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Steroid Injections May Worsen Arthritis

November 29, 2022 from the Daily Mail


Two studies indicate that steroid injections, intended to treat arthritis in the knee, may actually worsen the condition.


Data gathered by researchers from the University of California, San Francisco (UCSF) and Chicago Medical School observed hundreds of osteoarthritis patients. Researchers gauged how participants’ conditions would react to the injections.


Between both studies, 94 of the patients who received corticosteroids, an anti-inflammatory drug used to treat various medical conditions, saw their conditions deteriorate.


Patients who received hyaluronic acid injections, a substance that lubricated the joints, saw the progression of their condition slow.


Research previously done, suggests corticosteroids might damage the cartilage in a joint and make it more likely to wear down, requiring patients to get hip or knee replacements.


Over 32.5 million adults in the United States have knee arthritis, and roughly 80 percent of adults older than 55 show evidence of the condition. More than one in ten of these patients decide to receive corticosteroid or hyaluronic acid injections as an attempt to alleviate their pain.


Researchers in California analyzed data over two years for 210 patients with osteoarthritis in the knees. Over 50 percent of the patients did not get injections during this time, but of those who did, 44 had corticosteroid injections and 26 received hyaluronic acid injections.


Corticosteroids stopped the immune system from causing painful inflammation and lessened white blood cell activity. Hyaluronic acid acts as a lubricant for the joins, assisting in mitigating pain when used.


Later analysis demonstrated that patients who received the corticosteroid injections had a significantly faster arthritis progression compared to the other groups. Those from the hyaluronic acid treatment group showed decreased progression compared to those who received no treatment at all.


Dr. Upasana Upadhyay Bharadwaj, a radiologist at UCSF who led the study, stated that the results demonstrated that “corticosteroids are associated with significant progression of knee osteoarthritis up to two years post-injection and must be administered with caution.”. However, he pointed out that hyaluronic acid may slow down the progression and alleviate long-term effects.


The second study in Chicago, analyzed 150 patients over 36 months. The group was evenly split, with some receiving hyaluronic injections, others receiving corticosteroid injections, and the rest receiving none.


Two years later, results showed that those who received the corticosteroid injections had significant osteoporosis progressions, whereas those who received hyaluronic acid injections and those who received no treatment, did not show rapid deterioration.


In the long run, these studies suggest that corticosteroid injections in the knee may actually cause a more rapid deterioration in the joints, prompting more pain.