Corticosteroids

Corticosteroid injections have generated excitement, disappointment, and disdain since their discovery over 50 years ago. Interestingly, proliferant solutions were discovered 20 years before corticosteroids, but because "steroid" injections provide a more rapid pain reduction, many physicians began to use steroid injections to treat painful conditions. The overuse of steroid injections in the 1950's and 1960's led to the recognition of connective tissue atrophy, weakening of the tissues, and suppression of the immune response. Thus, there is healthy debate over the use of "steroid" injections. As with any medical treatment there is risk and benefit which must be weighed.

Corticosteroids block inflammation and therefore are useful when there is an excessive inflammatory response. This may be the case when there is a disk herniation causing swelling and injury to a nearby nerve root (radiculopathy). Other conditions that may benefit from a "steroid" injection include bursitis or tendinitis or an inflamed, swollen joint. Used judiciously, such an injection may result in a relatively rapid resolution of the problem.

However, many conditions are not associated with inflammation, and do not respond long-term to a single steroid injection. There may be a short-term positive response that then fades back to baseline. This is usually the case with chronic (longstanding) painful conditions, which are now known to be degenerative in nature usually. For many chronic, degenerative spine or joint conditions, Prolotherapy, Platelet-Rich Plasma and Mesenchymal Stem Cell therapies are proving useful.

The key is to safely, efficiently and cost-effectively determine whether the condition is inflamed, where a steroid injection may be curative; or whether it is degenerative in nature, where regenerative medicine technology is more likely to result in an optimal outcome. The Injection Response Curves page on our website outlines a typical algorithm which we use to try to resolve the best treatment option.