What Are the Side Effects of Orthopedic Injections and How Can You Minimize Them?
Orthopedic injections are generally well tolerated, and most side effects are mild and short-lived. Knowing what to expect helps patients recognize what is normal, take simple steps to reduce discomfort and identify the rare signs that require medical attention.
Understanding Orthopedic Injections
Orthopedic injections deliver medication directly into a joint or surrounding tissue. The main types are corticosteroids, hyaluronic acid viscosupplements such as SYNVISC®, MONOVISC®, DUROLANE® and ORTHOVISC®, combination products such as CINGAL®, and PRP. Each has its own side effect profile, described in the product monograph or instructions for use.
Common Side Effects
- Pain or soreness at the injection site, usually for one to two days.
- Mild swelling or a feeling of fullness in the joint.
- Bruising where the needle entered, more frequent in patients taking anticoagulants.
- A temporary flare of pain after a corticosteroid or PRP injection, typically within the first 48 hours.
- Warmth or stiffness in the joint for a short time.
These effects usually resolve on their own with rest and ice.
Less Common but Possible Reactions
- Skin changes after a corticosteroid, such as thinning or lightening of the skin at the injection site.
- A temporary rise in blood sugar in people with diabetes after a corticosteroid.
- Facial flushing for a day or two after a corticosteroid.
- A local inflammatory reaction after a viscosupplement, with more marked swelling and pain.
- Allergic reactions, which are rare. Some hyaluronic acid products are derived from avian sources and are not suitable for people allergic to avian proteins.
- Joint infection, which is very rare but serious and requires urgent care.
Factors That Influence Injection Reactions
- The type of product and the dose.
- The accuracy of needle placement; ultrasound guidance can improve it.
- The patient’s health, including diabetes, immune status and anticoagulant use.
- The number of injections received and the interval between them.
- The respect of aseptic technique and post-care instructions.
Our article on orthopedic injection techniques explains how precision affects results.
How to Minimize Side Effects
- Share your full medical history, medications and allergies before the injection.
- Follow the preparation instructions provided by the clinic.
- Rest the joint for 24 to 48 hours and apply ice regularly.
- Avoid baths, hot tubs and pools for at least 48 hours.
- Respect the recommended interval between injections.
- Monitor blood sugar closely if you have diabetes.
When to Contact a Healthcare Professional
Contact the clinic or seek medical care if you notice increasing pain after 48 hours, a hot, red and very swollen joint, fever or chills, discharge at the injection site, or signs of an allergic reaction. In an emergency, such as difficulty breathing or swelling of the face, call 911.
In Canada, patients and healthcare professionals can report any suspected adverse reaction to Health Canada through the Canada Vigilance Program. Reporting helps improve the safety information available for all products.
Maintaining Joint Health After Injection
Once side effects have resolved, the focus shifts to maintaining the benefit: physiotherapy, low-impact exercise, a healthy weight and regular follow-up. Our guide to post-injection care details each step. Clinics can find all options in our orthopedic injections category.
References
- Benzon, H. T., & Suresh, P. K. (2003). Complications of joint, tendon, and muscle injections. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC2084363/
- Mayo Clinic. (2023, September 20). Cortisone shots. Retrieved from https://www.mayoclinic.org/tests-procedures/cortisone-shots/about/pac-20384794
- NHS. (2025, October 22). Side effects of hydrocortisone injections. Retrieved from https://www.nhs.uk/medicines/hydrocortisone-injections/side-effects-of-hydrocortisone-injections/
- Bucks Healthcare NHS Trust. (2021). Side effects of post joint injections [PDF]. Retrieved from https://www.buckshealthcare.nhs.uk/wp-content/uploads/2021/04/PIL_radiology_side-effects-of-post-joint-injections.pdf
- Arthritis-health. (2020, May 6). Cortisone injection risks and side effects. Retrieved from https://www.arthritis-health.com/treatment/injections/cortisone-injection-risks-and-side-effects
