How Long Does It Take a Cortisone Shot to Work?

Cortisone injections are a commonly used treatment for conditions ranging from arthritis to tendonitis. Cortisone acts as a powerful anti-inflammatory and can help reduce swelling and inflammation, which in turn can decrease discomfort. The effects of cortisone generally take about five days to have their effects.

Woman with shoulder pain
BSIP/UIG/Universal Images Group/Getty Images

A cortisone shot starts to work very quickly once injected, although the time when you feel relief from your symptoms can vary. Some people report immediate relief, others report improvement within a few days, and others 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 Fast Cortisone Works

Cortisone shots work by decreasing inflammation. Many patients mistakenly think that cortisone only serves to cover up the 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 affect 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.

If your shot hasn't worked after a few weeks, let your doctor know so that you can discuss the next steps in treatment.

How Cortisone Is Administered

Cortisone can be administered in multiple forms. It can be taken as an oral medication, injected systemically, or injected to a specific location within the body. When speaking about orthopedic administration of cortisone injections, we are talking about cortisone that is administered as an injected form to a specific location within the body.

There are a number of different types of cortisone medication that are synthetically produced. These vary in terms of their potency, how long they last, and how soluble they are in water. Different preparations may vary in how they affect your body.

A typical cortisone injection is administered by mixing the medication with some local anesthetic. The local anesthetic can help to provide immediate pain relief, and also diminishes the discomfort associated with receiving an injection.

Your doctor will cleanse the skin over the area being injected. A needle can be placed in the location being injected, often a joint or a tendon sheath. Once the needle is in the proper position, your doctor will inject the medication. By feeling the amount of resistance while injecting, your doctor can be sure they have the needle in the proper location.

After the injection has been administered, the needle is removed, and a simple Band-Aid is placed over the injection site. Bleeding is generally minimal, although people on blood thinning medication may have some bleeding around the injection site.

When There Is 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 effect 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 into 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

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 of 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. After a few weeks without relief, call your doctor to see what the next steps should be in your treatment.

Was this page helpful?
Article 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.
  1. 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

  2. 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.

  3. 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

  4. 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

Additional Reading