidelines still recommend it for knee and hip osteoarthritis [10].
- **Plantar heel pain:** it's sometimes listed as a condition where injections may help [1], but how well it works for the heel isn't clear yet.

Relief often starts within 24–48 hours, sometimes up to a week, and lasts from a few weeks to several months [1]. It varies between people, and a few get no benefit [3].

## Is a cortisone injection right for me?

It suits people who are likely to benefit and have nothing that makes an injection unsuitable, so the doctor will check this first [11]. It shouldn't go ahead if you have an infection in the area or elsewhere in your body, a fever, a skin problem at the injection site, an allergy to the steroid or local anaesthetic, or poorly controlled diabetes, or if you feel unwell or have surgery planned in that area soon [11][12]. An injection in the weeks before arthroscopy (keyhole joint surgery) is linked with more infections afterwards [13], so tell your surgeon and ask about timing.

Tell the doctor about all your medicines and vaccinations, and if you have a weakened immune system or are pregnant or breastfeeding [1][3]. For a child, ask the doctor whether it's suitable.

## What happens during and after the injection?

Before the injection, the doctor explains the procedure and risks and checks it's suitable for you [2]. It's a prescription medicine, usually given by a specially trained doctor in a GP clinic or hospital clinic [14], using a sterile technique [15]. Ultrasound is sometimes used to guide the needle, which places it more accurately. It's strongly recommended for the hip but not required for knee or hand joints [16][10]. The medicine and amount depend on the joint or tendon being treated, so ask your doctor how many injections they suggest and how far apart.

Afterwards, the numbness from the local anaesthetic wears off after a few hours. You may then have mild soreness, called a steroid flare, for 24–48 hours until the steroid starts to work [1].

## What are the risks and side effects?

Serious problems are rare [17]. Joint infection happens in about 1 in 10,000 procedures [3]; it's serious and is treated with intravenous antibiotics in hospital [18]. A severe allergic reaction (anaphylaxis) is very rare and usually happens within minutes of the injection [17]. Repeated injections raise the chance of a tendon or ligament rupture [17]. Injections may also temporarily raise blood pressure if you have high blood pressure [2]. The warning signs are listed under "When to see a podiatrist".

> [!see] If you have diabetes
> A steroid injection can raise your blood sugar for a few days [2]. Tell the doctor you have diabetes before the injection and check your blood glucose for the next 48 hours, acting on the readings [11]. See your GP if you can't bring your blood glucose under control.

## How does it compare with other options?

For tendon problems, an injection often eases pain sooner, but it doesn't do better than physiotherapy or exercise beyond the short term. In rotator cuff tendinopathy (shoulder tendon pain) it seemed no more effective than physiotherapy at mid- and long-term follow-up [19]. In tennis elbow, physiotherapy did better over the long term, and injection was linked with more recurrence [16]; it also did worse than a placebo injection at 1 year [20]. In gluteal tendinopathy (pain at the outer hip), education on load management plus exercise did better than injection at 8 months [16].

So it works best as a short-term aid within a wider plan, not a stand-alone fix. Simple self-care and exercise-based care are a sensible first step for tendon problems. If an injection gives you a pain-free window, that's a good time to start or build up your exercises.

## When to see a podiatrist

Call 000 and ask for an ambulance if, within minutes of an injection, you have difficulty breathing or wheeze, or swelling of your face or tongue [17][1].

Go to the nearest emergency department if a joint becomes suddenly hot, swollen and very painful, with a fever, and you feel unwell [21].

See your GP or a podiatrist the same day if, after an injection, the area becomes red, hot or swollen; you have severe or worsening pain, a fever or a rash, or you feel unwell; you can't move the joint properly or put weight on it; or you have sudden severe joint pain with hot, swollen or red skin, as a joint infection may not cause a fever [1][4][17][21]. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic.

See your GP or a podiatrist if the injection hasn't helped after the time you were told to expect, or your symptoms are getting worse, so the plan can be reassessed.

Ask a podiatrist or your GP about an injection if a sore joint or tendon hasn't settled with self-care and exercise, and you'd like short-term relief while you rebuild.

## Common questions

### Is a corticosteroid the same as an anabolic steroid?

No. A cortisone injection uses a corticosteroid, an anti-inflammatory medicine that calms inflammation in a sore joint or tendon. It's given as a small amount placed right where it's needed. Corticosteroids are a different type of medicine from anabolic steroids, so having one doesn't involve the kind of steroid people often think of.

### Can I have a cortisone injection if I'm on blood thinners?

Not automatically ruled out, but it needs extra care. People taking blood thinners have a slightly higher risk of bleeding after an injection. Tell the doctor which medicines you take before the injection is planned. Your doctor or pharmacist can advise you about your medicines, so it's best to ask them rather than change anything yourself.

## Further reading

- [Cortisone injections on Clindice](https://clindice.com/corticosteroid-injection)
- [Guided Therapeutic Injection in the Ultrasound Dept](https://www.wwl.nhs.uk/pdfreader/accessiblePDF/cnv-wwl-68ca8bd103dc04.73049781), NHS
- [Local Steroid Injection](https://www.uhb.nhs.uk/media/seyp2kq0/local-steroid-injection-physiotherapy-pi.pdf), NHS
- [Musculoskeletal injection treatment](https://www.kentcht.nhs.uk/leaflet/musculoskeletal-injection-treatment/), NHS
- [Common questions about hydrocortisone injections](https://www.nhs.uk/medicines/hydrocortisone-injections/common-questions-about-hydrocortisone-injections/), NHS
- [Steroid injection referral guide :: Mersey Care NHS Foundation Trust](https://www.merseycare.nhs.uk/steroid-injection-referral-guide), NHS

## Sources

1. Joint Injection · NHS. https://www.torbayandsouthdevon.nhs.uk/uploads/25952.pdf?last-updated=20260305
2. Steroid (corticosteroid) injection · Healthdirect Australia. https://www.healthdirect.gov.au/medicines/steroid-corticosteroid-injection
3. Ultrasound-guided steroid injections · Chelsea and Westminster Hospital NHS Foundation Trust. https://www.chelwest.nhs.uk/your-visit/patient-leaflets/imaging/ultrasound-guided-injections
4. Is a Steroid Injection in Both Compartments More Effective than an Injection in the Extensor Pollicis Brevis Subcompartment Alone in Patients with de Quervain Disease? A Randomized, Controlled Trial. · Jung HS, Baek SH, Lee JS · Clinical Orthopaedics and Related Research · 2022. https://doi.org/10.1097/corr.0000000000002018
5. Comparison of Treatments for Frozen Shoulder: A Systematic Review and Meta-analysis. · Challoumas D, Biddle M, McLean M et al. · JAMA Network Open · 2020. https://doi.org/10.1001/jamanetworkopen.2020.29581
6. Ultrasound-guided intra-articular and rotator interval corticosteroid injections in adhesive capsulitis of the shoulder: a double-blind, sham-controlled randomized study. · Prestgaard T, Wormgoor MEA, Haugen S et al. · Pain · 2015. https://doi.org/10.1097/j.pain.0000000000000209
7. Evidence-based management strategies for adult trigger digits: a systematic review and network meta-analysis of randomized controlled trials. · Chiang CH, Liu WC, Wu ZH et al. · Annals of Physical and Rehabilitation Medicine · 2026. https://doi.org/10.1016/j.rehab.2025.102074
8. Intra-articular corticosteroid for knee osteoarthritis. · Jüni P, Hari R, Rutjes AWS et al. · The Cochrane Database of Systematic Reviews · 2015. https://doi.org/10.1002/14651858.cd005328.pub3
9. Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. · McAlindon TE, LaValley MP, Harvey WF et al. · JAMA · 2017. https://doi.org/10.1001/jama.2017.5283
10. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. · Kolasinski SL, Neogi T, Hochberg MC et al. · Arthritis & Rheumatology (Hoboken, N.J.) · 2020. https://doi.org/10.1002/art.41142
11. Steroid Joint Injection Patient Information · NHS. https://eastsussexmsk.nhs.uk/wp-content/uploads/2026/02/Patient-Information-Steroid-Joint-Injection.pdf
12. Expert consensus on glucocorticoids injection for knee osteoarthritis. · Huang Y, Liu P · Journal of Orthopaedic Surgery and Research · 2026. https://doi.org/10.1186/s13018-025-06363-1
13. Risk Factors for Infection After Ankle, Knee, Hip, Shoulder, or Elbow Arthroscopy: A Systematic Review and Meta-analysis. · Saraf A, Iwamoto S, Krishna S et al. · The American Journal of Sports Medicine · 2026. https://doi.org/10.1177/03635465261429468
14. About hydrocortisone injections · NHS. https://www.nhs.uk/medicines/hydrocortisone-injections/about-hydrocortisone-injections/
15. netFormulary · NHS. https://www.grampianformulary.scot.nhs.uk/Mobile/chaptersSubDetails.asp?FormularySectionID=10&SubSectionID=A100&SubSectionRef=10.01.02.02
16. Use and safety of corticosteroid injections in joints and musculoskeletal soft tissue: guidelines from the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, the American Society of Interventional Pain Physicians, and the International Pain and Spine Intervention Society. · Benzon HT, Provenzano DA, Nagpal A et al. · Regional Anesthesia and Pain Medicine · 2026. https://doi.org/10.1136/rapm-2024-105656
17. Royal Orthopaedic Hospital - Steroid Injection Therapy · Brown Y · Royal Orthopaedic Hospital · 2026. https://roh.nhs.uk/services-information/pain-management/steroid-injection-therapy
18. X-ray Guided Joint Injection · NHS. https://www.esht.nhs.uk/wp-content/uploads/2017/06/0146.pdf
19. Effectiveness of Additional or Standalone Corticosteroid Injections Compared to Physical Therapist Interventions in Rotator Cuff Tendinopathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. · Lazzarini SG, Buraschi R, Pollet J et al. · Physical Therapy · 2025. https://doi.org/10.1093/ptj/pzaf006
20. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. · Coombes BK, Bisset L, Brooks P et al. · JAMA · 2013. https://doi.org/10.1001/jama.2013.129
21. Septic arthritis · NHS. https://www.nhs.uk/conditions/septic-arthritis/

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This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.