Do Steroid Injections Raise Your Heart Rate? A Pharmacological Analysis

October 11, 2025 •

3 min read

While millions receive corticosteroid injections for inflammation, a potential side effect is an altered heart rhythm [1.9.3]. So, do steroid injections raise your heart rate? This is a valid concern for many patients, and the answer involves how these powerful drugs interact with the body's systems [1.2.3, 1.2.6].

Quick Summary

Yes, steroid injections can raise your heart rate, a condition known as tachycardia, or cause palpitations [1.2.6, 1.2.1]. This is a known side effect, often temporary, caused by the drug's systemic influence on electrolytes and the nervous system [1.3.5].

Key Points

Direct Effect: Yes, steroid injections can raise heart rate (tachycardia) and cause palpitations in some individuals [1.2.6].
Pharmacological Reasons: This occurs due to electrolyte shifts (especially potassium), fluid retention, and stimulation of the sympathetic nervous system [1.3.5, 1.2.6].
Usually Temporary: For most people, an elevated heart rate from a steroid injection is a transient side effect that resolves within 1 to 3 days [1.2.1].
Dose-Dependent Risk: The likelihood and severity of cardiovascular side effects increase with higher doses of corticosteroids [1.2.3].
High-Risk Individuals: People with pre-existing heart disease, high blood pressure, or kidney disease are at a greater risk for these side effects [1.2.3, 1.9.2].
Anxiety's Role: Steroids can induce anxiety, which can independently contribute to the sensation of a racing heart [1.8.1, 1.8.2].
When to Seek Help: If a rapid heartbeat is accompanied by chest pain, dizziness, or shortness of breath, immediate medical evaluation is necessary [1.3.5].

Understanding Steroid Injections and Their Purpose

Steroid injections, most commonly corticosteroid injections like methylprednisolone or prednisone, are widely used medical treatments to reduce inflammation in the body [1.3.5]. They are effective for a range of conditions, from joint pain and arthritis to autoimmune flare-ups and severe allergic reactions [1.3.5, 1.2.2]. These injections deliver a concentrated dose of medication directly to an inflamed area (intra-articular) or in a way that affects the whole body (systemic), such as an epidural or intramuscular shot [1.4.1, 1.5.2]. While highly effective for pain and swelling, the medication can be absorbed into the bloodstream and cause systemic side effects [1.6.5].

The Pharmacological Link: How Steroids Impact Heart Rate

The primary reason steroid injections can elevate your heart rate is tied to their pharmacological actions, which mimic the body's natural stress hormone, cortisol [1.2.3]. This can lead to several physiological changes:

Electrolyte Imbalances Corticosteroids can cause the body to retain sodium and water while increasing the excretion of potassium [1.2.6, 1.3.1]. Low potassium levels (hypokalemia) and high sodium levels (hypernatremia) can directly interfere with the heart's electrical signaling, potentially triggering a faster heartbeat or palpitations [1.3.6, 1.5.6].
Sympathetic Nervous System Stimulation The body's 'fight or flight' response, governed by the sympathetic nervous system, can be activated by corticosteroids. This stimulation can lead to an increased heart rate and higher blood pressure [1.2.3].
Increased Blood Pressure Fluid retention caused by steroids can lead to an increase in blood pressure [1.2.6]. The heart may beat faster to circulate blood against this higher pressure.
Anxiety and Insomnia Steroids are also known to cause side effects like anxiety, restlessness, and insomnia [1.2.1, 1.8.1]. These conditions themselves can lead to a sensation of a racing or pounding heart, even if the medication isn't directly causing it [1.8.2].

Tachycardia, Palpitations, and Arrhythmias

A direct result of these mechanisms can be tachycardia, which is defined as a heart rate over 100 beats per minute at rest [1.2.3]. Patients may also experience palpitations, which are sensations of a fluttering, pounding, or skipping heartbeat [1.3.5]. While often harmless and temporary, these symptoms can be disconcerting [1.3.5]. In some cases, particularly with high doses or in susceptible individuals, other arrhythmias like atrial fibrillation (an irregular and often rapid heart rate) can occur [1.3.6, 1.9.4]. These effects are generally dose-dependent, meaning the risk increases with higher doses of the steroid [1.2.3].

Comparison of Local vs. Systemic Side Effects

It's important to distinguish between side effects that occur at the injection site versus those that affect the entire body.


Side Effect Type	Examples	Onset & Duration
Local	Pain at the injection site, bruising, skin discoloration, temporary flare-up of pain ("cortisone flare") [1.6.6].	Usually occurs within hours and resolves in a few days [1.6.6].
Systemic	Increased heart rate, palpitations, facial flushing, insomnia, mood changes, increased blood sugar, fluid retention [1.2.1, 1.2.6].	Can appear within hours to days and may last 1-3 days or longer, depending on the dose [1.2.1, 1.6.1].

Who Is Most at Risk?

While anyone can experience these side effects, certain individuals have a higher risk of cardiovascular complications from steroid injections [1.9.2]:

Patients with pre-existing heart conditions, such as heart failure, a history of arrhythmias, or coronary artery disease [1.2.3, 1.9.4].
Individuals with uncontrolled high blood pressure (hypertension) [1.9.1].
Those with underlying kidney disease [1.2.3].
Patients receiving high-dose or repeated steroid treatments [1.9.3].
People with anxiety disorders, as the medication can exacerbate anxiety, which in turn affects heart rate [1.8.2].

It is crucial to discuss your full medical history with your healthcare provider before receiving a steroid injection [1.2.3].

Conclusion: A Manageable Side Effect

So, do steroid injections raise your heart rate? Yes, it is a recognized and relatively common side effect, often accompanied by palpitations or a feeling of anxiety [1.2.1, 1.3.5]. For most people, this effect is mild, temporary, and resolves on its own within a few days as the medication is processed by the body [1.2.1, 1.6.1]. However, the risk is greater for those with underlying cardiovascular conditions or those on high doses [1.9.2, 1.9.3]. If you experience a rapid heart rate along with symptoms like chest pain, shortness of breath, dizziness, or fainting, you should seek immediate medical attention [1.3.5, 1.5.3]. Always communicate with your doctor about any side effects you experience.

For more information on corticosteroid treatments, a valuable resource is the American College of Rheumatology. [1.5.2]

Frequently Asked Questions

For most patients, an increased heart rate is a temporary side effect that usually disappears within 1 to 3 days after the injection [1.2.1]. If it persists, contact your doctor.

Yes, although rare, epidural steroid injections can cause systemic side effects including an increased heart rate and palpitations. These effects occur in less than 5% of patients [1.2.1].

If the symptom is mild, try relaxation techniques like deep breathing [1.8.1]. Avoid stimulants like caffeine. If you experience chest pain, severe dizziness, or shortness of breath, you should seek immediate medical attention [1.3.5, 1.5.3].

Heart palpitations after taking prednisone can be concerning, but they are often harmless and temporary [1.3.5]. The risk increases with higher doses, and you should inform your doctor if they occur, especially if you have a history of heart problems [1.2.3].

Steroids can cause mood changes, including anxiety and restlessness, which can contribute to a faster heart rate. This can be a direct effect of the medication or a psychological response to the physical sensation [1.8.1, 1.8.2].

The risk depends on how much of the steroid is absorbed into your bloodstream. Injections given intravenously (IV) or at high doses are more likely to cause systemic side effects like an increased heart rate compared to a small, localized joint injection [1.2.3, 1.5.2].

Yes, corticosteroids can cause elevation of blood pressure, often due to salt and water retention [1.2.6, 1.3.1]. This effect is usually temporary but should be monitored, especially in those with pre-existing hypertension [1.6.1].