Steroids are Awful: More Evidence for Steroid Stem Cell Toxicity

by Chris Centeno, MD /

back steroid side effects

High dose steroids, the kind given out like candy by most physicians and used for everything from a herniated disc to asthma are awful drugs. These powerful anti-inflammatories are what I call a “bull in the china shop” pharmaceutical, as while they’re powerful anti-inflammatories, their side effect profile is just like that bombastic bull. Now a new study adds more data to the long rap sheet of just how awful these drugs really are.

You likely take for granted that many tissues in your body have stem cells that act as the local repairmen. When it comes to your bones, mesenchymal stem cells (MSCs) are there to turn into new bone cells when the need arises. Since bone is alive and always remodeling itself (and not lifeless cement), these MSCs allow it to respond to it’s environment. When the bone is placed under pressure, it has trillions of tiny crystalline sensors that can prompt the MSCs to build more bone in that area. In addition, these MSCs also respond to chemical clues. For example, many women in menopause loose the chemical signalling that allows MSCs to be instructed to maintain bone, so a switch is flipped on the cells that causes them to become fat instead of bone. The same thing can happen with medications, switches on the cells can be activated that instruct them to make less.

You also likely take for granted that your body’s ability to maintain itself is one big math equation that looks like:

Repair>=Wear and Tear

As long as the stem cells that repair your tissues are plentiful and active enough to exceed wear and tear, your body remains young and healthy. Once wear and tear exceed the local stem cell’s ability to repair, things begin falling apart. This is where our new study comes in, as it found that in patients with a severe bone disease, steroid stem cell toxicity was causative as steroids flipped a switch on MSCs so that they didn’t want to turn into bone.

Avascular necrosis (aka Osteonecrosis) is an awful disease where the bone turns to mush. The name comes from our old understanding that this disease happened when the bone lost it’s blood supply. While that can happen when a surgeon inadvertently places a screw through a critical blood vessel, we now know that AVN happens when the local MSCs aren’t able to keep up with repair. There are many different chemical insults to the cells that can cause them to lose their ability to repair including alcoholism. In addition, steroids have long been known to be a big culprit. Hence it’s not a big surprise that this new study showed that MSCs exposed to steroids had difficulty becoming bone, which reduces bone repair and allows the normal wear and tear to begin damaging the bone until it finally dies and collapses.

The upshot? Avoid steroids wherever possible. This can be tough to do in today’s medical care system as doctors generally sprinkle this stuff around like holy water during Catholic mass. One way to help a bit if you have to use these drugs is to reduce the dose to the lowest possible amouint. For example, for respiratory problems you can use a steroid inhaler that uses micrograms of steroid rather than taking a pill with milligrams (1,000 times as much). Or if you need an epidural for back or neck pain, we have been able to substitute growth factors isolated from the patient’s own blood platelets which work as well or better than steroids. Finally, if you need a steroid shot in the knee or for something like tennis elbow, tell your doctor that you would prefer platelet rich plasma (PRP). If your doctor doesn’t offer steroid alternatives, find another doctor!

Chris Centeno, MD

Regenexx Founder

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

Get Blog Updates by Email

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
Learn More
Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
Learn More
Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

Is Regenexx Right For You?

Request a free Regenexx Info Packet

REGENEXX WEBINARS

Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar

RECEIVE BLOG ARTICLES BY EMAIL

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog

FOLLOW US

Copyright © Regenexx 2019. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.