Pain Management Community

Water retention can occur after cortisone injection procedures. For most folks, it is not enough to be noticeable, but in some cases it can be bothersome. The good news is that this should resolve shortly. Cortisone can stay in the system for about a month after the injection.

Cushing's Syndrome can occur from plolonged exposure to too much cortisol and one of the signs can be a "moon face." Having three cortisone injections would not be expected to lead to this type of clinical scenario, but if your facial changes persist, then talk to your doctor about seeing an endocrinologist who could do further testing to assess the situaion.

Thanks for your response! I had a few follow up questions:

How long does it take the water retention and/or the moon face to subside after the cortisone clears the system? I still had a puffy face three months after the first two shots and it got puffier after the third.

Additionally, the injections interrupted my menstrual cycle---I have not had a regular period since January---either skipping, having three week long periods with almost black colored blood, stopping and starting, etc. I have always been very regular. How can this be corrected or will this subside in time? If so, how long?

I've also experienced an unusual amount of cystic acne and abnormal facial hair growth since the first injection in January. My skin also has been bruising very easily. Would this be an indication, combined with my other symptoms, that my cortisol levels are abnormally high?

Hi,
I had two cortisone shots this past winter (Late Jan/Early Feb) and my body completely freaked out due to abnormally high toxicity. Some side effects: Puffed face, hot flashes, period 4 times in 6 weeks, night sweats, adrenal, endocrine, nervous system all shut down. Digestive system shut down - couldn't digest things properly, still can't - it flared my chrons since and I had only had 3 flares in 22 years prior. Exploded candida everywhere - mouth, intestines, lower area. Had to go on an anti-candida diet to help my body deal with toxicity. Also had anxiety bordering on terror, welts, rashes, heart palapatations (sp)when I laid down, muscle twitches all over - all this went on for over 2 months. we had to do multiple testing, cat scan, mri's, ultra sound, etc. to make sure my body wasn't failing while it battled the toxic cortisone. My doc admitted it was all due to the cortisone which she shot willy nilly all over my back, neck, and back of head. It is time released so every so often my digestive will shut down and I will become anxious for no good reason. Could also not tolerate anything made with rice/bread, etc. It would not digest and literally rot in my stomach and smell like rotting vegetables and ammonia. Got welts all over body, legs, chest out of nowhere... it's very frustrating. Lost 15 pounds in one month and then gained 20 back due to steroid. I'm on a strict organic/fruit/some veggies/meat diet so there is no excuse for the huge gain except for the steroids. I"m actually in the process of suing her. I asked if there were side effects and let her know I had been on prednisone, and it was awful and I never wanted to be on it again. She said no side effects (LIE!) and it would "stay in one place". bigger lie! Google "side effects of cortisone shots, Kimi, Elizabeth", and you will get a site that has hundreds of stories like mine. Cortizone also damages the tissue, joints, bone, and muscle around the injection site. It can even leave dents in the skin/muscle/tissues where it damaged it. Cortizone is a "wonder drug" and "cure" like coke and heroin were "cures" in the late 18 and early 1900's. Meaning it is NOT. This "should" get out of your system in the next 3-6 months depending on your dose. It also spikes blood sugar.

Recommend not getting them again, trying acupuncture, chiropracture (sp), or other solutions. get on all-organic diet and stick to "cave man" diet (similar to anti-candida) to help your body get rid of it. Good luck and God bless. Docs give out these shots like candy and it's criminal that they don't tell patients what could actually happen to them and let them make an informed choice as to if they want it. My case is not unusual. All you have to do is a little googling to find out. Good luck.

Also: You may feel "better" and be able to do all sorts of things again on the shot, but in the meantime you are still damaging the area. Just because you can't feel it anymore doesn't mean the same damage isn't being done that you could feel before the shot. It's just treats the symptom, not the cause, and damages the area. Docs will try to dissuade you on everything I've said because steroids are a huge business and money-maker.

I'd also recommend you see a homeopathic doc. Take care and God bless.

Hi---Thanks so much for your response. Ddid you have moon face? How long did it take to go away? Do you still have it? What about the irregularities in your menstual cycle? Has that corrected itself?

Hi There..
i just wanted to mention..i've been going thru the same..on instinct i went back to a veg diet..been cutting sodium down more than i already do..the thrush thats been plaguing me for months finally backed off about a week ago..i keep hoping this means the steroid is finally leaving.yet..i have
only noticed my face being kinda puffy for the last few days.
its been about 3months since my last shot,but my doc insisted on giving them to me for close to 2yrs now.im a mess..25lbs heavier within the last few months..menses have been screwy since last october.i am amazed at what im reading..having hoped for relief..i trusted my doctor..i have degen.discs..as well as hypermobility syndrome..meaning..pain..and im a pretty vibrant one for 42..just..my back has been messed up since i was 9...keep yer chin up..this crap has to leave sometime..i feel blessed i found this info now..keep in touch.

I am 45 and every single thing you've listed here, I'm experiencing due to injections (maybe except for the welts!). I've never had them before, and now about to receive my third set in my neck for herniated cervical discs (c-5 & c-6) this week. They started them two weeks ago, and the plan was a round of injections every Wednesday for three weeks. I've had the weight gain, puffy face, night sweats, facial flushing, interruption (crazy off & on bleeding?) of menstrual cycle, hot flashes, heart racing, not sleeping well... and MAN, I hope it all subsides as quickly as it began! They are trying these injections along with physical therapy before discussing any neck surgery, and I'm thankful for that. But I had a MAJOR double lumbar fusion in 2010, and I'm thinking that if I can survive that; then I can handle a surgery for these cervical discs if these steroids wreak too much more havoc on my body & systems. I have been convinced for some time now that I'm getting close or even approaching menopause. It could even be a combination of that and these steroids. I thought they always said that a person could only have so many of these injections within a year? I've had mine every week for 3 weeks!

An epidural steroid injection (cortisone) is used to treat inflammation around the spinal nerves. It is administered into the epidural space and not into the spinal cord, as some falsely believe.


Cortisone is a type of steroid that is produced naturally by a gland in your body called the adrenal gland.


Cortisone is released from the adrenal gland when your body is under stress. Natural cortisone is released into the blood stream and is relatively short-acting.Injected cortisone is synthetically produced and has many different trade names (Celestone, Kenalog, etc.), but is a close derivative of your body's own product.
The most significant differences are that cortisone is not injected into the blood stream, but into a particular area of inflammation.

Cushing's syndrome is a relatively rare endocrine (hormonal) disorder resulting from excessive, long-term exposure to the hormone cortisol.


The disorder, which leads to a variety of symptoms and physical abnormalities, is most commonly caused by taking high doses of medications containing the hormone over a long period of time.


If you really think that you have Cushings syndrome, see an endocrinologist.


You can also read Dr Abaci's reply above.

I had two injections April 28 and May 8, I now have a very puffy face. What can I do to get rid of it. How long might it last?

You may be having an allergic reaction to the meds contained in the injection solution. Are you experiencing any other discomforts that have started after receiving the injections?

ATTN: DR ABACI~ PLEASE HELP!
"Moon Face" is one symptom of Cushing's Syndrome.


Cushing's Syndrome can occur from prolonged exposure to too much cortisol and one of the signs can be a "moon face."


Having epidural cortisone injections does not cause Cushings.


If you're honestly concerned about having this rare and dangerous disease, talk to your doctor about referring you to an endocrinologist.


I'm finding it bizarre that so many people who have had such minimal exposure to cortisol would worry about such a rare syndrome that is not attributed to epidural steroid injections.


One member posted that she had two epidurals and developed (from the cortisol)


" adrenal, endocrine, nervous system all shut down. Digestive system shut down..." all from two epidural steroid injections?


If your adrenal (which is part of the endocrine system), nervous, and digestive system all failed, you'd be dead from multi-system failure.


Dr Abaci, would you PLEASE post some reality about this fear of moonface, Cushings, multi-system failure (just what were this person's idea of "nervous system failure? doesn't that mean her diaphragm and heart would stop- hence DEATH?)


Steroid injection in the emergency room after my car accident spared me from worse damage from spinal cord injury than the damage with which I live every day.


These narratives are just spreading false fear among persons who could potentially get months of pain relief from epidural steroid injections.


This thread has turned into mass hysteria!

cortisone is a substance naturally produced by our bodies.

it is administered to stop allergic reactions.

two epidural steroid injections would not cause ones face to swell up.

shamk, have you reported this to your MD?

any water retention related to steroid should resolve itself within three to four weeks.

again, this is sounding like a case of mass hysteria.

Every form of medical intervention involves risks and potential side effects.
There are risks involved with simply taking an aspirin or over-the-counter cold remedy.
There are also risks associated with taking vitamins and herbal supplements especially when you're taking them for medicinal purposes.
The only long-term side effects associated with corticosteroids appear to be the result of excessive or prolonged steroid usage - not due to the limited number of injections we're talking about.
These included such things as stomach ulcers, cataracts, osteoporosis and arthritis.
Again, these disorders have only been shown to occur in people with long-term use of corticosteroids and not to people who merely undergo epidural injections.
In other words, they don't really apply to this discussion.
You will NOT get Cushing's Disease, "moon face", weight gain, nervous system "shut down", digestive system "shut down", or abnormal menstrual bleeding.
Yes, do google Epidural Steroid Injections and get as much accurate information as you need.
There is some caveat for persons with mental illness that is mentioned in the WebMD article on epidural steroid injections.
http://www.webmd.com/back-pain/epidural-steroid-injections-for-lumbar-spinal-stenosis
Really~ this discussion has the potential to frighten away persons who may derive successful, albeit temporary, relief from sciatica or other back and neck pain.
Please learn the reality and consider that "moon face" may be just expected perception or may be due to weight gain or water retention unrelated to the steroid injection(s).
Again, if in doubt, consult your MD.
Cushings Disease is pretty easy for your MD to diagnose.