If you’ve experienced flushing, warmth, or sudden hot sweats after a cortisone injection, you’re not imagining it — and you’re not alone.
Hot flushes are one of the more surprising side effects of corticosteroid injections, and many patients aren’t warned about them in advance. Understanding why they happen, how long they last, and what (if anything) you should do about them can make the experience far less alarming.
At Alton Pain Clinic, we believe in preparing patients fully before and after treatment. Here’s everything you need to know about hot flashes and cortisone injections.
Why Do Cortisone Injections Cause Hot Flashes?
When cortisone is injected into a joint or soft tissue, the goal is for it to act locally — reducing inflammation in a targeted area. However, a proportion of the medication inevitably enters the general bloodstream, where it can have systemic (whole-body) effects.
Corticosteroids are structurally related to hormones produced naturally by the adrenal glands, including cortisol. When an external steroid enters the bloodstream, it can temporarily disrupt the body’s hormonal balance — and in some people, this triggers vasomotor symptoms: flushing, sweating, and a sensation of intense heat. These are the same mechanisms that underlie menopausal hot flushes, which is why the two can feel remarkably similar.
The effect is generally short-lived because the injected cortisone is absorbed and metabolised by the body over the following days.
Who Is Most Likely to Experience Hot Flushes After a Cortisone Injection?
While anyone can experience this side effect, it is significantly more common in:
- Women who are perimenopausal or postmenopausal — the hormonal disruption caused by the cortisone interacts with already fluctuating oestrogen levels
- Women generally — hot flushes after cortisone are reported more frequently in women than men
- Patients who have received a higher dose of corticosteroid
- Patients who have had multiple injections in a short period
If you have a history of vasomotor symptoms or have previously experienced hot flushes after a cortisone injection, it’s worth mentioning this to your clinician before your next treatment. They may be able to adjust the dose or advise on what to expect.
What Do Post-Injection Hot Flushes Feel Like?
The experience varies between individuals, but commonly described symptoms include:
- Sudden warmth or heat, often starting in the face and neck
- Visible facial flushing or redness
- Sweating, sometimes at night
- A racing or elevated heart rate
- A feeling of agitation or general discomfort
These symptoms can feel alarming, particularly if you weren’t expecting them. It’s important to know that in most cases they are a nuisance rather than a danger — the body’s response to a temporary hormonal shift, not a sign that something has gone wrong with the injection itself.
How Long Do Hot Flushes Last After a Cortisone Injection?
For most patients, hot flushes begin within a few hours of the injection and last between one and five days. In some cases they may resolve within 24 hours; in others they may linger slightly longer.
The intensity tends to be highest in the first day or two and gradually decreases as the cortisone is absorbed and hormone levels normalise.
How to Manage Hot Flushes After a Cortisone Injection
There’s no specific medical treatment required for post-injection hot flushes in most cases. The following can help manage symptoms while they pass:
- Stay hydrated — drink plenty of water throughout the day
- Keep cool — use a fan, open windows, or wear loose, breathable clothing
- Avoid alcohol in the first 48 hours, as it can worsen flushing
- Avoid caffeine and spicy food, which can trigger or intensify vasomotor symptoms
- Rest — fatigue can make hot flushes feel more intense
- Cool compress — a damp cloth on the forehead or neck can provide temporary relief
When Should I Contact My Clinician?
Hot flushes are expected to be temporary and manageable. Contact your clinician if:
- Symptoms persist beyond 7 days
- You experience chest pain, palpitations, or shortness of breath alongside flushing
- Flushing is accompanied by significant swelling, heat, or redness at the injection site (which may indicate a different issue)
- You feel unwell in a way that doesn’t feel like a straightforward hormonal response
In rare cases, a severe systemic reaction to a corticosteroid injection can occur. This is different from hot flushes and typically involves more widespread symptoms. If you feel acutely unwell after any injection, seek medical attention promptly. To learn more about the cortisone injections side effects, read our blog here.
Key Takeaways
- Yes — hot flushes are a recognised short-term side effect of cortisone injections
- They are caused by the steroid temporarily entering the bloodstream and affecting hormone levels
- The effect is more common in women, particularly those who are perimenopausal or postmenopausal
- Symptoms typically begin within hours and resolve within 1–5 days
- They are not dangerous in most cases, but persistent or severe symptoms should be reported to your clinician
Concerned About Your Recovery? We're Here to Help
At Alton Pain Clinic, we take the time to explain exactly what to expect before, during, and after every cortisone injection — including potential side effects like hot flushes. If you have questions about an upcoming or recent treatment, please get in touch. Find out more about our cortisone injection services or read about shoulder injections and knee injections at the clinic.
This article is intended for informational purposes only and should not replace professional medical advice. If you are experiencing persistent symptoms, please consult a qualified clinician.
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PRP Injections
Platelet-rich plasma (PRP) injections use a concentrated preparation of your own platelets to support the body’s natural healing processes within the affected joint. They may help support tissue repair, reduce discomfort and promote improved joint function and mobility.
Frequently Asked Questions
Do hot flushes mean the injection isn't working?
Not at all. The flushing is caused by systemic absorption of the steroid — a separate process from its local anti-inflammatory effect at the injection site. You can experience hot flushes and still get excellent results from the injection.
Will I get hot flushes every time I have a cortisone injection?
Not necessarily — some patients experience them after one injection but not another. However, if you’ve had them before, it’s worth letting your clinician know so they can prepare you and monitor your response.
Can I take anything to prevent hot flushes before a cortisone injection?
There’s no standard preventive treatment. If you’ve had significant hot flushes before, discuss this with your clinician ahead of your appointment. They may consider the dose or formulation used.