What are the possible risks and side-effects of steroid injections?Corticosteroids are a class steroi medications that are related to cortisone, a steroid. Medications of this class powerfully reduce inflammation. They sterpid used to reduce the inflammation caused by a variety of diseases. Cortisone is one type of corticosteroid. For the purpose of this review, "cortisone" is used interchangeably with "corticosteroid. Corticosteroids can be taken by mouth, inhaled, applied to the skin, given intravenously into a veinor injected into the tissues of the body. Examples of corticosteroids include prednisone and prednisolone given by mouthmethylprednisolone sodium succinate injection Solu-Medrol given buy online anabolic steroids in indiaas well as triamcinolone Kenalogbetamethasone Celestonemethylprednisolone Depo-Medroland others given by injection long term complications of steroid injections body tissues.
Steroid Effects | Short Term, Long Term & Side Effects
Physicians commonly use intra-articular steroid injections for the management of osteoarthritis OA , which is the most prevalent joint disorder in the United States. The results of past research examining the risks associated with intra-articular corticosteroids have been mixed with animal studies but not human studies reporting cartilage damage.
Osteoarthritis is extremely common and the treatment of osteoarthritis has a very high economic burden. The majority of epidemiologic studies on OA have focused on knee OA with research reporting symptomatic knee OA in 10 to 13 percent of patients age 60 years and older.
While researchers initially regarded OA as solely a wear-and-tear process, studies have found OA to be an inflammatory disorder with inflammatory mediators leading to characteristic cartilage degeneration, synovitis, subchondral bone remodeling and joint capsule hypertrophy.
Intra-articular corticosteroids are a common treatment for OA. Corticosteroids exert their pain relieving effects in OA through anti-inflammatory and immunosuppressive mechanisms. Intra-articular corticosteroid injections have few short-term side effects. Research examining the long-term effects of corticosteroids has been lacking. There has been concern regarding the effect of intra-articular corticosteroids on intact joint cartilage.
Corticosteroids do cause soft tissue atrophy but previously, there has been limited evidence regarding their effect on cartilage. In the aforementioned JAMA study, McAlindon and colleagues performed a two-year, randomized, placebo-controlled, double-blind trial examining the effect of intra-articular triamcinolone in comparison with saline on pain and cartilage volume in patients with knee OA. Using magnetic resonance image measurements, researchers found increased cartilage loss in the corticosteroid group.
Both groups showed no clinically significant improvement in pain at the two-year endpoint of the study. Cartilage loss in this study was not associated with worsening of clinical symptoms but more studies are needed to assess the long-term effects of this cartilage loss. Additionally, further research is needed to examine the long-term effects of intra-articular corticosteroids on other joints including the foot and ankle.
Chandler GN, Wright V. Deleterious effect of intra-articular hydrocortisone. Decreased glycolytic enzyme activity in epiphyseal cartilage of cortisone-treated rats. The acute effects of intra-articular hydrocortisone on articular cartilage in rabbits. J Bone Joint Surg Am.
Injections in the treatment of osteoarthritis. Best Pract Res Clin Rheumatol. Am J Med Sci. Repeated corticosteroid injections into knee joints. Effect of intra-articular triamcinolone vs saline on knee cartilage volume and pain in patients with knee osteoarthritis: J Am Med Assoc.
Zhang Y, Jordan JM. Intraarticular drug delivery in osteoarthritis. Adv Drug Deliv Rev. Systemic effects of intra-articular corticosteroids.
Adverse effects of extra-articular corticosteroid injections: Skip to main content. Sign up for e-news Log in Apr 19, Add new comment Your name.
More information about text formats. Web page addresses and e-mail addresses turn into links automatically. Lines and paragraphs break automatically. What code is in the image?