For the last few decades standard of care non-surgical treatment for arthritis and tendinitis included steroid injections as needed for pain relief. But there is evidence that steroids and local anesthetics can be toxic to cartilage and tendons. So does this mean steroid injections are bad? The short answer is that it depends. The long answer is that it depends on what condition is being treated, what other options have failed, what other options are being considered, and what are your expectations for treatment.

If you have an acutely hyperinflamed joint or tendon, a steroid injection could be helpful. if you have a chronically painful joint or tendon that is not inflamed, then steroids could help with pain but won’t necessarily help fix your problem. If your knee is painful and swollen related to rheumatoid arthritis, then a steroid injection will help immediately, then you need to find a better long term treatment to prevent a future flare up. If your knee is painful chronically from osteoarthritis, then you should find a treatment that addresses the progressive cartilage breakdown you’re suffering from. That may include weight loss, strengthening your legs to better support your knee, and even cell based therapies such as prp and stem cells that may address the cartilage problem you are facing and the supporting soft tissue injuries that may be contributing to your pain. This approach requires more commitment from the patient to make appropriate lifestyle changes, and also requires more commitment from the physician to address problems with newer innovative approaches that require an open mind and more attention to their patient’s individual problem.

So, are steroid injections bad? Only if they are overused and used thoughtlessly.

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