[39F] Experiencing neurological and systemic symptoms post-cortisone injections

Patient Description

A 39-year-old female received two cortisone shots in her shoulders for bursitis. Since then, she has experienced muscle spasms, nausea, migraines, and numbness and tingling in her tongue, fingers, and toes. The numbness feels like pins and needles, particularly affecting the sides of her tongue and occurring in her fingers and toes when in certain positions for a few minutes. She also reports fatigue, insomnia, night sweats, and hormonal fluctuations, with a notable migraine lasting more than a day. The patient has a history of Hashimoto's disease, hypothyroidism, C-PTSD, and ADHD, managed with medications including Adderall, levothyroxine, liothyronine, and Prozac. She also has two herniated discs from a car accident and attends physical therapy and chiropractic sessions twice weekly. She has been more sedentary recently due to online work. No vomiting or bowel changes reported. She occasionally takes ibuprofen and Tylenol for migraines. No recent travel or significant environmental changes noted. She experiences dizziness described as lightheadedness and balance issues.

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Arora's Assessment

What might be happening

Based on your symptoms and recent medical history, here are some possibilities:

  1. Corticosteroid Side Effects: Cortisone shots can sometimes cause side effects, including mood changes, insomnia, and hormonal fluctuations. While less common, they can also lead to muscle weakness or spasms. The timing of your symptoms suggests a possible link to the injections.

  2. Nerve Compression or Irritation: Given your history of herniated discs, the numbness and tingling in your extremities could be due to nerve compression. This might be exacerbated by certain positions or activities, such as those in physical therapy.

  3. Thyroid Function Fluctuations: Your history of Hashimoto's disease and hypothyroidism could contribute to some symptoms like fatigue, hormonal fluctuations, and feeling flushed. It's important to ensure your thyroid levels are well-managed.

  4. Migraine and Neurological Symptoms: The severe migraine and associated symptoms like dizziness and lightheadedness could be part of a migraine episode, which can sometimes cause neurological symptoms like tingling.

What you can do

Numbness and Tingling:

  • Consider reaching out to your healthcare provider to discuss these symptoms, especially given your history of herniated discs. They may recommend imaging or adjustments to your physical therapy routine.
  • Avoid positions that exacerbate the symptoms and try gentle stretching exercises as advised by your physical therapist.

Muscle Spasms and Fatigue:

  • Stay hydrated and consider gentle stretching or relaxation techniques to help manage muscle spasms.
  • Ensure you're getting adequate rest and consider discussing your insomnia with your healthcare provider for potential solutions.

Hormonal Fluctuations and Nausea:

  • Monitor these symptoms and discuss them with your healthcare provider, especially if they persist or worsen. They may want to check your thyroid levels or adjust your medications.

Migraines:

  • Continue using Tylenol Migraine as needed, but be cautious about overuse. Discuss with your healthcare provider if migraines become more frequent or severe.

General Health:

  • Keep a symptom journal using MDandMe to track your symptoms, triggers, and any changes over time. This can be helpful for your healthcare provider to understand your condition better.

What you should look out for

  • If you experience worsening numbness, weakness, or difficulty with coordination, seek medical attention promptly.
  • Watch for any new or severe symptoms, such as chest pain, shortness of breath, or severe headaches, and seek immediate care if they occur.
  • Keep an eye on your thyroid symptoms and ensure regular follow-ups with your healthcare provider to manage your thyroid condition effectively.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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27 d ago


People Also Ask


Can cortisone shots cause side effects like muscle spasms and hormonal fluctuations?

Yes, cortisone shots can cause side effects such as mood changes, insomnia, hormonal fluctuations, and, in some cases, muscle weakness or spasms. These effects can vary depending on the individual and the dosage.


How can herniated discs lead to numbness and tingling in extremities?

Herniated discs can compress or irritate nearby nerves, leading to symptoms like numbness, tingling, or pain in the areas served by those nerves. This is often exacerbated by certain positions or activities.


What are the potential effects of thyroid function fluctuations on overall health?

Fluctuations in thyroid function, especially in conditions like Hashimoto's disease and hypothyroidism, can lead to symptoms such as fatigue, hormonal imbalances, and feeling flushed. It's important to monitor thyroid levels and adjust medications as needed.


How can migraines cause neurological symptoms like dizziness and tingling?

Migraines can sometimes cause neurological symptoms due to changes in brain activity and blood flow. These symptoms can include dizziness, lightheadedness, and tingling sensations, which may accompany or precede the headache phase of a migraine.

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