Side effects of steroid shots in the knee
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Osteoarthritis is the leading cause of disability in adults and affects over 50 million people in the US. The knee is the most common source of disabling pain caused by arthritis.
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One of the hottest topics of discussion with patients is the use of steroid (cortisone) injections. People always want to know how they work? Is it safe? What are the side effects?
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Pain relief from steroid injection is thought to work by reducing the inflammation in the knee.
A common recommendation by providers for people with moderate to severe arthritis is that injections can be performed 3-4 times per year (if they are successful @ reducing pain). Keep in mind this is not recommended for people with healthy normal cartilage. So if you are a young athletic patient, this is not an Injection that should be used frequently.
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Several studies have shown that steroid Injections have been successful at reducing pain in the short term. The exact duration of pain relief remains UNKNOWN. Several studies showed a definite improvement at 1 week, but there is no evidence that these injections are demonstrating benefit past 6 months. Additionally, there is evidence that in obese patients the injections are less effective.
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Steroids are not recommended in people with the following conditions:
allergies to corticosteroids
an active infection
difficulty clotting
Compromised skin
Fractures
Presence of knee implants
Labile diabetes
or if you are having a knee replacement within 3 months (higher risk of post op infection)
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Some Adverse effects include :
Skin pigmentation changes
Fat or skin atrophy
Residual injection site pain
Facial flushing
Increase in blood sugar
Infection (studies range from 1/7000 -1/50000)
Note: Studies demonstrating a toxic effect to cartilage have been shown in laboratory studies but not clinical studies. The clinical data showing local anesthetic has effect on chondrolysis is shown in continuous infusion of GH joint, not one time injections.