About to get steroid injections? Know more in this article if it is best for you.
Stories of the past and how steroid injections came into mind.
As an intern, I encountered numerous patients and clients who had a choice of steroid injections. It is pretty standard, especially for those diagnosed with chronic pain.
Despite how it happens frequently, some of my clinical staff supervisors and professor mention how it is not the ideal treatment from its side effects. Therefore, that is what I used to share with most of them, and if there is any other option they can do, it is best to do that in the meantime.
I thought that was it. Now, it also recently happened when I finally practiced the profession. One of my previous clients shared how her doctor offered her steroid injections to diminish pain in her leg after surgery or continue taking pain medications.
Like my superiors, I discussed its side effects and how costly it is. Even if my client agreed with the latter, the option persisted on every checkup visit.
After a while, she discovered that some people she knew did not return to their previous state before injections, or it worsened.
It brought me to ask: when is the right time to get steroid injections, and why do people still get it?
What are steroid injections anyway?
According to an article from the Canadian Association of Radiologist Journal, corticosteroid injections reduce inflammation and improve movement. Patients with muscle and/or bone problems often receive them.
It is necessary to mind that it is only limited to those who do not have underlying infections and unstable joints. Otherwise, it is not possible to get one because it is seen by research that it has side effects.
Then why do people get them?
A survey in 2019 from South Korea mentioned that patients referred to steroid injections as “ppyeojusa,” mainly given to those in their 50s to 60s. It is most common for them to get it due to nerve block conditions and other chronic pain problems.
Interestingly, some people are skeptical even if it is well-known. Unprofessional advice caught mainly on the internet, and the media are also factors as to why they try not to get it.
On the bright side, doctors are the ones who administer the injections. They typically offer it with pain medications and therapy. The good thing about this is they discuss the correct information on what to expect about it, what happens when you get a steroid injection and its main side effects.
Therefore, people get them out of their recommendation and assurance that pain and inflammation will go away afterward.
What are the pros of having steroid injections?
Generally speaking, having steroid injections relieve the pain that a person experiences and includes better function after pain decreases.
A systematic review from Joint Bone Spine concluded that intra-articular corticosteroid injections are effective in patients with symptomatic knee osteoarthritis, especially after less than six weeks. Although, it is not as effective as other treatments for knee pain if long-term effects are in question.
Dexamethasone, a type of high-dose steroid, is more effective than low-dose forms of steroids in reducing nausea and vomiting.
Additionally, post-operation pains decreased for those with total knee and hip replacements. In addition, it positively impacted functional rehabilitation and inflammation control.
Is it something I should do?
The current concepts for administering steroid injections insist on it as adjunct care rather than a sole treatment for any conditions. It means it is complemented with conservative therapy or other medications.
In a randomized control trial in 2020, carpal tunnel syndrome patients who had surgery had better outcomes than those who got injections two years after the procedure.
In addition, there is a small potential risk of periprosthetic joint infections for those who had pain after having total knee replacements, at around 1 in 14,000 to 15,000. In turn, it is not always the case. Still, as reiterated, it is crucial to consider it as an option as part of pain control.
Furthermore, the American Academy of Orthopedic Surgeons released a statement that they do not strongly support using injections for knee osteoarthritis. It is due to its adverse effects and possible complications.
What can be the possible complications of steroid injections?
An illustrative review from Guermazi et al. in 2020 summarized that joint events after injections on the hip and knees include the following in simple terms: increased severity of arthritis, pathological fractures, necrosis of the bones, and further destruction of bone.
Rheumatic disorder patients had minor adverse effects of rashes, skin defects, hypopigmentation, infections on joints and tendons, and cellulitis after receiving extraarticular injections. Others had systemic problems like facial flush and disturbance in menstrual patterns.
Then, how long does it last, and should I get it?
In a systematic review by Saltychev et al. (2020), it is said that intraarticular steroid injections are moderately effective in relieving pain in OA for up to 3 months after injection.
In the current concepts of corticosteroid injections, it is advised experts can do repeat injections at long intervals. It is best to provide it at least three times a year, if possible, at intervals of 2 to 3 weeks for a second injection and a repeat for another six weeks.
It is also best to rest and protect the site, to prevent overuse, especially if they are weight-bearing joints. In addition, it is best always to consider opting for therapeutic management such as physical or occupational therapy to improve function after three injections.
As one of our colleagues here in Kakayanan that I asked about this matter, he mentioned how this is a constant in our practice. We will continuously encounter this, especially with those who are in pain.
His disclaimer is he discourages it due to the long-term consequences of what I mentioned earlier in this article. He stated that this is why doctors give injections a lifetime limit. Still, he considers recommending it as a last resort if the pain becomes unbearable.
With all of these in mind, I believe it now only depends on the patient or client’s needs, not because it was forced by a friend or even a doctor who only wants to profit from it.
Nevertheless, as an advocate of the profession, I always choose to see the best of what I can provide to them. I also am very aware that in our company, we are very much open to working with patients and clients who choose to do it and will decide to do it.
For as long as it benefits them in the long run, that is what matters to us.
If you need therapy services before or after steroid injections, book a session on our Facebook page or our website!