What are possible adverse reactions from corticosteroid injections for pain management?

Updated: Jun 19, 2018
  • Author: Anthony H Wheeler, MD; Chief Editor: Meda Raghavendra (Raghu), MD  more...
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Commonly experienced adverse reactions from corticosteroid injections include dizziness, nervousness, facial flushing, insomnia, and transient increased appetite. [9] Flare-up of pain intensity at the injection site may occur, lasting for 24-48 hours in 10% of patients [9] and presumed related to a local inflammatory response to corticosteroid crystals. [3] The likelihood of a flare-up reaction is reduced by using a soluble, rapidly absorbed steroid. Rest and physical therapy are sometimes necessary in these cases. In addition, adverse reactions may occur in persons who have active peptic ulcer disease, ulcerative colitis, active infection, hypertension, congestive heart failure, renal disease, and psychiatric illness. [9]

Hyperglycemia in known diabetics warrants careful postprocedural monitoring. Other less serious side effects of corticosteroids include injection site hyperpigmentation, subcutaneous fat atrophy, peripheral edema, dyspepsia, and malaise. Systemic responses frequently occur even in local injections of corticosteroids. Allergic reactions to systemic glucocorticoids in slow-release formulations have been reported to occur up to 1 week after injection. [9]

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