New research reveals the danger of steroid injections

Recent research from Boston University School of Medicine (BUSM) has found steroid injections into the hip and knee can accelerate the progression of arthritis and contribute to joint destruction. The researchers conducted a search on patients they had injected during (2018) in the hips and knees.  They found that eight percent had complications, with 10 percent in the hips and four percent in the knees.  While thousands of steroid injections are given each day for treating arthritis and other joint related pain, there is conflicting evidence on their benefit.  

Although some patients may get pain relief with a steroid injection, it is important to consider the long term implications of injecting steroid into a joint.  We have known for a long time steroids weaken tissue. Does it make sense to inject something that is known to weaken tissue into a joint or tendon that is already in a weakened state?  The cartilage of an arthritic hip or knee is weaker than the cartilage of a joint without arthritis. The tendon of a shoulder with rotator cuff “tendonitis” (more appropriately called a tendinopathy or tendinosis) is already weaker than a healthy tendon.  If we know these tissues are already in a weakened state, it might not make sense to inject a steroid even if it provides short term pain relief.

It is also important to remember a steroid injection only treats symptoms and in most cases not the root cause of pain.  People with arthritis typically have weakness and limited mobility around the joint. Improving strength and mobility will frequently reduce the pain associated with arthritis and provide a longer term solution.  

Dr. Terry Gebhardt is a physical therapist and hypnotist at Colorado In Motion

Andrew J. Kompel, Frank W. Roemer, Akira M. Murakami, Luis E. Diaz, Michel D. Crema, Ali Guermazi. Intra-articular Corticosteroid Injections in the Hip and Knee: Perhaps Not as Safe as We Thought? Radiology, 2019; 190341 DOI: 10.1148/radiol.2019190341

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