What is a Hydrocortisone Injection for?

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Hydrocortisone is a powerful anti-inflammatory medication that reduces swelling and inflammation in joints, tendons, or soft tissues. The injection is guided by ultrasound imaging to ensure the medication is delivered precisely to the affected area. This technique is commonly used to treat conditions like arthritis, bursitis, tendinitis, or joint pain in areas such as the shoulder, knee, hip, or other joints.

 

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Benefits of Ultrasound Guidance​

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Accuracy: Ultrasound allows the physician to see the structures inside your body in real time, ensuring the needle is placed exactly in the right spot.

Safety: It reduces the risk of injury to surrounding structures like blood vessels or nerves.

Effectiveness: The precise placement of the cortisone increases the likelihood of pain relief and reduces inflammation.

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​Reasons for Cortisone Injection

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You may be recommended for this procedure if you have:

• Joint inflammation (e.g., arthritis in the knee, shoulder, or hip).

• Tendinitis (inflammation of tendons like the Achilles, rotator cuff, or elbow).

• Bursitis (inflammation of the fluid-filled sacs around the joints).

• Soft tissue inflammation causing pain or reduced mobility.​

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 ​What you need to know before the procedure ​

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Preparation:

• Medical History: Inform your clinician about any allergies (especially to steroids or anesthetics), medications you're taking, and if you have conditions like diabetes, high blood pressure, or a compromised immune system.

• Blood Thinners: If you're on blood-thinning medications like aspirin, warfarin, or clopidogrel, your clinician may ask you to stop these medications a few days before the injection to reduce the risk of bleeding. Always check with your doctor before stopping any medication.

• Comfortable Clothing: Wear loose clothing that will allow easy access to the injection site.

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Procedure Expectations:

• Local Anesthetic: In some cases, a local anesthetic may be used to numb the injection site, but you might feel some discomfort or pressure when the needle is inserted.

• Ultrasound Imaging: The clinician will use a handheld ultrasound device to locate the exact area to inject the cortisone. You will be asked to stay still during this process.

• Injection: The entire process usually takes 10-15 minutes, with the actual injection lasting only a few minutes.

 

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Potential side effects and risks

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Common side effects:

• Temporary pain or discomfort at the injection site (known as a "steroid flare"), which may last 1-2 days.

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Less common risks:

• Bleeding or bruising, especially if you're on blood-thinning medication.

• Skin changes like lightening (depigmentation) of the skin or thinning of the skin at the injection site.

• ​Infection at the injection site (although this is extremely rare due to the sterile environment).

• Elevated blood sugar levels (especially in patients with diabetes).

• Facial flushing or a feeling of warmth for a few hours after the injection.

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Frequency of Injections​

 

Cortisone injections can be very effective, but they should not be done too frequently in the same area due to the risk of tissue damage. Generally, you should not receive cortisone injections more than three to four times a year in the same joint or tendon.

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Common questions patients have

 

Will the injection hurt?

• You may feel a small pinch when the needle is inserted, but local anesthetics and the small size of the needle minimize discomfort. Any pain afterward is typically mild and temporary.

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How quickly will I feel better?

• Some people experience relief within a few days, but for others, it can take up to a week to feel the full benefits. The relief can last for several months.​

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Can I drive after the injection?​

• Yes, you should be able to drive yourself home after the injection, but if the injection is into a leg or foot, it might be wise to have someone drive you just in case.