The dangerous nature of routine or even one Corticosteroid Injection as a treatment for joint pain has been well documented in the medical scientific literature for many years based on both animal studies and human studies.
The continued routine use of Steroid Injections in clinical settings with patients for joint pain prompted one expert researcher to state:
1- Notable Medical Citations on Degenerative Cartilage Loss due to Corticosteroid Injections:
“The Patients who received steroid injections lost significantly more Cartilage than those who were injected with the placebo saline. This is exactly the opposite of what patients and their doctors want to happen.
Author: Dr. Diana Zuckerman, PhD, National Center for Health Research
corticosteroid injections in the treatment
of osteoarthritic joints is deplorable.”
By Ross A. Hauser, MD
2- Notable Medical Citations on Degenerative Cartilage Loss due to Corticosteroid Injections:
“In fact the only thing that changed significantly between the groups was the change in cartilage thickness. Those who got steroid lost 0.16mm more cartilage than those who got saline, a statistically significant if clinically indeterminate result.”
“Do steroids still have a role? I spoke with an orthopedic surgeon who pointed out that steroids should really only be used for flares of osteoarthritis, not as a long-term treatment strategy. He also mentioned that the pain relief is real, but short-lived, and may not have been captured by the every-3-month pain surveys the researchers conducted.”
F. Perry Wilson, MD, MSCE, is an assistant professor of medicine at the Yale School of Medicine.
3- Notable Medical Citations on Degenerative Cartilage Loss due to Corticosteroid Injections:
“Forty years ago, in an Editorial for the British volume of the Journal of Bone and Joint Surgery, Sweetnam stated, ‘We now have evidence, both clinical and experimental, that apart from the well recognized hazard of infection, intraarticular injections of corticosteroids, certainly, if repeated, may be harmful, yet the practice has continued. We believe that it should now cease.’ 131, 132
“This sentiment is reiterated by the International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine who state, ‘Although an extremely useful technique, the intermittent use of intraarticular cortisone should be deployed with caution. The potential risks of provoking hyaline cartilage degeneration, the hazards as they relate to joint infections, and the limitations of cortisone, should be fully discussed and disclosed with the patient.’133, 134 ”
“In summary, intraarticular corticosteroid injections degenerate articular cartilage in osteoarthritis. Studies have shown no long term benefit in joint osteoarthritis and substantial scientific evidence has been offered to the contrary, that the long-term sequelae of injections of corticosteroids into degenerated joints accelerates the arthritic process. Despite its widespread use, substantial scientific evidence exists to dissuade both clinicians and patients from using intraarticular corticosteroids in the treatment of osteoarthritis. The continued use of intraarticular corticosteroid injections in the treatment of osteoarthritic joints is deplorable.”
Bibliography Cited Above:
131 – Neustadt DH. Intraarticular steroid therapy. In, Osteoarthritis: Diagnosis and Medical/Surgical Management. Edited by RW Moskowitz, et al. Philadelphia, WB Saunders, 1992.
132 – Sweetnam R. Editorial. Corticosteroid arthropathy and tendon rupture. J Bone Joint Surg Br. 1969;51:397-398.
133 – Stanish W. A degenerative knee: how to keep them physically active. International Society of Arthroscopy, Knee Surgery & Orthopaedic Sports Medicine. Available at: http://www.isakos.com/innovations/degknee.aspx.
134 – Postume P, et al. The intraarticular and periarticular use of corticosteroid in knee and shoulder. Clin J Sport Med. 1994;4:155-159.
Journal of Prolotherapy – A Publication of Regenerative Medicine Techniques
By Ross A. Hauser, MD Physiatrist Journal of Prolotherapy. 2009;1(2):107-123.http://journalofprolotherapy.com/the-deterioration-of-articular-cartilage-in-osteoarthritis-by-corticosteroid-injections/
Many people do not know the definition of a Physiatrist. Here is what Physiatrists do:
Physical Medicine and Rehabilitation (PM&R) physicians, are also known as Physiatrists, these medical doctors are trained medical experts in treating a wide variety of conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons.
Patients often ask: “Why a person cannot have more than 2 Corticosteroids Injections in any one joint?”
While Corticosteroids are synthetic drugs made to closely resemble cortisol, a natural occurring hormone that your body produces in your adrenal glands naturally – The level of steroid in a treatment injection for Carpal Tunnel Treatment is over 1000 times the level of cortisol that the body produces naturally.
In animal studies medical researchers have found that injections of corticosteroids can lead to deterioration of soft tissue in the joint where it is being injected when it is repeatedly exposed. So, medical text books have drawn the line at 2 injections per joint. Steroid injections are only temporary stop-gap treatments that are effective to give the patient time to find a long-term solution or natural treatment that they can depend upon.
Some physicians offer Prednisone (another steroid) in pills to mitigate Carpal Tunnel Syndrome. The doctors at First Hand Medical suggest that patients stay away from oral pain medical for the treatment of a chronic syndrome like Carpal Tunnel.
There are too many side effects with serious complications for long-term use of Prednisone orally or Corticosteroid Injections. These should only be used in an emergency for a short time period of less than 2 months.
The possibility of side effects depends on many factors including the dose levels, the type of steroid being applied, and length of treatment and or the frequency of treatment. Some side effects are more serious than others.
Common side effects of steroid treatment include:
- Increased appetite, weight gain (bad for Carpal Tunnel and your overall health)
- Nervousness, restlessness
- Irritability and Sudden unexplainable mood swings
- Muscle loss and Muscle weakness
- Blurred vision – Cataracts or glaucoma
- Increased growth of body hair
- Lower Immunity to disease
- Lower resistance to infection
- Swollen, “puffy” face or round face syndrome
- Acne and skin disorders
- Osteoporosis – weakening bones and joints
- Aggravation of diabetes
- Increased Blood Pressure Measurements
- Upset Stomach
- Bloating Digestive System
- Sleep interruption – irregular sleep patterns
- Difficulty getting sufficient REM sleep
- Water retention, swelling
- Easy Bruising
Since Carpal Tunnel Syndrome is a chronic condition that comes back and has to be treated routinely – Steroid Injections are a dangerous treatment option for Carpal Tunnel Syndrome. Also, many of the complications listed above will make Carpal Tunnel Syndrome worse over time, another reason not to use steroids for treatment of CTS. Steroids are too risky to rely upon for a long-term treatment.
When one considers the downside of all of these potential side effects, it is a much better idea to order and try the Carpal Solution Natural Nighttime Stretching Treatment to avoid the potential complications associated with steroid therapy for the treatment of Carpal Tunnel Syndrome.