Tag: Corticosteriod injections

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Knee Osteoarthritis

Side Effects and Risks of Corticosteroid Injections

Corticosteroid and hyaluronic acid injections can help to relieve osteoarthritis knee pain, however, it is temporary.

Corticosteroid or hyaluronic acid injections can help to relieve knee pain, however, it is temporary.

Not only is the relief temporary but there is ample evidence to support that exercise can be just as effective, and so can a simple injection with plain old saline solution (which is often used as the placebo in clinical trials).

Again and again, exercise, in order to treat knee osteoarthritis pain, is recommended over knee injections. One reason is that knee injections come with many more risks than exercise.

One of the biggest risks of knee injections is infections of the knee joint. This is especially true of corticosteroids.

If there are germs on the needle that is used for corticosteroid injections, an infection can happen.

Though joint infections are rare, they do happen. And when they do, they can cause serious problems. Therefore it is critical that these knee injections and performed by experienced doctors that follow hygiene standards such as properly disinfecting the skin before the injection.

The risk of infection is slightly higher with corticosteroid injections than with hyaluronic acid, because of the effect that steroids can have on the immune response of the joint.

In fact, repeated steroid injections over a long period of time can weaken the joint cartilage as well, furthering this risk.

Other possible side effects of steroid knee injections include pain and swelling at the injection site. This is especially true in the days after treatment when the muscles and ligaments may be slightly weakened.

There is also the risk that, for those getting treated with multiple steroid injections, the skin at the injection sight can become permanently discolored.

Some of the other potential side effects of steroid knee injections are:

–  osteoporosis of nearby bone tissue

–  osteonecrosis, which is the death of bone tissue

–  a temporary flare of pain and inflammation in the joint

–  joint infection

–  nerve damage

–  thinning or lightening of the skin and soft tissue around the injection site

–  allergic reaction

–  elevated blood sugar levels in some people with diabetes

 

There is also evidence to suggest that cortisone injections come with not only the risk of infection post-injection but that when administered in the time period before knee surgery, these injections can lead to a much greater post-surgical infection risk.

Even when corticosteroids are effective, according to a research study published by an independent group of scientists from the Cochrane Collaboration, these injections might reduce osteoarthritis symptoms for several weeks in roughly 10 out of 100 people.

 

The Bottom Line: Though there was a time when corticosteroid injections were considered to be some sort of miracle cure for knee pain, in more recent years, research has shown that this isn’t entirely true.

In fact, several studies have found that corticosteroid knee injections provided no significant pain relief after two years. And, some studies have even shown that cortisone can make the situation worse by thinning out the meniscus, causing more bone on bone in the knee.

In our next article, we will take a look at the effectiveness of hyaluronic acid injections, as well as the potential side effects and risks.

Categories
Knee Osteoarthritis

Knee Injections: Do They Work?

Knee osteoarthritis is painful and can cause a decrease in mobility, and it puts limits on what you can do. Can knee injections help?

Knee osteoarthritis is painful and can cause a decrease in mobility that puts limits on what you can do. Therefore many people turn to knee injections to help relieve this pain.

So what are knee injections? And do they work?

When physical therapy and pain medication taken by mouth fail to relieve the aching pain caused by osteoarthritis of the knee, sometimes doctors will recommend an injection of medicine directly into the arthritic joint. These injections of medicine can reduce inflammation and relieve pain.

The most common type of knee injections are corticosteroid injections and hyaluronic acid injections. Let’s take a look at what these medicines are and how they work, starting with corticosteroid injections.

Corticosteroids are synthetic drugs that closely resemble cortisol- which is a hormone that is naturally produced by the adrenal glands and regulated by the pituitary gland inside the brain.

Cortisol is essential for life, as it helps to maintain blood pressure, immune function, and the body’s anti-inflammatory processes.

Cortisol can also:

–  help the body manage stress

–  convert protein into glucose to boost flagging blood sugar levels

–  work in tandem with the hormone insulin to maintain constant

–  blood sugar levels

–  reduce inflammation

–  contribute to the maintenance of constant blood pressure

–  contribute to the workings of the immune system.

Corticosteroid is a synthetic cortisol that is also used to help relieve knee pain by treating inflammation that is responsible for swelling and pain. Once injected into the knee, corticosteroids work quickly to temporarily relieve knee osteoarthritis pain.

The temporary pain relief from a corticosteroid injection can be helpful if a person with knee pain needs to engage in physical therapy, attend to an important life event, or postpone knee replacement surgery or genicular artery embolization to a later, more convenient time.

That being said, the key word here is temporary.

Though these injections can be helpful, they do not treat the knee condition itself, but rather provide short-term, temporary relief. Relief, that over time, will wear off completely.

It’s also important to note that just like any medication-related treatment, corticosteroid injections do not work for everyone. And, even when they are effective, the results may vary.

Some studies show that on average, just 40% of patients feel better after receiving cortisone shots for knee osteoarthritis.

In one study, one month after undergoing treatment, people who received cortisone injections were asked to report and rank their improvements on a 10-point scale, with 1 being the least improvement and 10 being the most improvement.

The average score that the participants ranked their improvement in symptoms was a 5 out of 10.

So yes, the injection helped, but only slightly.

The Bottom Line: Corticosteroid injections can be helpful for short-term knee pain relief leading up to a long-term solution treatment such as surgery or genicular artery embolization. However, these injections are not without their own set of side effects and risks.

In our next article, we will take a look at the use and efficacy of hyaluronic acid injections. As well as dive deeper into what the research says about these temporary solutions to osteoarthritis knee pain.