The corticosteroid injections they are a way for people with osteoarthritis to avoid taking steroids as a daily medication.
These injections are given directly into joints such as the hips and knees for people with arthritis to relieve their pain. These doses are usually injected every few months, and can provide pain relief for a few weeks or months.
Corticosteroid doses, used correctly, have been considered a safe and popular treatment for arthritis sufferers. However, a report published in the journal Radiologycollects evidence showing that these injections they could be more damaging to the joints than doctors anticipated.
Here’s what the research found and some natural ways to treat arthritis pain that you might consider.
Known Risks of Corticosteroid Injections
Before receiving a corticosteroid injection, as with most medical procedures, patients must review and sign a consent form acknowledging the risks of such a procedure.
However, what is not included in this form is the fact that these injections could make the hip and knee joints degenerate faster. This could lead to premature hip and knee replacements.
Generally, the most common risks of the procedure listed on the consent forms are infections, allergic reactions, and bleeding at the injection site.
Injections in the same area over a long period of time have also been shown to weaken tendons and bones. Another risk that patients should be aware of when opting for these injections.
The complications discovered by the investigation
The study reviewed the cases of 459 patients and found that 8 percent of them developed complications within 15 months of their injections. Of this 8 percent, 72 percent had moderate knee and hip osteoarthritis, and patients received between 1 and 3 injections. The ages ranged from 37 to 79.
Both patients and doctors believed that the injections were not harmful beyond their recognized risks. But the investigation of Radiology reveals four additional important concerns after reviewing the literature on the subject:
- Accelerated osteoarthritis with rapid loss of joint space. Joint space narrowing usually indicates cartilage loss, but it could indicate other problems with the joint.
- Subchondral insufficiency fracture (SIF). A type of stress fracture that occurs under the cartilage on the surface of a weight-bearing bone. SIF was previously thought to only affect older patients receiving these injections, but the new research shows that younger patients are also affected.
- Osteonecrosis. Also known as bone death, this has been a generally recognized risk of corticosteroid injections. Which is interesting since these injections are often used for pain relief in people with osteonecrosis. However, given the limited treatment options for osteonecrosis, sometimes these injections are the only option for pain relief other than a joint replacement.
- Rapid joint destruction. Joint destruction due to progressive osteoarthritis can lead to joint collapse. This can cause sudden, severe pain in the joint.
The researchers concluded that these risks should be presented to patients before determining whether or not corticosteroid injections are the most appropriate form of treatment for them.
The reason for these complications is not entirely clear. But the authors suggest that it is possible that the combination of drugs with an anesthetic agent can have a negative effect on the joints and cause cell death.
Researchers warn doctors to advise their patients
This is not the first time that the efficacy of these joint injections has been questioned. Research dating back nearly a decade points to the fact that while corticosteroid injections can be an effective short-term solution, they may not be part of an adequate long-term pain management strategy.
The study authors concluded that patients who have mild osteoarthritis, or osteoarthritis that does not show up on imaging such as X-rays, do not necessarily need these injections to treat their pain. Especially if the joint pain does not match the imaging results.
The authors also suggest additional diagnoses before receiving the injections. Since simple imaging techniques can sometimes reveal SIF and osteonecrosis before injection, this could give patients more information about the risks.
Additionally, the researchers note that the joint damage could have been present before the injections. But that was not detected at the time of giving them.
Patients with mild osteoarthritis, in particular, are at risk of developing one of the complications. including the rapid joint degeneration or acceleration of osteoarthritis after injection. For these patients, other lifestyle changes, such as diet and exercise, may be a more appropriate approach to managing the disease.
The authors argue that people who have recently been diagnosed with osteoarthritis and are in an early stage of the disease need to be aware of the risks of these injections rather than default to them simply because it is a common treatment.
The study of Radiology suggests that corticosteroid injections may aggravate arthritis or cause side effects that need to be further understood. They conclude that these injections are not harmless and patients should be aware of the risks.
Are there natural ways to treat osteoarthritis without corticosteroids?
Yes! In fact, the best non-invasive way to manage osteoarthritis pain is with certain lifestyle changes. Like hot and cold therapy, massage, supplements like glucosamine, natural eggshell membrane, and exercise. These are reliable ways to decrease arthritis pain and improve joint health.
The exercise is one of the best ways to treat arthritis pain and can help strengthen muscles that are responsible for supporting the joints. Some of the best activities you can do include swimming and cycling.
Remember to start slowly and gradually increase your routine. Also work with your doctor or a physical therapist to customize an exercise program that works for your level of pain and mobility.
Foods containing omega-3 fatty acids can also reduce joint pain, especially wild-caught fish such as salmon and tuna. Or plant-based sources like flaxseeds and walnuts. You can also consider taking a high-EPA omega-3 supplement.
For many arthritis patients, having a single treatment option will not be enough to reduce pain and improve quality of life. And some patients experiencing extreme pain may need corticosteroid injections. The risks should be discussed in detail with your doctor, including any additional diagnoses, before the injection procedure.