Hydrocortisone injections are put directly into painful or swollen joints. This means that less of the medicine gets into your body so it's less likely to cause side effects. Side effects are also less likely if only one part of the body is injected.
Common side effects
The most common side effect of hydrocortisone injections is intense pain and swelling in the joint where the injection was given. This usually gets better after a few days.
You may also get some bruising where the injection was given. This should go away after a few days.
It helps to rest the joint for 24 hours after the injection and avoid heavy exercise. It's safe to take painkillers such as paracetamol or ibuprofen.
Serious side effects
Sometimes, hydrocortisone from a joint injection can get into your blood. This is more likely to happen if you've had several injections.
In rare cases, if hydrocortisone gets into your blood, it can travel around your body and cause serious side effects.
If you're having repeat doses of hydrocortisone injections, or you're also taking other steroid medicines or tablets for fungal infections or HIV, you may get underactive adrenal glands as a side effect. Ask your doctor if you need to carry a red steroid emergency card (for adults), or an adrenal insufficiency card if the treatment is for a child.
Speak to a doctor if you get a puffy, rounded face, and weight gain in the upper back or belly. This happens gradually and can be a sign of Cushing's syndrome.
Call a doctor or call 111 now if you get:
- a high temperature, chills, a very sore throat, ear or sinus pain, a cough, coughing up more mucus (phlegm) or a change in colour of your mucus, pain when you pee, mouth sores or a wound that will not heal – these can be signs of an infection
- sleepy or confused, very thirsty or hungry, a need to pee more often than usual, flushing, breathing quickly or breath that smells like fruit – these can be signs of diabetes or complications of diabetes
- any changes to your eyesight
- breathlessness
- swelling or throbbing in your arms or legs
Immediate action required: Call 999 or go to A&E if:
- you have black or dark brown vomit or you're vomiting blood
Mood changes
You may notice mood or mental health changes while having hydrocortisone injections.
Talk to your doctor or call 111 if:
- you're feeling high, or have moods that go up and down
- you're feeling depressed
- you're feeling anxious
- you have problems sleeping
- you have difficulty in thinking, or are feeling confused and forgetting things
- you're feeling, seeing or hearing things that do not exist (hallucinations)
- you notice changes in the way you usually behave
Serious allergic reaction
It's possible to have a serious allergic reaction (anaphylaxis) to hydrocortisone injections.
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
Long-term side effects in 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'll be able to explain the benefits and risks of giving your child hydrocortisone injections.
Other side effects
These are not all the side effects of hydrocortisone injections. For a full list, see the leaflet inside your medicine packet.
You can report any suspected side effect using the Yellow Card safety scheme.