What should you know about steroids?

Corticosteroids, commonly referred to as steroids, are potent anti-inflammatory drugs used in various medical fields, such as rheumatological conditions (e.g., rheumatoid arthritis) and lung diseases (e.g., asthma).

Steroids work by inhibiting inflammation through reducing the activity of the immune system. Inflammation is the body’s natural response to foreign substances (e.g., bacteria, viruses), but in certain cases, the immune system overreacts and damages its own tissues.

They are often used for both acute and chronic pain relief.

Initially, steroids typically provide remarkable pain reduction, sometimes even for months. However, with repeated steroid injections (or oral steroid treatment), their effectiveness diminishes over time, and as the condition progresses, they may become ineffective. Up to four steroid injections per year are accepted due to the serious side effects associated with steroids.

What are the side effects of steroids?

Steroids are anti-inflammatory drugs, inhibiting the body’s self-healing mechanisms by suppressing inflammation. They hinder wound healing and the proper formation of collagen when needed, worsening the condition of joints and tendons when injected into them. Injected into joints, we now know that they accelerate cartilage degradation despite temporarily improving symptoms. (Hart 2011; McAlindon et al. 2017)

Other well-known side effects include, but are not limited to, short-term blood pressure spikes, elevated blood sugar levels, agitation, long-term bone loss, increased appetite and weight gain, gastric ulcers, weakened immune response, increased susceptibility to infections, high blood pressure, sleep disturbances, mood swings, muscle weakness, and at the injection site, muscle and fat atrophy, leading to tissue wasting.


Source:

McAlindon TE, LaValley MP, Harvey WF, Price LL, Driban JB, Zhang M, et al. Effect of intra-articular triamcinolone vs saline on knee cartilage volume and pain in patients with knee osteoarthritis a randomized clinical trial. JAMA – J Am Med Assoc. 2017;317(19):1967–75.

Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: A systematic review of randomised controlled trials. Lancet [Internet]. 2010;376(9754):1751–67. Available from: http://dx.doi.org/10.1016/S0140-6736(10)61160-9