Arthritis: Steroids to Treat Arthritis

What Are the Expected Benefits of Steroid Injections?

Injections into a specific area are generally well tolerated and are less likely than other forms of steroid medications to produce serious side effects. Also, the injections may help avoid the need for oral steroids or increased doses of oral steroids, which could have greater side effects.

What Role Do Steroid Injections Play In an Overall Treatment Program?

Steroid injections can be added to a treatment program that may already include anti-inflammatory pain killer medications (NSAIDs), physical therapy, occupational therapy or supportive devices such as canes and braces. Whether one or more of these treatment methods are used depends on the nature of the problem.

For example, in an otherwise healthy person, tendinitis may be adequately treated with only a steroid injection into the inflamed area. However, in a person with rheumatoid arthritis, injections are generally a small part of a multifaceted treatment approach.

When Should Steroid Injections Not Be Used?

Steroids should not be injected when there is infection in the area to be targeted or even elsewhere in the body because they could inhibit the natural infection-fighting immune response. Also, if a joint is already severely destroyed, injections are not likely to provide any benefit.

If someone has a potential bleeding problem or is taking anticoagulants (often referred to as blood thinners), steroid injections may cause bleeding at the site. For these people, injections are given with caution.

Frequent steroid injections, more often than every three or four months, are not recommended because of an increased risk of weakening tissues in the treated area.

What Side Effects Are Associated With Steroid Injections?

Steroid injections are one of the most effective ways to decrease pain and improve function, yet they generally do not cure the illness.

In rare instances, the following side effects might occur:

• Infection
• allergic reactions
• Bleeding into the joint
• Rupture of a tendon
• Skin discoloration
• Weakening of bone, ligaments and tendons (from excessively frequent, repeated injections into the same area)

Not everyone will develop side effects and side effects vary from person to person. If steroid injections are infrequent (less than every three to four months), it is possible that none of the listed side effects will occur.

What Are the Possible Side Effects of Oral Steroids?

The occurrence of side effects depends on the dose, type of steroid and length of treatment. Side effects are much more common with oral medications. Some side effects are more serious than others. Common side effects of steroids include:

• Acne
• Blurred vision
• Cataracts or glaucoma
• Easy bruising
• Difficulty sleeping
• High blood pressure
• Increased appetite, weight gain
• Increased growth of body hair
• Insomnia
• Lower resistance to infection
• Muscle weakness
• Nervousness, restlessness
• Osteoporosis
• Stomach irritation
• Sudden mood swings
• Swollen, puffy face
• Water retention, swelling
• Worsening of diabetes

Please note: The side effects listed are the most common side effects. All possible side effects are not included. Always contact your doctor if you have questions about your personal situation.

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