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Possible adverse effects and risks of cortisone shots include: Joint cartilage damage Osteonecrosis (death of surrounding bone) Weakening or rupture of a tendon Nerve damage Joint infection Temporary flare of pain and swelling in the joint Temporary facial flushing Temporary increase in blood sugar Osteoporosis (thinning of bones) Thinning of skin near the injection site Lightening or whitening of skin near the injection site Why does joint pain get worse after a cortisone shot

Split dosing: Some practitioners split the daily dose into 250 mcg AM and 250 mcg pre-sleep on the rationale that two smaller pulses maintain steadier receptor exposure

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