Daily Wisdom: Cortisone Shots Are Passé
While they might help arthritis, healthy athletes can benefit from newer medical advances.
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TODAY'S TOPIC: WHEN ATHLETES SHOULD GET STEROID INJECTIONS
Researchers at Tufts Medical Center in Boston gave 140 patients with knee osteoarthritis localized injections of either triamcinolone (a type of steroid) or saline every three months. After two years, participants hadn’t seen any more pain relief, improved movement, or improved stiffness from the steroid shots compared to the placebo solution. The steroid group also showed a decrease in knee cartilage as opposed to their saline counterpart.
“There are a lot of other peer-reviewed studies pointing to the efficacy of steroid shots for arthritis, and there’s at least one that has almost the same set up with the opposite conclusions,” says K. David Moore, M.D., orthopeadic surgeon at Andrews Sports Medicine and Orthopeadic Center in Birmingham, Alabama. It's important to note that the new study didn’t find zero pain relief for patients; they found comparable relief between saline and cortisone shots, and there’s a lot to be said of the placebo effect. What's more, Rheumatology Advisor notes the researchers didn't measure pain in the four-week window following injections, which is when most benefits are known to occur.
“We know some of the chemicals in steroids do damage to cartilage overtime, so we recommend people spread out shots as much as they can,” notes Moore. Three months is typically the minimum time frame for repeating the injections, but Moore says he has patients who respond well and do not need another one for up to a year or 18 months.
While steroid injections can also be used for non-arthritic issues, such as inflammation caused by training for a marathon, they are falling out of favor. This is because more effective treatments exist such as platelet rich plasma (PRP) or viscosupplementation injections, explains Moore.
“I don’t think it’s time to throw out steroid injections as a treatment option for arthritis. As far as athletes are concerned, I would not be worried if my physician recommended a steroid injection on a one-time basis, but they’re typically not done regularly anymore,” Moore says. However, he advises asking your doctor first about all of your pain-management options.