Corticosteroid shots are injections that help to improve pain and inflammation in the joints resulting from arthritis.
Arthritis is a chronic inflammation of joints. It can lead to:
- stiffness
- pain
- swelling
- loss of joint function
Several treatment options are available to reduce pain and improve joint functions. These include pain relief medications, exercises, and physical therapy. However, doctors recommend injections when conservative treatments cannot relieve symptoms.
In this article, we will be mainly discussing corticosteroid injections. We also look at how to prepare for the injection, its effectiveness, who can and cannot have them, possible side effects, and alternative treatments.
Doctors use these injections to treat acute flare-ups of joint pain or swelling resulting from arthritis. This may help improve people’s quality of life and make it easier to perform daily activities.
Using steroid injections is common for reducing inflammation in the joints. Although they are not able to treat the underlying condition, they can help to improve the symptoms.
How do they work?
These shots either go directly into the joint or into the muscle or soft tissue.
These injections consist of corticosteroids, which are chemicals similar to the cortisol in the body. Cortisol is the body’s natural anti-inflammatory hormone, which the adrenal glands produce. After injection, the medication slowly releases into the joint, helping to reduce inflammation and pain.
Some injections start to relieve pain within hours, and the effects should last from a few weeks to a few months. The duration of the effect depends on the type of arthritis and its severity.
Short-acting soluble steroids can easily dissolve into the body and start acting. Therefore, they can start showing effects within a few hours. Long-acting steroids take longer to dissolve into the system. They require a week to become effective.
Read more about steroid injections here.
Where do doctors inject them?
According to the location of inflammation and pain, a doctor will inject the shots in the following areas:
- directly into the inflamed joint, also known as an intra-articular (IA) injection
- into the muscle, also known as an intramuscular injection
- into the soft tissue close to the joint, also known as a peri-articular injection
Sometimes a doctor will use a local anesthetic to reduce the discomfort of the injection.
After injection
Doctors may advise people to wait in the clinic 10–15 minutes after the injection in case of any reaction to it.
Some people may also experience pain and swelling near the joints after the injection. However, this gets better in a day or two.
Bruising can also occur at the region of the injection. This also goes away after a few days.
Doctors may recommend different types of injections for people with arthritis, including:
Methylprednisolone acetate injections
Methylprednisolone injections are similar to prednisone, but doctors can administer them at higher doses. These may be as an intravenous (IV) infusion for treating severe inflammation.
A doctor will determine the dosage and length of time of the infusion. Some people may receive the infusion over a few hours, whereas others may require slower infusions if they experience specific side effects.
There are some possible short-term and long-term side effects from receiving these types of injections. A person should discuss these with a doctor before starting a course of treatment.
Triamcinolone acetonide injections
Triamcinolone acetonide is an
To overcome the corticosteroid-related adverse effects, in 2018, the Food and Drug Administration (FDA) approved an extended-release injection of triamcinolone acetonide known as Zilretta. A person can receive it once, but its anti-inflammatory effects may last longer than other types of injections.
Other types
Other types of shots are available, including:
- hyaluronic acid injections, also known as viscosupplementation
- prolotherapy
- platelet-rich plasma (PRP)
- autologous conditioned serum (ACS)
- stem cell injections
However,
In many cases, an ultrasound scan or X-ray, known as a fluoroscopy, takes place before the shot. This is to
Generally, people can continue to take their usual medications before having the injection.
However, a person taking blood thinners may need to adjust their dose before the shot. They may also need an extra blood test to ensure their blood is not too thin to have the injection.
Also, people with diabetes and hemophilia must inform their doctor before taking the shot as these conditions increase the risk of complications when receiving it.
For example, a steroid injection may raise a person’s blood sugar levels a few days afterward. Therefore, people with diabetes need to monitor their levels after an injection. Meanwhile, a person with hemophilia has an increased risk of bleeding in the joint following the injection.
People must discuss their health status with a doctor before receiving a shot.
According to the study, corticosteroid injections were more effective in reducing pain 1–2 weeks after injection, while their effectiveness was less significant 4–24 weeks after injection.
However, the pain relief from IA corticosteroid injections is of short duration. This may be due to the short half-life of IA corticosteroids.
Some of the other
- betamethasone acetate
- triamcinolone hexacetonide
- betamethasone sodium phosphate
- dexamethasone
A
Another 2021 study indicated that IA corticosteroid injections significantly improved pain and sensitization for people with knee osteoarthritis.
These shots are suitable for most adults and children. Their use is also safe during pregnancy and breastfeeding. However, such individuals must consult a doctor to discuss possible considerations before receiving the injection.
Arthritis injections are not suitable for a few people. This can be due to the following:
- previous allergic reaction to steroids or any other medicines
- previous diagnosis of depression or having a close relative with the condition
- presence of an infection
- contact with someone with:
- recently taking or about to take certain vaccinations
People must also consult their doctor if they have:
- high blood pressure
- unhealed wounds
- eye conditions such as glaucoma
- fragile bones
Doctors should also use steroid injections with care in young people. Children must receive the lowest dose for the shortest possible time because excessive steroid treatment may affect their growth.
Most people do not experience any side effects from these shots. However, long-term use can result in some side effects, such as:
- increased joint pain within the first 24 hours post-injection
- changes in skin color at the injection site
- lightening of skin color at the injection site in dark-skinned
people - thinning of the skin near the injection site
- infection in the joint, although rare
- sometimes, menstrual cycle disturbances
- changes in mood
- weight gain, which is rare but more likely if a person receives injections more frequently
These shots may also deteriorate the joint cartilage and weaken tendons.
Other possible side effects of steroids include:
- dizziness
- blurred vision
- irregular heartbeat
- numbness
- difficulty urinating
- shortness of breath
Doctors recommend using injections to treat arthritis no more than
Other treatment options for arthritis include:
- Topical creams: Creams containing nonsteroidal anti-inflammatory drugs, capsaicin, or other medications can help to reduce pain by rubbing them on the skin over the joint.
- Disease-modifying anti-rheumatic drugs (DMARDs): These help suppress the overall immune system and prevent inflammation. They mostly treat rheumatoid arthritis.
- Biologics: Manufacturers make these drugs from chemicals in a laboratory. They target specific parts of the immune system that trigger inflammation.
- Surgery: Joint surgery is the last resort for people with arthritis. People who do not respond to nonsurgical treatment may undergo surgery.
Natural therapies
A few natural therapies that can help people with arthritis include:
- balanced diets containing:
- omega-3 fatty acids
- fish oil
- vitamin D
- calcium
- folic acid
- performing exercises regularly to strengthen muscles around the joint and maintain joint mobility
- movement exercises such as yoga, swimming, and tai chi
Corticosteroid shots are injections that help to reduce pain and inflammation of joints. Currently, most of the research focuses on steroid injections. Although few other options exist, their use is not widespread due to a lack of evidence and standardization.
These injections provide short-term pain relief, but long-term use may cause adverse effects for both children and adults. Before taking the injection, people must consult a doctor to understand the risks and benefits.