Side Effects and Risks of Corticosteroid Injections
Corticosteroid or hyaluronic acid injections can help to relieve knee pain, however, it is temporary.
Not only is the relief temporary but there is ample evidence to support that exercise can be just as effective, and so can a simple injection with plain old saline solution (which is often used as the placebo in clinical trials).
Again and again, exercise, in order to treat knee osteoarthritis pain, is recommended over knee injections. One reason is that knee injections come with many more risks than exercise.
One of the biggest risks of knee injections is infections of the knee joint. This is especially true of corticosteroids.
If there are germs on the needle that is used for corticosteroid injections, an infection can happen.
Though joint infections are rare, they do happen. And when they do, they can cause serious problems. Therefore it is critical that these knee injections and performed by experienced doctors that follow hygiene standards such as properly disinfecting the skin before the injection.
The risk of infection is slightly higher with corticosteroid injections than with hyaluronic acid, because of the effect that steroids can have on the immune response of the joint.
In fact, repeated steroid injections over a long period of time can weaken the joint cartilage as well, furthering this risk.
Other possible side effects of steroid knee injections include pain and swelling at the injection site. This is especially true in the days after treatment when the muscles and ligaments may be slightly weakened.
There is also the risk that, for those getting treated with multiple steroid injections, the skin at the injection sight can become permanently discolored.
Some of the other potential side effects of steroid knee injections are:
– osteoporosis of nearby bone tissue
– osteonecrosis, which is the death of bone tissue
– a temporary flare of pain and inflammation in the joint
– joint infection
– nerve damage
– thinning or lightening of the skin and soft tissue around the injection site
– allergic reaction
– elevated blood sugar levels in some people with diabetes
There is also evidence to suggest that cortisone injections come with not only the risk of infection post-injection but that when administered in the time period before knee surgery, these injections can lead to a much greater post-surgical infection risk.
Even when corticosteroids are effective, according to a research study published by an independent group of scientists from the Cochrane Collaboration, these injections might reduce osteoarthritis symptoms for several weeks in roughly 10 out of 100 people.
The Bottom Line: Though there was a time when corticosteroid injections were considered to be some sort of miracle cure for knee pain, in more recent years, research has shown that this isn’t entirely true.
In fact, several studies have found that corticosteroid knee injections provided no significant pain relief after two years. And, some studies have even shown that cortisone can make the situation worse by thinning out the meniscus, causing more bone on bone in the knee.
In our next article, we will take a look at the effectiveness of hyaluronic acid injections, as well as the potential side effects and risks.
