The study reviewed the cases of 459 patients and found that 8 percent of them developed complications within 15 months of their injections . Of this 8 percent, 72 percent had moderate knee and hip osteoarthritis, and the patients received 1-3 injections. The ages ranged from 37 to 79.
Both patients and doctors believed that the injections were not harmful beyond their recognized risks. But the Radiology research reveals four other important additional concerns after reviewing the literature on the subject:
- Accelerated osteoarthritis with rapid loss of joint space. Joint space narrowing usually indicates cartilage loss, but could indicate other problems with the joint.
- Subchondral insufficiency fracture (SIF). A type of stress fracture that occurs under cartilage on the surface of a weight-bearing bone. It was previously thought that SIF only affected older patients receiving these injections, but new research shows that younger patients are affected as well.
- Osteonecrosis. Also known as bone tissue death, this has generally been a recognized risk of corticosteroid injections. Which is interesting since these injections are often used to relieve pain in people with osteonecrosis. However, given the limited treatment options for osteonecrosis, sometimes these injections are the only option for pain relief other than a joint replacement.
- Rapid joint destruction. Joint destruction due to progressive osteoarthritis can lead to joint collapse. This can cause sudden, severe pain in the joint.
The researchers concluded that these risks should be presented to patients before determining whether or not corticosteroid injections are the most appropriate form of treatment for them.
The reason for these complications is not entirely clear. But the authors suggest that it is possible that combining the drugs with an anesthetic agent could have a negative effect on the joints and cause cell death.
Researchers warn doctors to advise their patients
This is not the first time that the effectiveness of these joint injections has been questioned. Research dating back almost a decade points to the fact that while corticosteroid injections may be an effective short-term solution, they may not be part of an adequate long-term pain management strategy .
The study authors concluded that patients who have mild osteoarthritis, or osteoarthritis that does not show up on images like X-rays, do not necessarily need these injections to treat their pain. Especially if the joint pain does not match the imaging results.
The authors also suggest additional diagnoses before receiving the injections. Since simple imaging techniques can sometimes reveal SIF and osteonecrosis prior to injection, which could give patients more information about the risks.
Additionally, the researchers note that joint damage could have been present before the injections. But that was not detected at the time of giving them.
Patients with mild osteoarthritis, in particular, are at risk of developing one of the complications. Including rapid joint degeneration or acceleration of osteoarthritis after injection . For these patients, other lifestyle changes, such as diet and exercise, may be a more appropriate approach to managing the disease.
The authors argue that people who have recently been diagnosed with osteoarthritis and are in an early stage of the disease need to be aware of the risks of these injections rather than receiving them by default simply because it is a common treatment.
The Radiology study suggests that corticosteroid injections can aggravate arthritis or cause side effects that need to be further understood. They conclude that these injections are not harmless and patients should be aware of the risks.
Are there natural ways to treat osteoarthritis without corticosteroids?
Yes! In fact, the best non-invasive way to control osteoarthritis pain is with certain lifestyle changes. Such as hot and cold therapy, massage, supplements such as glucosamine, the natural membrane of the eggshell, and exercise. These are reliable ways to decrease arthritis pain and improve joint health .
The exercise is one of the best ways to treat arthritis pain and can help strengthen the muscles that are responsible for supporting the joints. Some of the best activities to do include swimming and cycling .
Remember to start slowly and gradually increase your routine. Also work with your doctor or a physical therapist to customize an exercise program that works for your level of pain and mobility.
Foods that contain omega-3 fatty acids can also reduce joint pain, especially wild-caught fish such as salmon and tuna. Or plant-based sources like flax seeds and walnuts. You can also consider taking an omega-3 supplement high in EPA.
For many arthritis patients, having just one treatment option will not be enough to reduce pain and improve their quality of life. And some patients experiencing extreme pain may need corticosteroid injections. The risks should be discussed in detail with your doctor, including any further diagnoses, prior to the injection procedure.