How do you get rid of a cortisone headache? Comprehensive Relief and Management

October 12, 2025 •

4 min read

Headaches are a known, though not the most common, side effect of corticosteroid medications like cortisone injections. These headaches can stem from various factors, including blood sugar fluctuations, insomnia, and, in rare cases, a puncture during a spinal injection. Learning how to get rid of a cortisone headache effectively involves identifying its cause and choosing the appropriate management strategy, from over-the-counter pain relievers to home remedies.

Quick Summary

This article explores the causes behind cortisone-induced headaches and outlines specific strategies for relief. It details common medication options, lifestyle adjustments, and when to seek professional medical advice for persistent or severe symptoms.

Key Points

Identify the Cause: Cortisone headaches can be triggered by blood sugar changes, insomnia, or, rarely, a spinal puncture, so identifying the cause is crucial for targeted relief.
Consider Acetaminophen First: For mild pain, acetaminophen is generally the safest over-the-counter painkiller to use alongside corticosteroids, avoiding the stomach risks associated with NSAIDs.
Use NSAIDs with Caution: While effective, nonsteroidal anti-inflammatory drugs like ibuprofen should be used only after consulting a doctor, especially if on oral steroids, due to increased risk of gastrointestinal issues.
Prioritize Rest and Hydration: Simple home remedies like resting and drinking plenty of fluids can help alleviate general discomfort and headaches.
Beware of Positional Headaches: If your headache is severe when sitting or standing and improves when lying down, it could be a rare but serious post-dural puncture headache (PDPH) requiring medical attention.
Consult a Doctor for Persistent Symptoms: For severe, worsening, or persistent headaches, particularly those accompanied by other concerning symptoms like fever, seeking medical advice is essential.

Understanding the Causes of a Cortisone Headache

Experiencing a headache after a cortisone injection or oral steroid course can be disconcerting. While often temporary, knowing the potential causes can help in finding the right solution. Corticosteroids affect various bodily systems, leading to several possible headache triggers.

Blood Sugar and Blood Pressure Fluctuations: Cortisone can temporarily raise blood sugar and blood pressure levels. These changes can lead to a headache, especially in individuals with diabetes or hypertension.
Insomnia and Sleep Disturbances: Sleep problems are a documented side effect of steroids and can be a significant contributor to headaches.
Post-Dural Puncture Headache (PDPH): This is a specific and rare complication that can occur after an epidural steroid injection in the spine. If the injection needle punctures the protective outer membrane (dura) of the spinal cord, cerebrospinal fluid can leak. A hallmark of PDPH is that the headache worsens when sitting or standing and improves when lying down.
Steroid Withdrawal: When tapering off a long-term course of oral corticosteroids, withdrawal symptoms, including headaches, can occur.

Pharmacological Approaches to Cortisone Headache Relief

For most cortisone-related headaches, over-the-counter (OTC) pain relievers can provide sufficient relief. However, the choice of medication should be discussed with a doctor, especially if you are taking oral steroids, due to potential interactions and side effects.

Acetaminophen (Tylenol): This is generally considered the safest option for pain relief when taking corticosteroids, as it does not carry the same risk of gastrointestinal irritation as NSAIDs. It's important not to exceed the recommended daily dose to avoid liver damage.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen (Advil, Motrin) and naproxen (Aleve) are effective anti-inflammatory pain relievers. However, combining NSAIDs with corticosteroids can increase the risk of stomach ulcers, bleeding, and high blood pressure, especially with long-term use. A doctor's approval is necessary before combining these medications.

Comparison of Headache Treatment Options


Treatment Method	Typical Cause Addressed	Speed of Relief	Cautions & Side Effects
Acetaminophen (Tylenol)	General cortisone headache, mild to moderate pain	Generally within 30-60 minutes	Liver damage at high doses
NSAIDs (e.g., Ibuprofen)	General cortisone headache, inflammatory pain	Generally within 30-60 minutes	Increased risk of GI bleeding, ulcers, and high blood pressure when combined with steroids
Rest & Hydration	Dehydration, general discomfort, PDPH (lying down)	Varies based on individual and cause	No direct contraindications, but only helps with certain headache types
Caffeine	PDPH, some general headaches	Can be fast-acting for some	Potential for insomnia, jitters
Epidural Blood Patch	Post-Dural Puncture Headache (PDPH)	Usually provides rapid relief for PDPH	Invasive procedure with associated risks

Non-Pharmacological Strategies for Relief

In addition to medication, several home remedies and lifestyle adjustments can help manage a cortisone headache. These methods can be used alone for mild headaches or in conjunction with medication for more severe cases.

Stay Hydrated: Drinking plenty of fluids is a simple but effective way to alleviate many types of headaches.
Rest and Relaxation: Taking it easy and resting can be very helpful, especially for the first day or two after an injection.
Adjust Your Position: For the positional pain of a PDPH, lying flat can bring significant relief.
Caffeine Consumption: Drinking coffee, tea, or soda can help alleviate headaches, especially PDPH, by altering blood flow.
Manage Blood Sugar: If you have diabetes, carefully monitoring your blood sugar levels in the days following a cortisone shot is critical. Your doctor may advise adjusting your diabetes medication temporarily.

When to Seek Medical Attention

While most cortisone headaches are temporary and resolve with simple care, certain symptoms warrant a call to your healthcare provider.

Severe or Persistent Pain: If the headache is severe, worsens, or lasts for more than a few days despite home care, contact your doctor.
Positional Headache: If your headache is notably worse when you sit or stand and improves when you lie down, especially after a spinal injection, it could be a PDPH. This requires medical evaluation.
Signs of High Blood Sugar: For those with diabetes, symptoms like increased thirst, frequent urination, or a pounding headache could indicate hyperglycemia and require attention.
Fever or Swelling: After an injection, a severe headache accompanied by fever or increasing swelling could signal an infection, a rare but serious side effect.

Conclusion

Cortisone headaches are a recognized side effect of steroid treatment, but they are typically manageable with the right approach. From OTC pain relievers like acetaminophen to simple adjustments like rest and hydration, relief is often achievable. For the specific and rare PDPH, caffeine and rest are primary treatments, with more advanced options available for persistent cases. Always communicate with your healthcare provider about any persistent or worsening symptoms to ensure the cause is properly identified and managed. For more detailed information on steroid side effects and patient management, consult authoritative medical resources like those provided by the Mayo Clinic.(https://www.mayoclinic.org/tests-procedures/cortisone-shots/in-depth/steroids/art-20045692).

Frequently Asked Questions

Yes, headaches are a known side effect of cortisone injections, though they are not the most common one. They can be caused by various systemic effects, not just the injection itself.

Acetaminophen (Tylenol) is typically considered the safest OTC pain reliever to take with cortisone, especially for those on oral steroids, as it does not increase the risk of stomach issues like NSAIDs do.

A Post-Dural Puncture Headache (PDPH) is a rare but serious side effect after a spinal injection, characterized by a headache that worsens when you sit or stand and improves when you lie down.

Yes, drinking caffeinated beverages like coffee or tea can sometimes help alleviate cortisone-induced headaches, particularly in cases of PDPH.

You should contact your doctor if the headache is severe, lasts more than a few days, changes with your position (worse when standing), or is accompanied by fever or swelling.

Yes, cortisone can temporarily raise blood sugar levels, and this hyperglycemia can, in turn, cause a headache.

Most mild cortisone-induced headaches are temporary and resolve within a few days to a week. If the headache persists, it is important to contact your doctor.