Doctors from Boston University are raising the warning flag on new medical concerns over steroid injections. A study, first released by the peer-reviewed journal Radiology in October 2019, shows 8% of patients that receive a steroid injection in their hips or knees experience complications. The team behind these results spoke to the media to share the exact cause of their fears, and what these findings mean for the many patients who receive steroid injections. (1)

The Best Way To Treat Joint Pain?

Steroid injections have long been used and perceived as a safe method to manage joint pain by doctors throughout America. Among patients with osteoarthritis, a condition characterized by joint pain, steroid injections are considered especially popular. The definitive treatment of osteoarthritis is not steroid injection, but rather joint replacement. However, many patients are not eligible for joint replacement, either due to past medical history of obesity, and then, are only left with non-surgical options, like pain control. (2)

Administered by a doctor, steroid injections are often completed in a healthcare office, hospital, or clinic space. The steroid used in these injections is a synthetic version of a natural steroid that all humans produce. Providing the patient with anesthetics in advance, the doctor will inject the steroid into the intra-articular space (joint) of the patient. Knees and hips are common injection sites, but shoulders and ankles may also be injected depending on the patient’s condition and available medical options. (1, 2)

A Concerning Outcome

Dr. Guermazi, a doctor at Boston University, is considered the driving force behind the new worries for steroid injections. He shared with journalists that some time ago he had personally provided a new mother with a steroid injection, who was suffering postpartum hip pain. She returned to him six months later with worsening pain, and he discovered her joint was completely deteriorated. The woman required a rapid hip replacement for no apparent reason.

With this experience in hand, Dr. Geurmazi was concerned and initiated a study with several other colleagues at Boston University. The group sought to understand what the exact risks of steroid injections were, and how common these complications occur. (3)

Newfound Risks

In Dr. Guermazi’s study, 36 of 459 patients who participated experienced a health complication after a steroid injection. Examining the location of injection, 10% of complications were seen in the hips and 4% in the knee. All complications worsened the state of the patient’s joint through either small fractures, altering bone supply, speeding up arthritis, and in some cases deteriorating the joint. Other complications of steroid injections, located in previous studies, include soft-tissue infections at the injection site, toxicity from anesthetics given prior to the procedure, and destruction of joint cartilage. (2)

Ultimately, more research is required to determine the full extent of complications experienced by patients who receive steroid injections. Until this research is complete, patients should speak openly about their concerns with their healthcare providers, and carefully weigh the pros and cons of steroid injections as a treatment option. Meeting candidacy for surgical correction of diseases like osteoarthritis might be more crucial than ever for the safe resolution of joint pain. (2)