Foot Health

What happens after cortisone shot in toe?

Cortisone shots are widely recognized as one of the leading treatments for inflammation-related conditions such as Hallux Rigidus, an ailment of the toe. But what exactly happens after you receive this injection in your toe? The body’s response to this treatment can be divided into three main phases: the immediate aftermath, the intermediate recovery, and the long-term effects.

Immediate Aftermath

The Cortisone Flare

Immediately after the cortisone shot, some patients may experience what is known as a ‘cortisone flare’. This is a reaction to the crystalline substance in the injection, leading to a sharp increase in pain in the toe for a few hours post-injection. The flare is usually transient and can be managed with icing the area and taking non-prescription pain relievers if necessary.

Skin Discoloration and Thinning

The area around the injection site might undergo some changes. Some patients may notice a lightening of the skin (hypopigmentation), especially those with darker complexions. This happens due to cortisone’s inhibition of melanin production. Similarly, the skin might thin out (atrophy) slightly due to cortisone affecting the collagen in the skin. Both of these effects are usually mild and often resolve with time.

Intermediate Recovery

Reduced Inflammation and Pain Relief

In the intermediate phase, typically 24 to 48 hours post-injection, the cortisone starts to take effect. Cortisone acts by suppressing the immune system’s response, reducing inflammation in the joint. The result is decreased swelling and pain in the affected toe. The extent and duration of relief vary widely from patient to patient, depending on the severity of the condition and individual response to the treatment.

Potential Side Effects

However, during this phase, some patients may experience side effects such as a rise in blood sugar levels. This effect is particularly noticeable in patients with diabetes, necessitating close monitoring and possible adjustment of diabetes medication.

Long-Term Effects

Therapeutic Benefits

The long-term benefits of cortisone shots typically emerge a few days to a week after the injection. Patients often enjoy significant pain relief and improved mobility, which can last several weeks to several months. The anti-inflammatory properties of cortisone allow the joint to move more freely, reducing stiffness and aiding in overall foot function.

Repeated Injections

For long-standing relief, some patients may require repeated injections, though this is generally limited to three or four times a year in a single joint to prevent potential adverse effects. Over time, repeated cortisone injections can lead to weakening or deterioration of the joint and surrounding tissues. This is a vital consideration when evaluating the long-term treatment strategy for conditions like Hallux Rigidus.

Alteration in Immune Response

Long-term usage might also lead to a reduced immune response in the area, leaving it slightly more susceptible to infections. As such, care should be taken to prevent any possible sources of infection.


Cortisone shots have proven to be an effective short-term solution for relieving pain and inflammation associated with toe conditions such as Hallux Rigidus. However, patients need to be aware of both the immediate and long-term effects post-injection. Balancing the therapeutic benefits against potential side effects requires thoughtful consideration and discussion with your healthcare provider to determine the best course of treatment.