Posted on 10/17/2019 7:51:22 AM PDT by Red Badger
It's been a full 90 years since Dr. Philip S. Hench and his colleagues from the Mayo Clinic discovered cortisone can be effective in the treatment of rheumatoid arthritis.
Cortisone was first prescribed for rheumatoid arthritis in 1949, or 70 years ago, after it was first produced commercially by Merck & Co. in 1948. In the seven decades since, hundreds of millions of people around the world have had cortisone shots for short-term pain relief and to reduce the swelling from both rheumatoid arthritis and osteoarthritis.
Worldwide, corticosteroid injections into the hips and knees remain a common treatment for patients in significant pain. One study revealed that half of more than 16,500 patients that underwent knee or hip joint replacement received corticosteroid injections in the previous two years.
Today, however, new and dismaying research reveals that corticosteroid shots in the hips and knees might instead accelerate the progression of osteoarthritis. Corticosteroid shots might potentially even hasten the need for joint replacement surgeries in the long run, according to a study published in the journal, Radiology, led by the Boston University School of Medicine (BUSM).
“The intra-articular corticosteroid injections in the hips and knees are not as safe as we thought,” Dr. Ali Guermazi, study lead author and a professor of radiology at BUSM, said.
Dr. Guermazi said corticosteroid injections might be detrimental in the long run despite temporary pain relief.
“They may actually harm your knee or your hip,” he said.
In the study, researchers reviewed existing literature on corticosteroid injections for osteoarthritis. They also looked at data on 459 patients at Boston Medical Center that received one to three corticosteroid injections in the hip or knee in 2018.
Researchers found that eight percent of patients developed complications in the two to 15 months following the injections. These complications include stress fractures, bone deterioration, cartilage loss and joint destruction.
The rate of complications surprised the researchers. They surmised this figure might actually be an underestimate because 218 of the patients didn't have follow-up imaging tests to assess the health of their joints.
Dr. Guermazi said an exact explanation for the findings is unclear. There is, however, some evidence corticosteroid injections can be toxic to cartilage. More studies are needed to understand their effects and clarify their benefits and risks.
rheumatoid arthritis Adding to a laundry list of ailments, researchers find rheumatoid arthritis is twice as common in Ground Zero first responders. handarmdoc, CC BY 2.0
My dear friend has arthritis that bad.
Long term use of steroids causes AVN of the joints. It eats them up horribly. Know way too many people who suffer from AVN due to steroid use.
So, it doesn’t surprise me if cortisone injections hastens joint ‘disintegration’.
There is no data presented about on-going deterioration PRIOR to the injections. Rather, they got shots, there was deterioration. A does not definitely confirm B. May or may NOT be related.
My Father in Law had RA that looked like that. It was just horrible and the pain was chronic and constant. The amazing thing is that I never ONCE heard him complain about the lousy had he was dealt. Not one time. He was always chipper and upbeat. What an amazing man.
"some evidence corticosteroid injections can be toxic to cartilage"
see some posts that a Keto diet *may* help.
That is amazing. God bless him.
A buddy at work started taking Celebrex for arthritis in his back and said it works great. I have an appointment for Saturday to try it for my hands.
Is it not possible that using the steroids allows for more joint use, leading to premature wear of those arthritic joints?
Wear or disintegration, that is the question...................
Thank you. I knew him about 15 years before he passed. He was a real inspiration.
My understanding is repeated injections into the same joint have diminishing results and should be avoided if possible.
Several years ago my doc gave me the choice of shots or knee replacement. He said the shots might work for a year or two but eventually... So I went ahead with the surgery. No regrets. Not a fan of drugs, period.
Cayenne pepper capsules help me.
I was having knee problems among other things, for years. The hurt, they were crunchy, they “tricked out” when descending stairs. I Stopped taking ibuprofin — two months later, no symptoms.
Throw away your ibuprofin.
Over the years I have had four cortisone injections in my knee for osteoarthritis. One or two gave me significant relief for a few months, but the others did little or nothing. Fortunately my arthritis does not give me pain only stiffness. Physical therapy gave me more long term relief and I am putting off an eventual knee replacement until things become unmanageable.
My Mom’s hands also looked like that, maybe worse. After awhile she didn’t even pay attention to the pain and worked around the disfigurement.
Pain has a purpose
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