Pregnancy brings many changes — weight gain, fluid retention, and shifting hormones — that can lead to aches and pains in the joints and tendons. Sometimes these are severe and don’t settle with simple measures. And because we usually advise avoiding common anti-inflammatories such as ibuprofen in pregnancy, the question of a cortisone injection often comes up. So, can you have a cortisone shot while pregnant, and is it safe?
The short answer: the available evidence is reassuring, but it’s a decision to make with your obstetrician or midwife, weighing the benefit against your individual situation.
What happens to your joints and tendons in pregnancy?
Hormonal changes raise oestrogen and relaxin. Relaxin alters collagen, making ligaments stretchier and more lax. Combined with the weight gain of pregnancy, this leaves many women prone to joint and tendon aches.
Common joint and tendon problems in pregnancy
Sacroiliac joint pain
Changes to the uterus increase the curve of the lower back and tilt the pelvis forward. The sacroiliac joints resist this tilt, which loads them. Simple treatments — a support belt, soft-tissue therapy, and strengthening — are usually effective. Occasionally, a cortisone injection into the joint is considered in severe cases.
Osteitis pubis (pubic symphysis pain)
Common in athletes, but pregnant women are also prone to pubic symphysis pain. It usually builds gradually, with pain in the pubic area spreading to both inner thighs — occasionally severe enough to need rest. Cold packs, soft-tissue therapy, acupuncture, and pelvic strengthening help, and a cortisone shot is sometimes useful in stubborn cases.
Carpal tunnel syndrome
Hand pain is common in pregnancy, and carpal tunnel syndrome is the usual cause, driven by fluid retention. Symptoms often settle within days to weeks of delivery, though a small number persist. Splinting and massage are usually effective; sometimes a cortisone shot is needed during pregnancy or after delivery, and surgery is rarely required.
Meralgia paraesthetica
This causes burning pain, numbness, and tingling over the front and outer thigh, from trapping of the lateral femoral cutaneous nerve near the pelvis, and pregnancy raises the risk substantially. Wearing loose clothing and avoiding carrying a child on the affected hip can help, and symptoms usually resolve after delivery.
Can you have a cortisone shot while pregnant?
This is best decided together with your obstetrician, but the evidence is broadly reassuring.
Older concerns suggested cortisone in pregnancy might affect fetal brain development. More recent and larger studies have not found an increased risk of cerebral palsy or abnormal brain development in women who had cortisone tablets or one or more cortisone injections. Where possible, we still prefer to avoid the first trimester, use the lowest effective dose, and reserve injections for when simpler measures haven’t worked — the standard cautious approach to any medication in pregnancy.
Cortisone can also raise blood sugar for a few weeks. Women with gestational diabetes are therefore more likely to see higher sugar levels. Sothis needs monitoring and a conversation with your maternity team, though serious complications after one or more shots are not generally seen.
On balance, the evidence suggests a cortisone injection in pregnancy carries low risk to mother and baby, particularly when it’s genuinely needed and given thoughtfully.
Can a cortisone shot while pregnant harm your baby?
Current evidence is reassuring: studies have not shown that one or more cortisone injections increase the risk to the baby, including abnormal brain development. As with any treatment in pregnancy, it’s about weighing a low risk against the benefit of relieving severe pain — a judgement best made with your obstetrician, rather than something to decide alone.
Can I have a cortisone shot while breastfeeding?
Yes — there’s no need to stop breastfeeding for a cortisone injection. The amount passing into breast milk is minimal, far less than a single 40mg cortisone tablet, and isn’t considered harmful to the baby.
Frequently asked questions about a cortisone shot while pregnant
Is a cortisone injection safe in the first trimester?
Overall, the evidence is reassuring, but where it’s possible to wait, we generally prefer to avoid the first trimester and use injections later in pregnancy if needed. This is a precautionary approach common to most medications in early pregnancy — discuss the timing with your obstetrician.
Why can’t I take ibuprofen instead?
NSAIDs such as ibuprofen are generally avoided in pregnancy, especially in the third trimester, because of effects on the baby’s circulation and kidneys. That’s partly why a targeted cortisone injection is sometimes considered when pain is severe and simpler measures haven’t worked.
Will a cortisone shot affect my blood sugar?
It can raise blood sugar for a few weeks. If you have gestational diabetes, mention this to your maternity team, so your sugars can be monitored after the injection.
Are there alternatives to a cortisone shot in pregnancy?
Yes, and we try these first: physiotherapy, support belts or splints, soft-tissue therapy, acupuncture, activity modification, and targeted strengthening. Many pregnancy-related aches also settle after delivery, so simple measures to get you through are often enough.
Is it safe to have a cortisone shot just before delivery?
This is best discussed with your obstetrician, as the right timing depends on your individual circumstances. However, the general evidence on cortisone injections in pregnancy remains reassuring.
Final word from Sport Doctor London about a cortisone shot while pregnant
Joint and tendon pains are common in pregnancy, and simple treatments work for most. When pain is severe and doesn’t settle, a cortisone injection is an option — and the evidence on its safety in pregnancy and breastfeeding is reassuring. The key is to make the decision together with your sports doctor and obstetrician, using the lowest effective dose when it’s genuinely needed.
If you’re pregnant with severe joint or tendon pain, Dr Masci can assess you in London and liaise with your maternity team. Contact the team here or call +44 (0) 203 488 0350.
Leave A Comment