How long does a steroid injection take to work?

I had a steroid injection to reduce inflammation in my joints yesterday, GP told me that I will be free of pain for approx 3mths. Last night I developed a headache, ringing in my ears and every joint in my body felt really painful and felt like it was burning. I had the worst night sleep! I have also started taking Plaquenil a week tomorrow and I'm now experiencing hot flushes. This morning I was still in a lot of pain. Is this normal? Thanks Roz

39 Replies

  • Hello, you'll get better informed responses than mine I'm sure. But meanwhile - I think steroid injections can make things worse before they get better. Thinking back my first injections might have done that although there was a lot going on at the time. However most people seem to agree that steroid injections provide real relief once they kick in, which should be days not weeks and that's my past experience too.

    However, having said that my latest steroid injection, intended more to address swelling and inflammation than for pain, has not lived up to expectations. But I don't think it has caused any problems either. How about phoning the Rheumy nurse just in case?

    Luce x

  • Hi Luce

    Thanks for your response it has been most helpful. I wasn't sure if I could phone the rheumy nurse as it was my GP who gave me the injection. I have just been to see the rheumy nurse and mentioned that I had been in constant pain for nearly 3mths, she couldn't find my file and therefore couldn't offer an injection which I was unhappy with as it had been mentioned by the consultant on my last appt in Dec. I'm sorry to hear that your injection hasn't been what you expected, hope you do feel the benefit soon. Roz x

  • I think it varies mine took nearly a week to kick in though most people should get some benefit in 72 hours.

  • Hi Summer,

    Thank you for your reply :)

  • Hi i had great hope's for mine as previously arranged 2 weeks prior to my holls had the injection and pain still there. I don't have much hair but if i did then it would be all out.

  • Hiya a injection that last's up to 3 months,what was it called? i have now had 3 steroid injection i was receiving one every month, I had my last one over 2 weeks ago, I was give 120mg of IM Depo-Medrone, Like everything it work's for some people, Well i have been really disappointed in it, It took at least a week for me to notice any different, and to be honest i am now not sure if it is the steroid injection that is helping me or the MTX. at first i noticed that the stiffness was being to improved, but then when i had the second one they then started me on the MTX , So i have been on the MTX now for 6 weeks, so as you can see why i am unsure,

    I really do hope it works well for you, as it has for some people on here... But i would give it at least a week and don't expect to much sometimes, Like i did, i even arranged a good nite out as i had been in pain for nearly 4 months before i got it, So take care and remember everyone is different , Shirley XX

  • Hi Shirley,

    I'm pretty sure it was the same as what you have named, my GP said it would last for 3 months. I can see why its difficult for you to know if it helped you now that your also taking MTX. I tried that last year for 3 weeks and was very ill, so I'm glad its working for you. Like you Shirley I got very excited and have accepted a party invite and was planning on doing some exercise, maybe I need to calm down and not build my hopes up so much. Thanks for your advice and take care. Roz x:)

  • Hi as a rule when I have a steroid injection it kicks in within a couple of days, MTX can take up to 3 months to get into your system when you first stars on it x

  • Hi there, I've found that sometimes the steroid jabs kick in straight away, other times it takes a day or two. But generally they seem to work well for me. And although they can last up to 3 months, I've never found them to last quite that long. I think the best I got was about 6 weeks. But they do calm the inflammation down, so it can really keep things quiet for ages as it takes a long time to build up again. And Hydroxy can take weeks and weeks to have an effect but hopefully the steroid will last until it does. Polly

  • Hi Polly,

    Thank you for your reply, its really helpful getting everyone's views. I hope that it does work for me. I think I am seeing a slight improvement, but will be patient and see how things go. Roz :)

  • I found it a little difficult to notice when it kicked in, because the effect was a bit more subtle than the tablets, but it should really start to kick in within a day or two, and last at least a month before it slowly wears off again.

    Some folk do get "steroid flares" though, where you feel quite a lot worse for a day or two before you start to feel better.

  • Thank you Earth witch, I think I may have had a steroid flare, however I did call the rheumy nurse and she hadn't heard of it, I have read a fair bit of information that mentions them. Thanks for your advice Roz :)

  • I had a steroid on Friday. By Saturday I was feeling much brighter. Like earth witch says its subtle, but I am feeling less pain and less dragged down. I asked my GP yesterday how long I could expect it to work suggesting 10 days and she said more than that. I asked her about pain control after that, while I wait for anti tnf and she said paracetamol initially, coodamol, and a bit reluctantly because of stomach ibuprofen.

  • Hi cathie, I hope that you are continuing to improve, thank you for your reply. Roz :)

  • Sadly mine didn't work, still in pain and worse I can't see the specialist nurse until the end of Feb, because she lost all my details!! She even said I had not been referred to her,which I knew I had. Not even met her,and can't say I'm looking forward to meeting her.Have only spoken twice on the phone to her and she has been of no help what so ever!!

  • Hi Elaine, sorry to hear that yours didnt work, I must say that I haven't had the improvement I was hoping for either but I'm trying to be patient. Its unacceptable that they have lost all your details, I hope thios gets resolved for you quickly and that she is nicer in person. Hope your pain has eased a little. Roz :)

  • Elaine, when I have intra joint Kenalog injections to my knees they usually work the day after by first of all taking down inflammation. The stiffness and pain subsides about a day after that for me. Often it takes a good few days to feel the full benefit as I find often the site where they have injected can sometimes be painful/sensitive and a bit restrictive. Also about the flushes - I was told this can happen .. And does to me. I have a very pink glow for two or three days. Also find the first day after I am peeing more. That is usual as well. I am sure you will feel full benefit in a few days. Also I find that because of immobilising the joint for a full 24 hours after injection (bathroom visits excepted!) I become white stiff too for not moving so that is to take into consideration. Hope you soon feeling the benefit anyhow.

    Neon Kitty x

  • Hi Neon Kitty,

    Thanks for your reply, its been really helpful and made me calm down and be patient. Its 4 days later and I'm feeling a slight improvement but still have pain in elbows, wrists and fingers. I agree with you about going to the loo I'm going more often! Hope your feeling ok. Roz :)

  • Sorry Elaine ... I have given you Rozzi's answer!! DOH!

    Elaine, I am sorry you have been messed around with your lost details and feel little confidence In your nurse. (I used to have one very unhelpful aggressive nurse a while ago and after several of her shouty incidents and one where she phoned me up and shouted at me knowing my husband had just had major surgery) I asked my consultant to not have to see her as I am a very gregarious sort but just didn't see the point of her stressing me at a time I was stressed anyhow. What about meeting her face to face and seeing if she is better than on the phone. It could be that she is not great on the phone. Some people just aren't. Fortunately the nurses I know are very different now ;-) Can you tell the Rheumatologist's Sec or the Department you would go on standby for a cancellation or is that not possible. I have done that but it depends what else you are doing on a daily basis of course. Anyhow, I am so sorry the shots didn't work for you.

    Neon Kitty x

  • Hi Neon kitty, I will be meeting her face to face so will see how we get on!! I asked if there was any cancelled appointments to let me know, sadly she is the only nurse there, so won't be holding my breath on that one.Hopefully she might not be the battle axe I think she is,time will tell!!!

    Sounds like you have been through the mill as well with your hubbys op,hope he's OK,you can certainly do without people shouting at you,what gives them the right?? Going to see my GP on Friday will have a word with her. Take care xx

  • Quite stiff not White stiff ... Sorry my fingers are cold! Must bump up the C/H ;-)

  • Hi Elaine, this winter weather does not help does it. My hubby ok now thanks, that was a few years back but she came on the phone ranting. I had to tell her I was putting the phone down. Naughty of her to do that. I bet face to face your nurse is fine. If you did have a problem, then next time maybe ask to see the Consultant's Registrar if the consultant is really busy booked up with appointments. It makes all the difference if they are nice with it and have people skills doesn't it. Anyhow hope you feeling not too bad and good luck with your GP on Friday.

    Neon Kitty x

  • Thanks,and I'm sure your right when I meet her she will be OK, she hopefully will be nice and easy to talk too. I'm hoping the Doctor can five me something but she also wants to see me because of my blood test I had, so not looking forward to that!!! Seems to be one thing after another! X

  • Had one over a week ago and it has had no effect at all.


  • Hi, sorry to hear this, was it your first injection? Have you spoken to anyone about it not having an effect. Hope that your coping, take care Roz

  • Hi Rozzii

    As you can see from the responses you've had so far, results with steroid injections do seem to vary widely, but I hope you feel some benefits from it soon.

    In terms of the Plaquenil this usually takes between 3-12 weeks to start to work so after a week you wouldn't really expect to be noticing the effects just yet so don't worry.

    In the meantime, while waiting for the Plaquenil to kick in, it might be worth speaking to your GP about some painkillers and anti-inflammatory medications that you could take to help with the pain. We also have quite a useful article on managing the pain of RA which might be helpful at this time:

    Kind regards

    Sarah Kate


  • Thanks Sarah Kate,

    Its good to get feedback from others. Will check out the link, Roz :)

  • I am sure if the blood test had anything way out of synch the GP's sec would have phoned you straight away. Good luck tomorrow. I get my results and I expect a high ESR after my knees going bonkers. Hope the GP can prescribe better pain for you.

    Neon Kitty x

  • Better pain?? Oh like we want that!! LOL. I can't see what I have typed when I have to do it in that tiny little box as the reply button won't work for me. Sorry meant pain RELIEF of course ;-)

  • Hi Rozzii

    No I have had a few in the past. Initially they made me worse, but helped for a short while after. Very limited re pain relief. Due to non cf bronchiectasis I cannot take DMARDS and GI have said I must not have NSAIDs again. Not phoned the nurse as rheumy said there is nothing else. Hope the medication kicks in for you and you see an improvement soon.

    Thank you Sarah Kate for the link - I'm sure many will find it helpful, including me.

    Love xxx

  • Hi,

    I'm sorry to hear that your having such a difficult time, do you have any meds at all and hopefully some pain relief? Like you I think the injection made me feel worse for a few day, a week and half later I'm feeling some relief but its not taken all the inflammation and pain away. I'm still having to take anti-inflammatories, so its not been the miracle I thought it would be. I have just returned to work and still finding that after a full day of typing my fingers are very painful. I hope that your feeling a bit better today.

    Roz :)

  • Hi Rozzi,

    I get about 3 to 4 a year, I had one last week and had the same issues as you and was surprised, as it is different each time, But, eventually after the Flare from the injection, I am now getting relief in addition to my many other tablets and High doses of Pain Meds, It took I would say 3 to 4 days this time, But it is now helping, it seems to last different months for some we are all different, you will learn in time, when is your time, and soon know how many a year you will need to help you

    Hope this Helps.

    Lisa :)

  • Hi Lisa,

    Thanks for you reply it was very helpful. I think I was very naieve to be honest as I'm quite new to all of this. My GP said I would be painfree for 3mths so thats what I was expecting. It has made some improvement to the pain and stiffness but like you this is on top of pain meds and dmards. I'm sure I will become the expert over time like many of you on this site.

    Hope that your well.

    Thanks Roz :)

  • Also Rozzie,

    I have been on MTX about a year, and gradually increasing, My last increase made me more sick than normal, So I am going end Feb for Injection training, to be able to tolerate the increase in dose Hopefully) That is the Plan Fingers Crossed


  • My first steroid injection -IM- only lasted two weeks but that was when I'd only just been diagnosed and waiting for the MTX to kick in, but I felt the effects within a couple of days. I've also recently had injections into two joints in my foot and again I felt the effects after a couple of days and - fingers crossed - am still feeling the benefit of being pain free (in my foot at least) a month later.

    I hope things settle down for you soon.

  • Afternoon from a newbie!

    Just been diagnosed after scans etc.

    The pain I have been in since September has been unbearable at times. This has resulted in taking Oramorph and having to go private for tests!

    Finally last week got full diagnosis and was given 3 ml of steroid injection into (A huge fatty area below the waist on the other side!) I will never lose my SOH!

    I have been like some of you just waiting for this afternoon to be pain free, sadly it has not happened. Felt so despondent. I was told it would work 24-48 hours.

    I started to "Google" and found all of you and it has been great to read everyone's experiences.

    Over last 48 hours I have felt so much worse, none of the "buzzing that you will not sleep" more like leave me in bed to sleep for 48hours!

    Just had to resort to another dose of Oramorph..... So now I presume be patient and fingers crossed it starts to work soon

    I NEED to improve as I need some of my life back to keep working!

    I have it in both shoulders, elbows, fingers and now moving to my knees :(

  • yes all those things come with having injection.

  • I had one on Wednesday, pain 48hrs later gone!!! but got a head ache for few hrs and nightmares for 2 nights, ring ing in ears !! but hey pain gone...result!!!

  • I had my first injection on Friday in my low back. I had surgery about 6 years ago with titanium rods implanted. I broke my back during the Gulf War and just lived with it. After I retired from the military it just kept getting worse. Last year I fell and developed sciatica. Pain 24/7. All kinds of pain meds do nothing to the sciatica. Well, it's Sunday and the pain feels worse than before. Doc said I should know by today if it will help. So, I guess I may have to try something else but will have to wait a few more days to be certain I guess. They said I have another bulging disc and a couple other things had shifted. This pain is depressing. I have PTSD and all this together just really has a profound negative affect on my quality of life. I used to be so active running 6 miles a day, lifting weights, climbing, etc. I am 57 years old but feel 80. I really hope and pray I get something to work. I don't want to live the rest of my life like this. So, I am so happy for those who do get relief. I wish I had just one day pain free which I have not had since 1991.

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