1. About hydrocortisone injections
Hydrocortisone injections are used to treat swollen or painful joints, such as after an injury or if you have arthritis.
The hydrocortisone is injected directly into the painful joint. This is called an intra-articular injection. The joints most often injected are the shoulder, elbow, knee, hand, wrist or hip.
Hydrocortisone injections are also used to treat painful tendons and bursitis (when a small bag of fluid which cushions a joint gets inflamed). They're sometimes used to treat muscle pain when it's in a particular area.
The injections usually help relieve pain and swelling, and make movement easier. The benefits can last for several months.
Hydrocortisone is a type of medicine known as a steroid (or corticosteroid). Corticosteroids are not the same as anabolic steroids.
Hydrocortisone injections are only available on prescription. They're usually given by a specially trained doctor in a GP's surgery or hospital clinic.
In an emergency, medical staff may give higher dose hydrocortisone injections to treat severe asthma, allergic reactions, severe shock due to injury or infection, or failure of the adrenal glands.
NHS coronavirus advice
As long as you have no symptoms of coronavirus infection, carry on taking your prescribed steroid medicine as usual.
If you develop any coronavirus symptoms, do not stop taking your steroid medicine suddenly. Ask your doctor about whether you need to stop taking it or not.
Updated: 20 March 2020
Other types of hydrocortisone
There are different types of hydrocortisone, including skin creams, suppositories and tablets.
3. Key facts
- Hydrocortisone injections for joint pain work by releasing the medicine slowly into the joint. This reduces pain and swelling.
- After an injection, your joint may feel better for several months –sometimes as long as a year.
- Some people get increased pain and swelling in their joint immediately after having the injection. This pain tends to go away after a few days.
- Depending on which joint is being treated, you may be able to have injections in the same place up to 4 times a year.
- Hydrocortisone injections can affect your immune system, so you're more likely to get infections. Tell your doctor if you come into contact with chickenpox, shingles or measles as these infections could make you very ill.
- If you are having long-term treatment with hydrocortisone injections, you also need to carry the new steroid emergency card. Ask your pharmacist or doctor if you do not have one.
4. Who can and cannot have hydrocortisone injections
Most adults and children, including babies, can have hydrocortisone injections.
Hydrocortisone injections are not suitable for some people. Tell your doctor before starting the medicine if you:
- have ever had an allergic reaction to hydrocortisone or any other medicine
- have ever had depression or manic depression (bipolar disorder) or if any of your close family has had these illnesses
- have an infection (including an eye infection)
- are trying to get pregnant, are already pregnant or you are breastfeeding
- have recently been in contact with someone with chickenpox, shingles or measles (unless you're sure you are immune to these infections)
- have recently had, or you're due to have, any vaccinations
Hydrocortisone injections can make some health problems worse so it's important that your doctor monitors you.
Make sure your doctor knows if you have:
- any unhealed wounds
- high blood pressure
- an eye problem called glaucoma
- weak or fragile bones (osteoporosis)
- type 1 or type 2 diabetes
If you have diabetes and monitor your own blood sugar, you will need to do this more often. Hydrocortisone injections can affect your blood sugar control.
5. How and when to have hydrocortisone injections
A specialist doctor will usually give you your injection. This may be at your GP surgery.
If the injection is for pain, it may contain a local anaesthetic. You might also have a local anaesthetic by spray or injection to numb the skin before the hydrocortisone injection.
You can go home after the injection, but you may need to rest the area that was treated for a few days.
You may be able to have a hydrocortisone injection into the same joint up to 4 times in a year. The number of injections you need depends on the area being treated and how strong the dose is.
If you have arthritis, this type of treatment is only used when just a few joints are affected. Usually, no more than 3 joints are injected at a time.
The dose of hydrocortisone depends on the size of the joint. It can vary between 5mg and 50mg of hydrocortisone.
Will the dose I have go up or down?
If you need a follow-up injection, the amount of hydrocortisone could go up or down. It depends on how well the previous injection worked, how long the benefits lasted and whether you had any side effects.
6. Side effects
Most people do not have any side effects after a hydrocortisone injection. Side effects are less likely if only one part of the body is injected.
Common side effects
The most common side effect is intense pain and swelling in the joint where the injection was given. This usually gets better after a day or two.
You may also get some bruising where the injection was given. This should go away after a few days.
Serious side effects
With hydrocortisone injections, the medicine is placed directly into the painful or swollen joint. It does not travel through the rest of your body. That means, it's less likely to cause side effects.
Sometimes, though, hydrocortisone from a joint injection can get into your blood. This is more likely to happen if you've had several injections.
If hydrocortisone gets into your blood, it can travel around your body and there's a very small chance that you may have a serious side effect.
Call a doctor straight away if you:
- are depressed (including having suicidal thoughts), feeling high, mood swings, feeling anxious, seeing or hearing things that are not there or having strange or frightening thoughts – these can be signs of mental health problems
- have a high temperature, chills, a very sore throat, ear or sinus pain, a cough, pain when you pee, mouth sores or a wound that will not heal – these can be signs of an infection
- are sleepy or confused, feeling very thirsty or hungry, peeing more often than usual, flushing, breathing quickly or having breath that smells like fruit – these can be signs of diabetes or complications of diabetes
- have a "moon face" (a puffy, rounded face), weight gain in the upper back or belly – this happens gradually and can be a sign of Cushing's syndrome
- have swelling or throbbing in your arms or legs, or if you feel breathless or have chest pain – these can be signs of a deep vein thrombosis (DVT) or a blood clot
- have any changes to your eyesight
Some of these side effects, such as mood changes, can happen after a few days. Others, such as getting a rounder face, can happen weeks or months after treatment.
Children and teenagers
In rare cases, if your child or teenager has hydrocortisone injections over many months or years, it can slow down their normal growth.
Your child's doctor will monitor their height and weight carefully for as long as they're having treatment with hydrocortisone. This will help them spot any slowing down of your child's growth and change their treatment if needed.
Even if your child's growth slows down, it does not seem to have much effect on their overall adult height.
Talk to your doctor if you're worried. They will be able to explain the benefits and risks of giving your child hydrocortisone injections.
Serious allergic reaction
It's extremely rare to have an allergic reaction (anaphylaxis) to a hydrocortisone injection.
These are not all the side effects of hydrocortisone injections.
7. Pregnancy and breastfeeding
Hydrocortisone and pregnancy
Hydrocortisone injections can be used in pregnancy and breastfeeding.
Your doctor will only prescribe hydrocortisone injections for you while you're pregnant or breastfeeding if the benefits of the medicine outweigh the chances of it being harmful.
Tell your doctor if you're trying to get pregnant or if you're already pregnant before having a hydrocortisone injection.
Hydrocortisone and breastfeeding
It's safe to have hydrocortisone injections while you're breastfeeding.
Only very small amounts of hydrocortisone get into breast milk, so it's unlikely to be harmful.
For more information about how hydrocortisone can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPs) website.
9. Cautions with other medicines
There are many medicines that can affect the way hydrocortisone injections work.
It's very important to check with your doctor or pharmacist that a medicine is safe to mix with hydrocortisone injections before you start having them.
10. Common questions about hydrocortisone
How do hydrocortisone injections work?
When will I feel better?
How many hydrocortisone injections will I need?
Will the injections hurt?
How well do hydrocortisone injections work?
Why do I need to be careful of infections?
Can I have vaccinations?
Do I need to carry a steroid card?
Can I drink alcohol with it?
Are there any food or drinks I need to avoid?
Will it affect my fertility?
Will it affect my contraception?
Are other treatments available?
Can lifestyle changes help painful joints?
Page last reviewed: 18/12/2020
Next review due: 18/12/2023