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A Warning From a Doctor Who Has Done Thousands of Steroid Injections for Arthritis

After giving birth to a baby, a young woman told her nurses at Boston Medical Center that she was having pain in her hip. That happens sometimes after births, says Ali Guermazi, one of the doctors involved. As he recounts the case from a few years ago, he looked at X-rays and saw a small amount of extra fluid in the joint. Otherwise things looked normal. “We injected her hip with steroids, hoping to help with the pain,” Guermazi says. They seemed to help, and the women went home with her baby.

Guermazi didn’t think more of it until the woman returned to the hospital six months later, unable to walk. “The head of her femur was gone,” says Guermazi, who is now the chief of radiology…

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 Giving steroid injections a shot

If you're battling with a flare-up of arthritis, bursitis, or tendinitis, you may find relief from an injection of cortisone (a type of steroid). "People turn to injections when conservative treatments like over-the-counter and prescription pain medication or physical therapy no longer work, and their pain begins to interfere with quality of life," says Dr. Rob Shmerling, clinical chief of rheumatology at Harvard-affiliated Beth Israel Deaconess Medical Center. But are shots always the right choice? While steroid injections can help people for some time, they don't always work, and there are some concerns about long-term risks. "Steroid shots have a place in pain management, but they often provide only temporary relief and not a cure," says Dr. Shmerling.

 Steroid Injections May Not Be the Arthritis Cure-All That You Think

Researchers are urging doctors to inform patients of the risks found in their study before receiving a steroid injection to treat their osteoarthritis.

Articles of Interest

Are Cortisone Shots Healing Athletes, or Helping to Cripple Them?

Cortisone, the patch-’em-up injection of choice for injured athletes, may be worse than useless at healing some tendon injuries, the Lancet reported.

Cortisone: The End of an Era

There are, of course, times when healing won't occur and cortisone can be symptomatically helpful, but our job is to figure out how to promote healing in those tough situations as well as the more straightforward overuse cases.

Steroid Shots Do Little for Knee Pain of Arthritis

Doctors often prescribe steroid injections for the pain of knee arthritis, but a rigorous trial has found they work no better than a placebo.

Resources

NHS

Steroid injections are different from the anabolic steroids used illegally by some people to increase their muscle mass.

Patient

There is also some evidence that steroid injections may be either completely ineffective or effective for just a relatively short period of time.