Inject Or Not To Inject? That’s the Question…

We have all been there before, that pain that will not go away.  It seems to wake you up at night, hurts when you take that first step, maybe even seems to catch your breath.  That's when you call me, or at least someone like me. (Or if your my family member or friend, you text in a panic 🙂  It is human nature to want a pill, cream, or patch to take the hurt away.  None of us are immune, and if you are in my family you tend to get hurt a little more often!

Many times I have seen a patients in a similar situation and they too want the aching or stabbing to stop in their given joint.  The topic of steroid injections comes up often in this scenario. Where steroid injections can be helpful in reducing pain, they should also be approached as an infrequent or one time treatment.  Steroids are not a benign medication and should not be treated like they are a Flintstones vitamin.  Unfortunately, I do see some people who have had many injections over the course of their lives into the same area.  This is not necessarily the best practice when it comes to our joints.

Using my uncle as an example: he had terrible arthritis of his knees.  He had limped around for years in pain, failed injections. therapy, and knee scopes.  If he had chosen to get steroid injections every 3-6 months in his knees for years he would have only treated his symptoms.  Instead he treated the problem and got both knees replaced and is very happy.  Having one or two steroid injections get you through an injury maybe helpful. However, for someone with a chronic arthritic problem, continued injections do not addressing their underlying problems.


Also, studies have shown that repeated steroid injections to the same area in a short amount of time can be destructive to the tissues.  Detrimental Effect of Repeated and Single Subacromial Corticosteroid Injections on the Intact and Injured Rotator Cuff, in the American Journal of Sports Medicine tests one and three steroid injections in the shoulders of rats.  The researchers had rats with both non injured shoulders and some with rotator cuff tears. Then they either gave them saline injections, one steroid injection, or three steroid injections over 3 weeks. The rotator cuffs were then tested for failure.  The single injection rats took 17% less load to cause the cuffs to fail then the saline group, and the triple injection took 32% less load to fail.1  Also, they found the bone volume was decreased in the triple injection group and the stiffness of the cuff tissue decreased by 50% in the triple injection group.1   What does it all mean?  Multiple injections can cause damage to the tissues within the joint.

I wish I could tell you that everything that made you feel better was good for you.  But that just in not true, or responsible.  Steroid injections have a great place in orthopedics and medicine but often get overused because people want a quick fix.  Remember to look for a solution to the problem if possible.  As with everything there are always gray areas and it is best to discuss this with your provider individually.


1. Maman, E., Pritsch, T., & Morag, G. et al (2015, July 27). Detrimental Effect of Repeated and Single Subacromial Corticosteroid Injections on the Intact of Injured Rotator Cuff: A Biomechanical and Imaging Study in Rats. The American Journal of Sports Medicine, 44(1), 177-182. 

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