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 husband has had multiple steroid injections to his vertebrae. Because he is on inhaled steroids for copd, steroids sometimes “wind him up”, and he has diabetes, his doctor uses a greatly reduced dose. The injections usually help, and his mri’s have actually improved over the years.
My paternal grandmother had arthritis that made her hands look like that...
Next thing you know, some quack will be warning against antibiotics,
Oh let me guess. They want to ban it so Merck can come out with the latest steroid that they own.
Typical.
Shots in my right shoulder worked probably 2 out of 3 times (torn/repaired labrum, loss of cartilage, bone-on-bone contact, arthritis). The relief was wonderful though. There was already deterioration.
The doc recommended a reverse shoulder replacement, but I would’ve been more restricted in my movements than I was already (I wouldn’t be allowed to lift anything heavier than a gallon of milk.) I said “no thanks”...no more shots and I’ll live with the pain. It’s not constant, but if I twist it a certain way...it gets my attention.
I had them in my back once. They did help, but I was also told they eventually wouldn't. Like you, I opted for surgery while I still had a good pre-Obamacare Insurance plan. Fusing two pairs of vertebrae worked out great.
I recently had a cortisone injection for a “frozen shoulder”. Couldn’t lift it above horizontal and kept me awake nights. Was back to normal before I left doctors office and remains that way.
A while back they reached the same conclusions about injected hyaluronic acid, which is your basic joint lube.
I suspect that about anything injected into a joint will be detrimental to it. However, at least in the short term, both cortisone and hyaluronic acid seem to help at least some people.
Importantly, arthritis is a group of over 100 diseases. To expect a panacea for it is unrealistic. Many of the best treatments for it come by personal experimentation.
Watch our for GI GERD side effects all OA drugs have it.
Glaucoma patients are NOT allowed Cortisone, Prednisone or other steroids. First thing hubby’s Glaucoma informed him of.
All they do for me is Side effects, no medical effects.
And the scary part about Avascular Necrosis of joints is that doctors generally don’t tell patients about the dangers of taking corticosteroids, or that AVN even exists! Young people are finding themselves getting bilateral hip replacements as a result of following the doctor’s orders and taking them.
Right?! I help run a page for Bone Marrow Transplant survivors. One young lady has had both hips and shoulders replaced and she’s just 22. She’s just one of many. Steroids are commonly given post bmt. I had significant osteoporosis before the BMT, so I was not given them/nor take them. I ‘only’ took tacrolimus. But, I don’t believe that’s an issue for bone/s/joints.
The injections or is it the oral tablets that don’t help? In the past, I never had much luck with the injections.
Thanks for the info about glaucoma. I’ll pass it on to my brother who has glaucoma.
Welcome, hubby sees his regular ophthalmologist twice a year as he has Retinal Atrophy from heavy metals they cleaned electronic gear with in the Navy. He didn’t say a word about it. Dean was taking an occasional Prednisone for ear pain, his pressures went from 12 to 23 over night. And he took Cortisone and Steroid shots for joint pain.
He now sees a Glaucoma specialist.
Update: The doc prescribed Meloxicam instead of Celebrex. On day two of it, and the pain is 90% gone.
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