Knee Steroid Shot Side Effects-Is a Narcotic Shot Better?

Steroid shots in the knee are bad news, because of the damaging knee steroid shot side effects.  These powerful anti-inflammatory injections are often added to local anesthetics, both of which kill cartilage quite dead. If there is a single common knee shot that will harm your knee more than anything else, it’s a steroid shot with the very common local anesthetic Marcaine (Bupivicaine). Is there another way? We’ve often advocated for biologic injections like PRP (platelet rich plasma), which has been shown to beat out the older biologic alternative (hyaluronic acid lubricating gel). We’re also big advocates for other and more powerful biologics like stem cells. However, if you’re still on the fence about getting a biologic injection, is there something that your doctor can inject for pain that won’t be as tough on the existing cartilage? Maybe. This new article looked at the traditional side effect laden steroid shot against a Morphine shot in to the knee joint. This is quite different than the usual Morphine shot into the vein or muscle, where the medication spreads rapidly to the rest of the body, but instead into the contained knee joint where there is much less spread of the medicine to the rest of the body. In the end, both types of injections were equally effective up to about 3 months. So is Morphine any better on chondrocytes (cartilage cells) than steroids? In one study that looked at the two head to head, morphine didn’t seem to have the same sledgehammer negative side effects of steroids. The upshot? If you have to have a shot in your knee to help the pain and things like hyaluronic acid (rooster comb gel shots with names like SynVisc, OrthoVisc, Supartz, Hyalgan, and others) aren’t working, then ditch the nasty steroids and talk to your doctor about using Morphine instead. In fact, I would print this article and take it to him or her to review. If you end up at our clinic for a biologic injection at some later date, given the side effects of knee steroid shots, we’ll be much happier to see that you had a Morphine shot in your knee because it likely leaves more viable cartilage cells remaining.

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Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile