Cortisone now shown to cause faster arthritis progression

Dr Leisa

One of the most common treatments for arthritis, corticosteroid injections, may actually increase the progression of the disease, according to new research.

Osteoarthritis is the most common type of arthritis, especially as we age. It occurs when the cartilage that cushions a joint, breaks down over time, causing pain and stiffness. More than 32 million U.S. adults suffer from this condition, which most often affects the hands, the hips and the knees. There is no cure, but the discomfort is commonly treated with corticosteroid shots. Another pain-relieving injection is Hyaluronic Acid, which is not a steroid, and cushions the degenerated joint.

Two small unpublished studies were recently presented at the Radiological Society of North America’s annual meeting. The studies found that on average, knee arthritis advanced much more quickly in patients who got corticosteroid injections than those who did not. Hyaluronic acid injections were actually associated with slower progression of the arthritis, in comparison to the corticosteroid group.

Both studies evaluated patients from the Osteoarthritis Initiative, a yearslong observational research project involving close to 5,000 people with knee osteoarthritis. The researchers analyzed X-rays from 50 patients who received corticosteroid shots, 50 who received hyaluronic acid and another 50 in a control group. The scans, collected annually for four years, revealed worse arthritis progression among those injected with corticosteroids compared to the other two groups.

The second study, from the University of California, San Francisco, examined MRI scans from 210 participants, 44 who received corticosteroid shots and 26 received hyaluronic acid.

The researchers looked at scans that were taken at the time of the injections, as well as two years before and after, and found more severe cartilage deterioration by the two-year follow-up among the steroid-taking group. The researchers are encouraging patients to make more informed decisions on which injections they receive.
They also agreed that more research is needed, as are peer reviews for their studies.

If you or anyone you know has been receiving corticosteroid injections, and would like to have injections that actually help regenerate the cartilage, please call my office for a complimentary consultation.

One rheumatologist at NYU Langone Health, said “It’s tough to determine causation in studies like the two new ones, because many factors can influence the progression of arthritis and no two patients are the same.” “We don’t have the biology to prove that the injection itself is causing accelerated damage. It’s hard to connect the dots from injection to damage from this preliminary data,” he said. “But it’s an important question, because it’s such a common practice to be injected with steroids.”

One research team did try to control the possibility that people who received steroid injections were perhaps more likely to engage in activities that furthered the progression of their arthritis afterward. As a result, they selected participants who had maintained similar activity levels throughout the study period.

So to recap, it’s important to know what you are being injected with, and what the repercussions are if injected into your joints. Yes, you will probably feel fast relief, and be able to return to your activities quickly with less pain, but at what cost in the long run? Regenerative treatments are available, and are designed to rebuild and protect the cartilage, not further damage it. PRP, PRF, ozone, and HCTs, (formerly known as stem cells), may actually get you back to the activities you love, without the degenerative effects.

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Leisa-Marie Grgula. DC
Chiropractic Physician
Accurate Care Medical Wellness Center
18261 N. Pima Rd. Ste. #115
Scottsdale, AZ 85255