The Side Effects of Steroid Shots

by Chris Centeno, MD /

Receive a Regenexx® Patient Info Packet by email and learn why it's a superior regenerative solution.

cortisone shot side effects

Cortisone steroid shots in the knee, shoulder, ankle, or back are a common treatment to manage swelling and reduce pain. In the doses commonly used (milligrams), these drugs are very powerful anti-inflammatories. However, these doses may be too powerful, as research shows the array of cortisone steroid shots side effects are many and negative.  These include creating problems with blood sugar in diabetics, changing the normal cortisol control system in the body, and killing off cartilage and stem cells. For example, a recent study looked at what happened to patients after a steroid epidural (for low back pain and sciatica) and an intra-articular (inside the joint) injection of steroids. In diabetic patients, there were significant increases in blood sugar that lasted for about a week. Most concerning, were changes in the body’s own cortisol system that lasted for more than 3 weeks when patients received these steroid shots epidural. This cortisol suppression caused by steroid epidural shots throws off the body’s ability to manage infections, control blood sugar, and regulate other important body functions involved in the metabolism of processing foods. Is there other evidence showing that steroid shots may be a problem?  Repeated joint injections of steroids have been associated with greater cartilage breakdown in animal models. In our closest animal relative (primates), repeated steroid shots have been shown to cause ligament failure and breakdown. Even at much lower doses than those commonly used by doctors to inject into joint (about 100 times less), certain steroids still kill cartilage cells. In particular, a steroid suspension containing the preservative benzalkonium chloride was very toxic toward cartilage cells, with the preservative being the main offender. Even without the preservative, steroids have still been shown to kill cartilage cells (called chondrocytes). Even steroids given orally to help swelling can lead to cartilage degeneration. In particular, steroids combined with local anesthetic (the most common way steroid is injected into joints), makes the steroid even more toxic to cartilage cells.How do steroids impact your stem cells? The same. In this study, steroids reduced the ability of bone stem cells to make new bone. This fits with other studies that show why some patients on oral steroids can develop avascular necrosis of the bone (death of bone maintaining stem cells).

Is there a better way? Yes. First, for injection into joints, we’ve all but abandoned the use of milligram dose steroids. Instead, our experience with culturing mesenchymal stem cells has taught us that the body responds much more appropriately to 1,000,000 times less steroid. So rather than milligram dose, we use a million times lower dose of nanograms. In these dose ranges, lab research has shown a net positive to stem cell health rather than a net negative. As noted above, high dose steroids in the epidural space (the most common form of non-surgical injection treatment for a disc bulge or herniation causing sciatica), can have more wide reaching negative effects on the body. As a result, we offer patients the option of using the growth factors from their own platelets in the Regenexx-PL-Disc procedure.

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.