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Steroid Injections For Tendonitis Or Joint Pain

Millions of people are affected by tendon, joint or ligament pain each year. If the pain is debilitating and hinders daily life, doctors often suggest steroid injections to help manage the pain.

Cortisone shots are still widely considered to be an effective short term treatment for chronic pain issues such as tennis elbow, neck, back, or knee pain, rheumatoid arthritis, gout or bursitis. However, multiple studies have shown that over time, these steroid injections can actually do more harm than good. They may serve as a quick fix for pain, but can seriously slow down long-term recovery.

How Steroid Injections Work

Cortisone shots were first cultivated in 1950 by the Mayo Clinic. They have since become a staple for treating chronic pain. However in reality, steroids aren’t designed to be a long-term solution for pain management.

Cortisone shots reduce inflammation and relax the immune system. But studies show that pain from tendonitis or other degenerative joint issues are usually caused by wear and tear over time rather than by inflammation.

Steroids work to numb pain by interacting with the neural receptors, giving the patient quick relief which can last up to several months. But over time, the use of corticosteroids can actually destroy tissue and cells and break down cartilage.

In fact, Dr. Bernard Morrey, the former chairman of orthopedic surgery at Mayo Clinic, says he feels he has a moral obligation to not use steroid injections on joints and soft tissue for this very reason.
(1) (personal communication)


The Dangers Of Steroid Injections

Short Term Side Effects Of Steroids

Although these short-term side effects are rare, they are worth mentioning and should be taken into consideration when making a decision of whether or not to seek this type of treatment.

In some cases, patients can experience side effects that range from depigmentation of the skin to increased pain, anxiety, restlessness, fever in the hours following injection, high blood sugar, cataracts and stomach ulcers.

Also, a recent study showed that for up to several weeks after a steroid injection, the body’s own natural cortisol level,  its main stress and hormone regulator, tends to decrease. This affects the strength of the immune system and lowers the body’s ability to fight infection and disease.

Long Term Side Effects Of Steroids

Perhaps one of the main red flags in choosing steroid injections is that they have been proven to cause cartilage loss by killing cartilage cells over time.

Among patients with knee osteoarthritis, an injection of a corticosteroid every three months over two years resulted in significantly greater cartilage volume loss and no significant difference in knee pain compared to patients who received a placebo injection, according to a study.” (3) (4)

In addition, steroid shots have been shown to damage the body’s cell production and decrease its ability to make new bone. (5)

This increases the chance of osteoporosis and weakens bones.

Other possible long-term side effects of cortisone shots include:

  • Weakening of the tendon over time
  • Infections in the joint
  • Increased risk of rupture
  • Increased development of arthritis because of destroyed cartilage (6) (7)

To combat these negative side effects, doctors will typically limit the frequency of shots and do proper health screening before administering injections. Also, most doctors have significantly lowered steroid dosage. But even with these precautionary measures, the negative effects remain a serious danger.


Alternatives To Steroid Injections

Since steroid injections aren’t an effective long-term solution to pain, what other options are there besides surgery?

The good news is that there are natural alternatives for those who suffer from tendonitis, arthritis or other degenerative diseases. Leading orthopedic surgeons are now focusing more on ways to heal the affected area naturally, instead of treating the pain. In addition to physical therapy and supplements, regenerative therapy is fast becoming one of the first-line treatments for chronic pain or injuries in tendons, ligaments and joints.

What Is Regenerative Therapy?

Regenerative therapy focuses on healing the damaged area, rather than just dulling the pain. It takes cells from other parts of your body and injects them into the affected area to stimulate cell regrowth. In areas where your cartilage or tendons have worn down, stem cell therapy has been proven to help your body rebuild and restore itself, instead of just masking the pain.

Another positive of regenerative therapy: Healing time is shorter than traditional surgery and in most cases, people experience a significant decrease in pain soon after treatments.  

When paired with physical therapy and nutritional supplements, the majority of patients are able to fully heal and restore the damaged area and avoid steroid shots or surgery altogether.

But caution: Not all regenerative therapies are equal and it’s important to do your research and understand the caliber of treatment you’ll be receiving before you make a decision.



5 Fast Facts On Steroid Injections  

  1. Steroid injections are administered locally and help to immediately stop the pain
  2. They can help decrease your pain up to several months
  3. Doctors usually space out injections six weeks or more to lower the risk of negative side effects
  4. They have been proven to decrease cartilage and weaken tendons over time
  5. They have been proven to decrease  natural cortisol and weaken the immune system


About Nashville Regenerative Orthopedics

As one of the world’s most advanced clinics for regenerative medicine, we exist to help your body restore itself to peak performance in less time and without surgery.

Dr. Kellum is a sports medicine fellowship trained orthopedic surgeon who has worked with some of the top athletes in the world. As a Regenexx musculoskeletal expert, he’s one of the top 1% of doctors in the U.S. in PRP (Platelet Rich Plasma)  and stem cell treatments. His passion is to make sure that you get the best possible outcome and recovery.