Orthopedics Medication & Injections How Long Does It Take a Cortisone Shot to Work? By Jonathan Cluett, MD Jonathan Cluett, MD LinkedIn Twitter Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery. Learn about our editorial process Updated on December 27, 2022 Medically reviewed by Stuart Hershman, MD Medically reviewed by Stuart Hershman, MD LinkedIn Stuart Hershman, MD, is a board-certified spine surgeon. He specializes in spinal deformity and complex spinal reconstruction. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents How They Work How They're Given Quick Relief Side Effects Cortisone injections start to work very quickly. However, depending on the person, they can take days or weeks to relieve pain. Cortisone is a powerful medication that reduces swelling and inflammation. This, in turn, can decrease pain. The shots are often used to treat orthopedic conditions such as arthritis and tendonitis. Some people report immediate relief while others say the process takes longer. Thianchai Sitthikongsak / Getty Images This article goes over how cortisone shots work, how long until they take effect, and what side effects are possible. Should You Get Cortisone Shots? How Cortisone Shots Work Cortisone shots work by decreasing inflammation. In people with conditions like tendonitis, bursitis, and arthritis, pain is caused by inflammation. Once the inflammation goes away, the pain will get better. A cortisone shot starts to work immediately. Inflammation usually improves within a few days. Pain relief can take a few days to a few weeks, depending on how long it takes for the inflammation to settle. Most people who have had a cortisone shot say the pain gets better quickly. The amount of inflammation, the type of injection, and other factors can all affect how long it will take for you to feel relief after getting a cortisone shot. If your inflammation is severe, or if it's been around a long time (chronic), the shot may take longer to work. In some cases, you may need more than one dose of cortisone to feel better. Cortisone shots are effective for many common inflammatory conditions, but they don't help every person who has these conditions. If your shot has not worked after a few weeks, let your healthcare provider know. They can talk to you about other treatment options. 1:10 Click Play to Learn What to Do If a Cortisone Shot Doesn’t Work This video has been medically reviewed by Chris Vincent, MD. How Is Cortisone Given? Different types of cortisone vary in terms of how strong they are, how long they last, and how they are given. Cortisone can be taken by mouth as an oral medication. It can also be injected into a muscle or joint. For bone and joint conditions, cortisone shots are given in the spots where there's inflammation. Cortisone is often mixed with numbing medication (local anesthetic). The anesthetic can help relieve pain. It also makes getting the shot itself a little less uncomfortable. Your healthcare provider will clean the skin over the area where they will be giving you the shot. Then, they will inject the medication where it is needed—often in a joint or tendon sheath. Your provider will check that the needle is in the right place by making sure it meets the right amount of tension. After the injection, the needle is taken out and a Band-Aid is placed over the site. You might have a little bit of bleeding. If you're taking a blood thinning medication, you may have a little more bleeding at the injection site. How Intramuscular Injections Are Given Why Some Cortisone Shots Work Quickly Cortisone typically takes a few days or longer to begin to take effect. Even so, many people report almost immediate relief after an injection of cortisone. Pain relief is faster for some people for a couple of reasons. The most common reason is that a provider mixed an anesthetic medication (such as lidocaine or marcaine) with cortisone. Local anesthetics work right away. In fact, many providers will use this effect as a test to make sure the medication went into the right spot. If the area was numbed by the injection, your provider can be confident the cortisone was delivered to the spot where it's needed. The other reason why some people feel better faster is that sometimes, a provider also removes fluid from a swollen joint. For example, many patients with a swollen knee have the fluid drained from the joint just before they get a cortisone shot. Having the fluid removed from the joint can bring a lot of pain relief. When to Call Your Provider If you’re not feeling better or are feeling worse after a cortisone shot, check with your provider. In some cases, this is temporary. However, it’s also possible that the treatment isn’t the right fit for you. Your provider can assess and figure out what the next steps in your treatment plan should be. What Does Lidocaine Do? Side Effects of Cortisone Shots Some patients react to cortisone injections with what is called a cortisone flare. A cortisone flare is a condition where the injected cortisone forms crystals. This can cause brief pain that is worse than before the shot. The discomfort usually lasts a day or two and can be treated by icing and resting the injection area. Other side effects of cortisone shots are possible but uncommon. These could include: Skin color changes Increased blood sugar (glucose) levels Allergic reactions What Is a Cortisone Flare? Summary Cortisone shots reduce inflammation, a common cause of joint and tendon pain. For many people, relief comes right after the shot is given. However, the length of time for pain relief varies and can take days or weeks. If your provider mixes a local numbing agent with the cortisone, you may feel relief immediately. Relief may also be quicker if your provider drains fluid from your joints. However, your pain could temporarily get worse if you have a reaction called a cortisone flare. In this case, rest and ice on the spot where you had the injection can help. Most people find cortisone helpful for treating orthopedic conditions, but it doesn't work for everyone. If you're not finding the injections helpful, let your provider know. A Word From Verywell If you had a cortisone shot and don't feel better right away, give it a little time. You might need to wait a few days or weeks to get relief. However, it's also possible that the cortisone was not enough to lower the inflammation and relieve your pain. If it's been a few weeks and you don't feel any improvement, let your provider know. They can talk to you about the next steps and what your other treatment options are. Can You Get Cortisone Shots If You Have Diabetes? 4 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Alsop RJ, Khondker A, Hub JS, Rheinstädter MC. The lipid bilayer provides a site for cortisone crystallization at high cortisone concentrations. Sci Rep. 2016;6:22425. doi:10.1038/srep22425 Nuelle CW, Cook CR, Stoker AM, Cook JL, Sherman SL. In vivo toxicity of local anesthetics and corticosteroids on supraspinatus tenocyte cell viability and metabolism. Iowa Orthop J. 2018;38:107-112. Bhatia D, Bejarano T, Novo M. Current interventions in the management of knee osteoarthritis. J Pharm Bioallied Sci. 2013;5(1):30-8. doi:10.4103/0975-7406.106561 Fawi HMT, Hossain M, Matthews TJW. The incidence of flare reaction and short-term outcome following steroid injection in the shoulder. Shoulder Elbow. 2017;9(3):188-194. doi:10.1177/1758573217693808 By Jonathan Cluett, MD Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit