Traditional medicine has a secret addiction that’s hurting patients. Like the addict who just can’t stop, it needs a serious intervention. What are physicians addicted to? Steroids shots that are reimbursed by insurance but that are making patients worse. So let’s dive into steroid shot side effects and find out what all of the traditional medical sites will never tell you.
What are Steroid Shots?
Steroid shots are often used to treat joint pain due to arthritis or tendinopathy like tennis elbow or shoulder rotator cuff pain. They are composed of high doses of corticosteroid, which is similar to natural substances found in your body that reduce inflammation, but your body uses about one-millionth the dose. Hence the milligram dose of steroids injected by the doctor is massive compared to what your body is used to seeing, which is where the problems with these medications begin. These medications are anti-inflammatories and go by names like Depo-Medrol, betamethasone, dexamethasone, triamcinolone, methylprednisolone, Celestone, and Kenalog.
Steroid Shot Side Effects Chapter 1: Destroying Cartilage
Cartilage is that cushiony stuff on the ends of long bones that acts as a shock absorber for the joint. When arthritis sets in, the cartilage gets worn away causing a “bone on bone” situation. So anything that’s used to treat arthritis pain that causes cartilage to die-off is a bad therapy.
We’ve known for a LONG time that steroid shots destroy cartilage. In fact, the first paper on steroid shot side effects was in 1951! (7) That was followed by others in the 60s and then a parade of animal studies showing that steroid shots hurt cartilage cells in joints, (9,11) If there was any doubt left that steroids hurt joints, recently a randomized controlled trial in real patients with knee arthritis showed that patients who got steroid shots for knee arthritis not only showed no improvement over saline injections, but they also had an accelerated loss of cartilage (1).
Steroid Shot Side Effects Chapter 2: Increasing Risk of Infection or Joint Replacement
It’s hard to imagine that a simple steroid shot in a joint could increase your risk for a joint infection if you need a joint replacement, but this is a real thing. In addition, it’s equally hard to imagine that this shot could make you more likely to need a joint replacement if you have arthritis. Let’s dig into what we know.
We’ve also known for quite some time that patients who get steroid shots for various types of joint pain or arthritis are at higher risk for infection if they get a joint replacement at some point down the road (3). This is a thing not only for knees but also for hips as well (5). We also know that getting a steroid shot to help knee arthritis pain can increase the likelihood of needing a knee replacement, meaning the shot causes more knee cartilage breakdown (2). Hence, steroid shot side effects include increasing the risk for a joint replacement complication or for needing one in the first place.
How big a deal is an infected knee or hip replacement? Major. The average patient will need 6-12 weeks of IV antibiotics through a catheter inserted to a spot near the heart. For some patients, this won’t be enough to heal the infection and instead, they’ll have to have their infected joint ripped out and a new one implanted.
Steroid Shot Side Effects Chapter 3: Systemic Problems
While the local impacts of steroid shots are quite real and devastating, there are also impacts on the whole body. Why? The steroids injected into joints and tendons are at high enough dose that they leach into many parts of the body. Hence, steroid shot side effects can include problems with bone repair, the endocrine system, and blood sugar.
For example, one study demonstrated that steroids used in epidural injections for back pain worsened osteoporosis in women (4). The same type of steroid shots also mess with the cortisol endocrine system that helps to keep you healthy (6). Finally, getting your knee joint injected also messes with your blood sugar, causing it to increase (12),
Steroid Shot Side Effects Chapter 4: New Research
We’ve known for a while that steroid shot side effects include problems with shoulder rotator cuff healing. For example, in one study measuring the healing blood vessels that grow into shoulder rotator cuff tears, patients who had steroid shots had fewer new blood vessels (10). In another, tendon cells in patients getting steroid shots were injured by the medication (13). In a more recent large review, steroid shot side effects in patients undergoing rotator cuff repair included higher retear rates (when the rotator cuff surgery fails) as well as the need for another surgery (14).
The new research on knees is also not good for patients who get steroid shots. In this study, the authors looked at almost four thousand patients who were part of a government-funded arthritis study (15). Each steroid shot in the knee increased the likelihood of needing a knee replacement by 9%. Meaning if you got 4 steroid shots to help arthritis pain, this increased the likelihood that you needed a knee replacement by about 36%!
Chapter 5: Is There an Alternative that Won’t Fry My Joints?
Platelet-rich plasma (PRP) is a well-researched alternative to steroid shots without the crazy side effects. This is where the doctor takes blood from a vein and then concentrates the healing platelets and then reinjects that preparation. How much research do we have that PRP helps? Let’s take a look at just one common problem area, knee arthritis
We have almost 30 high-level studies to date on PRP used to treat arthritis. These studies have compared PRP to other common treatments like steroid shots, hyaluronic acid (HA) injections (aka knee gel shots), or physical therapy exercises (16-32). PRP was as effective as knee gel shots or better and worked better than steroid shots or exercise. We also have research that shows that PRP works well when compared to a placebo treatment like saline.
The upshot? Steroid shot side effects are very real. Please avoid these procedures! There are newer ways to help joint pain or torn up tendons that use your body’s own healing agents like PRP. We in traditional medicine need to stop our addiction to injecting these dangerous substances just because they’re covered by insurance.
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