What to Do After a Cortisone Injection: Post-Procedure Care Guide

Understanding Ultrasound-Guided Cortisone Injections

Cortisone (corticosteroid) injections are a common medical procedure performed at the office of Dr Sébastien Bolduc at the Clinique de médecine musculo-squelettique to treat various inflammatory conditions: tendinitis, bursitis, osteoarthritis, carpal tunnel syndrome, and other musculoskeletal pathologies. The injection is performed under ultrasound guidance, allowing the physician to visualize the needle in real-time and deposit the medication exactly where it is needed.

Although the injection itself is a simple and quick procedure (a few minutes), the period that follows is crucial to maximize its effectiveness and minimize the risk of complications. Here is everything you need to know to properly manage the days following your injection.

The First 24 to 48 Hours: Rest and Ice

Immediately after the injection, it is normal to feel mild discomfort or a sensation of pressure at the injection site. Here are the instructions to follow:

• Relative rest: avoid any intense physical activity for at least 48 hours. You may resume light daily activities (walking, light housework) the next day, but listen to your body.
• Ice application: apply an ice pack (wrapped in a cloth) to the injected area for 15 to 20 minutes, 3 to 4 times a day for the first 48 hours. Ice reduces local inflammation and soothes pain.
• Keep dry: keep the injection site dry for 24 hours (no shower or hot bath). A small protective bandage may be applied.
• Elevation: if the injection is in a lower limb (knee, ankle), elevate it when sitting or lying down to reduce swelling.

It is common to experience a transient inflammatory flare (flare reaction) within 24 to 48 hours after the injection. This is a normal reaction related to the needle micro-trauma and corticosteroid crystallization. Ice and rest are usually sufficient to control it.

The Following Days (Day 3 to Day 14)

From the third day onward, the cortisone begins to take full effect. Pain decreases significantly. This is the time to gradually resume your activities, with caution:

• Resume normal daily activities according to your tolerance.
• Avoid impact sports, running, jumping, and heavy lifting for 7 to 10 days.
• Do not perform maximal effort on the treated area before 2 weeks.
• If physiotherapy is prescribed, begin it generally after 5 to 7 days, when the anti-inflammatory effect is at its peak.

Return to Sports and Normal Activities

The return to sports must be gradual. For shoulder, knee, or Achilles tendon injections, allow approximately 2 to 4 weeks before resuming full sports activity. Your physician will provide a specific timeline adapted to your condition. It is important to understand that the injection treats inflammation but does not cure the underlying cause — a rehabilitation program (physiotherapy, eccentric exercises) is often necessary to prevent recurrence.

Warning Signs and Possible Complications

Consult promptly if you experience any of the following signs:

• Intense pain that increases rather than decreases after 48 hours
• Significant redness, local heat, or fever (possible infection)
• Worsening swelling
• Numbness or weakness in the treated limb
• Skin color changes around the injection site

Can I drive after a cortisone injection?

After an injection, it is generally recommended not to drive for the first 24 to 48 hours. The local anesthetic injected with the corticosteroid can temporarily numb or weaken the treated limb (especially the leg after a knee, hip or spinal injection), which may reduce your reflexes behind the wheel. Arrange to be accompanied or use transportation for the ride home, and ask your doctor when it is safe for you to drive again.

How many cortisone injections can you get per year?

As a rule, cortisone injections are limited to 3 per year at the same site to avoid the tendon or skin atrophy risks associated with corticosteroids. A minimum interval of 6 weeks is usually respected between two injections at the same site. If pain persists or returns, alternatives such as PRP (platelet-rich plasma) or ultrasound-guided injections can be discussed with your doctor, who will always weigh the risks and benefits in your situation.

For any questions or concerns, Dr Sébastien Bolduc and his team at the Clinique de médecine musculo-squelettique (8131 boul. Cousineau, Saint-Hubert) remain available. Do not hesitate to contact us if you have any doubt about your recovery.

Looking for a clinic treatment? Dr. Sébastien Bolduc offers cortisone injection in Saint-Hubert, on Montreal's South Shore. Book an appointment for a personalized assessment.