Common questions about hydrocortisone injections

Hydrocortisone injections are a steroid (or corticosteroid) medicine.

The injection releases the hydrocortisone slowly into the part of your body that is painful or swollen. Like other steroids, it works by calming down your immune system. This reduces inflammation and helps to relieve the pain and swelling.

A hydrocortisone injection usually takes a few days to start working, although sometimes they work in just a few hours.

This depends on your joint pain. Hydrocortisone injections usually help with pain and swelling for around 2 months, so you may only need 1 injection for a short-term injury. This will often help you start to move again so that your body can heal itself.

For long-term joint pain, an injection should help for a few months, but you may need further injections. You'll usually have to wait at least 3 months before having another hydrocortisone injection in the same joint.

The injection can be a little uncomfortable, but a local anaesthetic is sometimes given with the injection to help any pain.

Having hydrocortisone injections makes you more likely to catch infections such as flu, COVID-19, the common cold and chest infections. Tell your doctor if you get symptoms of an infection or test positive for COVID-19.

Keep away from people with infectious diseases, especially chickenpox, shingles or measles. If you've never had these illnesses they could make you very ill.

Tell your doctor straight away if you come into contact with someone who has chickenpox, shingles or measles. Your doctor may be able to prescribe a medicine to protect you.

If you need any vaccinations, let the doctor or nurse know that you're having hydrocortisone injections.

Some types of vaccines, known as live vaccines, are not suitable if you're having hydrocortisone injections, because they can affect your immune system. This means that you're more at risk of infection if you have a live vaccine.

Live vaccines include the:

• BCG (tuberculosis) vaccine
• yellow fever vaccine
• MMR (measles, mumps and rubella) vaccine
• nasal spray flu vaccine

There are non-live versions of vaccines available for conditions including flu, shingles and polio. They're safe to have while having hydrocortisone injections.

Red steroid emergency card

If you're having hydrocortisone injections, your adrenal glands may not make as much of some of the hormones your body needs such as cortisol (known as the stress hormone). This is known as adrenal insufficiency.

It's more likely to happen if you take high doses for a long time (especially tablets and injections), or if you regularly use different kinds of steroids at the same time (such as a steroid nasal spray and a steroid inhaler).

Your doctor or pharmacist will check your risk of adrenal insufficiency based on the type and dose of steroids you're taking. They may recommend that you carry a red steroid emergency card. The card is the size of a credit card and fits in your wallet or purse. A similar card, called the adrenal insufficiency card, is available for children.

Find out more about the steroid emergency card for adults, on the Addison's Disease Self-Help Group (ADSHG) website.

Blue steroid card

If you've been having hydrocortisone injections for longer than 3 weeks, or you've been prescribed a high dose, your doctor or pharmacist will give you a blue steroid treatment card.

The card is the size of a credit card and fits in your wallet or purse. It tells you how you can reduce the risks of side effects. It also gives details of your doctor, how much hydrocortisone you're having and how long the treatment will last.

If you need any medical or dental treatment, show your blue steroid card to the doctor or dentist.

There are other types of medicine for treating swollen or painful joints.

You could try a painkiller like paracetamol or an NSAID like ibuprofen.

NSAIDs (non-steroidal anti-inflammatory drugs) are medicines that are used to relieve pain and reduce inflammation.

You can either get them from a pharmacy, or they may be prescribed. They're available as tablets and capsules, suppositories, injections, creams and gels.

NSAID creams and gels can also help if you have muscle or joint pain in a particular part of your body, as they tend to have fewer side effects than tablets or capsules. They include painkilling creams such as ibuprofen or diclofenac. You massage these into the skin over the painful area.

If these treatments do not work, your doctor can prescribe stronger painkillers such as naproxen and codeine.

Hydrocortisone injections do not affect any types of contraception, including the combined pill or emergency contraception.

Yes, you can drink alcohol before and after a hydrocortisone injection.

You can eat and drink normally before and after a hydrocortisone injection.

There are other things that can help sore or swollen joints.

It might help to:

• exercise more, particularly exercises that can increase muscle strength around your joint
• use hot and cold treatments on your joint
• use a walking stick or frame to support yourself (if your walking is affected)
• use a TENS machine, which helps pain with small electric pulses – ask a physiotherapist or occupational therapist for advice