How Long Does It Take a Cortisone Shot to Work?

A cortisone shot starts to work very quickly once injected, although the time when you feel relief from your symptoms can vary. I have patients who will tell me they found immediate relief, others who report improvement within a few days, and others who state that the relief took several weeks to take effect. Some of this difference can be explained by the fact that the relief being experienced may be the result of factors other than simply the cortisone that was injected.

Understanding how cortisone injections can be effective, can help explain some of the differences in how pain relief may be experienced.

How It Works

Cortisone shots work by decreasing inflammation. Many patients mistakenly think that cortisone only serves to cover up pain. That's not really true. Cortisone can be a very effective method to reduce the inflammation caused by a variety of common orthopedic conditions including tendonitis, bursitis, and arthritis. Once the inflammation subsides, pain relief follows.

Cortisone starts to work immediately following the injection, and inflammation usually begins to subside within a few days. Depending on how quickly the inflammation subsides, the timing of pain relief can vary from a few days to a few weeks.

Most people who have a cortisone shot, and find relief from the injection, will describe the gradual reduction in symptoms over a span of days to weeks.

However, the amount of inflammation, the type of injection administered, and other factors can all effect the length of time it will take before you experience relief.

If the inflammation is severe, or if the inflammation has been around a long time (chronic), the cortisone injection may take longer to take effect and may require more than one injection.

Not every patient will respond to a cortisone injection, but the good news is that most people find this to be an excellent treatment for many common inflammatory conditions.

When Is There Immediate Relief?

While the effects of cortisone typically take a few days or longer to begin to take effect, many patients will report almost immediate relief of pain following an injection. There are two possible reasons why pain relief is sometimes more immediate. The most common reason for immediate pain relief is that most physicians will mix an anesthetic medication, such as lidocaine or marcaine, with the cortisone injection.

These local anesthetics can take their effects more immediately, and provide dramatic relief soon after the injection. In fact, many doctors will use this effect as a test to ensure the medication was injected to the located problem. If the problem was numbed by the injection, then your doctor can be confident the cortisone was delivered to the proper location.

The other reason why some people find immediate relief is that sometimes your doctor will remove accumulated fluid at the same time they inject a swollen joint. For example, many patients with a swollen knee may have the fluid drained from the joint just prior to the injection.

Having the accumulated fluid removed from the joint can lead to dramatic relief of pain.

Side Effects to Note

Some patients may react to the cortisone injection with what is called a cortisone flare. A cortisone flare is a condition where the injected cortisone crystallizes and can cause a brief period of pain, worse than before the shot. This usually lasts a day or two and is best treated by icing and resting the injected area. 

There are also other possible side-effects of cortisone. While these problems are uncommon, they sometimes do occur. Most patients find cortisone to be a helpful treatment for a variety of orthopedic conditions.

Unfortunately, not every patient finds the relief they hope for with this medication.

A Word From Verywell

Cortisone injections can be effective at reducing inflammation, a common cause of joint and tendon pain. When cortisone is injected, the effects at reducing inflammation begin immediately, but the length of time it takes to experience pain relief may vary from days to weeks.

If you haven't experienced pain relief, either you haven't given the shot long enough to have its effects, or the injection is not going to adequately relieve the inflammation, thus leading to pain relief. If your shot hasn't worked after a few weeks, let your doctor know so that you can discuss the next steps in treatment.

Sources:

Hepper CT, at al. The efficacy and duration of intra-articular corticosteroid injection for knee osteoarthritis: a systematic review of level I studies. J Am Acad Orthop Surg. 2009 Oct;17(10):638-46.

Koester MC, Dunn WR, Kuhn JE, Spindler KP. The efficacy of subacromial corticosteroid injection in the treatment of rotator cuff disease: A systematic review. J Am Acad Orthop Surg. 2007 Jan;15(1):3-11.