The Shocking Truth: Can Cortisone Shots Cause Insomnia?

 

Can Cortisone Shots Cause Insomnia? What You Need to Know

Cortisone injections are widely used to relieve pain and inflammation in joints, tendons, and soft tissues. For many people, a single shot can mean weeks—or even months—of comfort. But some patients notice an unexpected side effect after their injection: difficulty falling or staying asleep. Could cortisone shots actually cause insomnia? Let’s look at what the science and clinical experience say.

How Cortisone Works in the Body

Cortisone is a corticosteroid—an artificial version of hormones your adrenal glands naturally produce during stress. When injected, cortisone reduces inflammation locally, calming pain and swelling. Although much of the medicine stays near the target joint, a small amount can enter the bloodstream and briefly mimic the effects of natural stress hormones.

Because corticosteroids act on multiple systems—immune, endocrine, and nervous—some short-term systemic effects are possible, even from a local shot.

Why Sleep Problems Can Occur

Several mechanisms may explain why you feel “wired” or restless after an injection:

1. Hormonal Stimulation: Corticosteroids can temporarily elevate cortisol levels, which naturally rise in the morning to keep you alert. If levels remain high at night, falling asleep can be harder.

2. Increased Energy or Mood Changes: Some people experience a mild “steroid high,” feeling more energetic or mentally alert—great for productivity, not ideal for bedtime.

3. Pain Relief Paradox: If pain kept you tired before, sudden relief can disrupt your routine sleep cues, making your body feel “off schedule.”

4. Individual Sensitivity: Everyone metabolizes steroids differently. Age, dosage, and overall health can change how long stimulating effects last.

How Long Does Insomnia Last?

Most people, if affected, notice sleep disruption only for 1–3 nights after the injection. In rare cases—especially with higher doses or multiple injections—sleep disturbance may linger for a week or more. Chronic insomnia is uncommon from a single shot but may be more likely with repeated or systemic steroid use.

Practical Tips to Protect Your Sleep

If you’re scheduled for, or have recently received, a cortisone shot, these steps can minimize sleep issues:

• Plan Timing: If possible, schedule injections in the morning so stimulation tapers off by bedtime.

• Wind-Down Routine: Keep lights low, avoid caffeine, and do calming activities (reading, gentle stretches) to encourage melatonin release.

• Stay Hydrated: Adequate fluids help metabolize medication and reduce systemic effects.

• Limit Naps: To preserve sleep pressure, avoid long or late naps.

• Communicate: Let your healthcare provider know if you experience persistent insomnia—they may adjust dosage or suggest short-term sleep aids.

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When to Call Your Doctor

Contact your provider if you notice:

• Sleeplessness lasting more than a week

• Severe mood swings, anxiety, or heart palpitations

• Unusual swelling or pain

These symptoms may indicate a stronger-than-expected systemic reaction.

Bottom Line

Yes—cortisone shots can cause temporary insomnia in some people due to steroid-related stimulation of the nervous system. Fortunately, the effect is usually mild and short-lived. With good sleep hygiene and proper timing, most patients sleep normally within a few days.

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Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your doctor or a qualified health provider regarding any questions you have about medications or side effects.