Marc Darrow MD,JD

Systemic and local side-effects of corticosteroid injections including joint destruction

A patient will often come into our office with conflicting ideas about cortisone injections. The patient will tell us that his/her other doctors told them that cortisone injections are safe, effective, and will help their pain, if used sparingly. But, intuitively, the patient had doubts and concerns.

But as this patient continued to wait for a surgery, decisions had to be made as to how much pain management would be needed to “hold them over,” until the surgical date.

Corticosteroids are powerful anti-inflammatory substances. They are not used to relieve pain, but rather, to reduce inflammation, which in turn can lessen a patient’s level of discomfort. Numerous studies over the years have shown that prolonged use of cortisone will eventually cause degenerative joint disease in the joints they are injected into.

Understanding the possible complications of corticosteroid injections

Here are some of the most recent papers reminding doctors about the possible side effects of corticosteroids:

A January 2021 (1) study issued this statement:

“The current evidence would suggest that the use of corticosteroids provides moderate short-term benefit for reducing pain and improving functioning. These benefits generally last several weeks without long-term effectiveness. In addition to its limited short-term effectiveness, there are multiple potential adverse effects including toxicity to articular cartilage and numerous systemic side effects such as increases in blood glucose levels, a reduction in immune function, and an increased risk of infections.”

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Marc Darrow MD,JD

Traditional methods of treating Carpal Tunnel Syndrome include wearing a splint at night or injections of cortisone to reduce swelling. If these measures are not successful, carpal tunnel release surgery, which sections the tough transverse carpal ligament and relieves pressure on the median nerve, may be performed. Despite some people having good success with surgery, there have been many patients who have presented to my office with worse symptoms after they had the carpal tunnel surgery.
Study: Surgeons confident Carpal Tunnel Surgery is a good option for patients, but not for them.

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Marc Darrow MD,JD

We have seen many patients over the years who were looking for options to an arthroscopic wrist surgery for their unresolved wrist pain. They, like you perhaps, had a wrist pain that an MRI could not explain and their doctors felt that exploratory arthroscopic surgery may help find this pain. While the surgeons explored, the hope is that they may come upon something that they could repair. Whether or not that was the cause of the patient’s wrist pain, could not be confirmed until after the recovery period.

This type of surgical option is also one that many parents are trying to avoid for their young athlete. You may imagine that an athlete, with a small time table to return to sport would not want to chance a surgery and recovery where the outcome may be in doubt.

We offer non-surgical options to unresolved wrist pain. Stem cell therapy and Platelet Rich Plasma Therapy. In this article I want to present our research findings on the effects of Platelet Rich Plasma Therapy on unresolved chronic wrist pain published in the journal Orthopedic & Muscular System: Current Research (March 2019).
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