Intra-articular injections with corticosteroids is a very common medical treatment for the pain caused by joint osteoarthritis. Patients get joint pain and see their doctors for it, and this commonly leads to an intra-articular injection with corticosteroids. The reason for this is that there are no really good medical treatments for arthritis of the joints. Also, corticosteroids usually result in quick relief of the pain, so doctors love them.
However, most people are not aware of the downsides of this treatment. Most people do not know that corticosteroids are not a treatment for arthritis and does not heal the joint. They work by reducing inflammation and that is what provide quick relief of pain. This pain relief, however is short lived: usually lasting only for no more than 2-3 months. Repeated injections are then needed to continue the pain relief.
For some time it has been known that corticosteroids, when injected into joints can harm the cartilage in the joint. Corticosteroids have been shown to have an inhibitory effect on the synthesis of cartilage proteins and induce early death of chondrocytes, the cells that produce cartilage. Therefore, intra-articular corticosteroid injections accelerate the loss of cartilage and predispose that joint to further degeneration and arthritis.
If that wasn’t bad enough, the local anesthetics usually mixed with the corticosteroids in these injections can also be harmful to cartilage and when combined with corticosteroids produce a double whammy that can harm the joint even after just one injection.
Corticosteroids also have a large number of systemic side effects, including an increase in blood sugar, weight gain, infections, and suppression of the adrenal glands. Until recently it was thought that this adrenal suppression only occurred with large dosages or after long term use of corticosteroids. However, studies have shown how just one injection into corticosteroids into the joints can depress the function of the adrenal glands.
Knowing the limitations of the benefits, the damage to the cartilage, and other potential serious side effects, why is this still a mainstream orthopedic medicine treatment? Again, because the medical options for treating osteoarthritis are very limited.
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