What every person with joint or spine pain should know about cortisone injections. 

Cortisone steroid shots for joint pain are a common treatment to manage and reduce joint pain and swelling. They are powerful anti-inflammatory drugs that impact a person’s entire body in ways they may not expect. Even though the research shows an array of negative cortisone steroid shots’ side effects, doctors still recommend them every day for most pain conditions, and insurance commonly pays for them.

Unfortunately, I find that most patients who make the decision to have cortisone shots have not really been informed of the potentially serious health risks that one exposes themselves to with each injection. These health risks involve suppressing natural processes in the body. This includes the possibility of lowering one’s immune system and negatively impacts the body’s ability to manage and fight off infections. I think it’s especially important for people to understand this in the setting of a global pandemic. Cortisone also impacts the regulation of metabolic function and can negatively affect blood pressure, blood sugar, osteoporosis, and contribute to poor wound healing. It’s also toxic to cartilage and stem cells and has been associated with worsening osteoarthritis and joint tissue degeneration. It can also cause psychological issues. The list goes on, and even corticosteroids taken orally, such as prednisone can lead to these types of side effects.

Hence, if you’re trying to stay healthy, keep your immune system optimized, and avoid a joint replacement surgery, it might be best to seek an alternative to high-dose cortisone injections for joint pain.
Q. Are there any alternative treatments for joint pain that aren’t associated with the above health risks and side effects?
A. Yes, according to many studies, one of those treatments is platelet-rich plasma (PRP).
PRP, which stands for platelet-rich plasma, is made from your own blood. This tissue contains platelet derived growth factors, which are cytokines that can have positive effects on pain and inflammation and can help other tissues such as cartilage, muscles, ligaments, tendons and nerves. For these reasons and more, PRP may be a better option to try instead of high-dose corticosteroids.
Q. What kind of doctor can treat my joint pain problem with PRP?
A. PRP injections must be administered by a board certified D.O. or M.D. with specialty training in orthobiologics and the use of image guidance for both diagnosing and treating musculoskeletal issues throughout the body. Furthermore, PRP injections should not be administered in the same manner as cortisone, which is commonly done without image guidance for peripheral joints such as knees. In other words, in most cases the doctor administering cortisone injections simply feels for the soft spot in the knee, and places the injection there. This is called a “blind” injection because the doctor can’t see exactly where the needle or the medicine went.
Instead, proper image guidance should include the use of ultrasound and/or fluoroscopy (x-ray) to target a variety of specific joint tissues during any PRP treatment. Doctors trained in Interventional Orthopedics are uniquely qualified to perform these types of injection therapies from head to toe.
If you’re being offered any form of injection therapy, ask your provider about the risks and benefits before agreeing to treatment, and make sure your provider truly has the experience and credentials to accurately diagnose and treat your condition.

In Health,
Dr. Silva

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