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Steroid Injection Therapy vs Non-Steroid Injection Therapy

Steroid Injection Therapy vs Non-Steroid Injection Therapy

steroid vs non-steroid injection therapy

 

When you think of the word steroid, there may be a lot of misinformation floating around in your mind. If your doctor asks if you would be comfortable with steroid injection therapy, or non-steroid injection therapy, your brain probably thinks it will have to do with the “steroids” used by athletes. Steroid injections can be an effective tool for treating joint pain or joint conditions, so we’re going to discuss what it actually is. In today’s article, let’s look at steroid injection therapy, non-steroid injection therapy, how both of them work and what they are, and how they compare to each other. 

 

What are steroids?

In the medical world, steroids (shorts for corticosteroids) are anti-inflammatory medicines, used to help treat many different conditions. For Integrated Orthopedics, steroids are used to treat joint pain and joint conditions. According to this study, “Corticosteroids suppress the multiple inflammatory genes that are activated in chronic inflammatory diseases.” They do this by mimicking the effects of hormones, such as cortisol. Doctors will usually prescribe corticosteroids to increase the action of these hormones above a typical level or return it to a standard level if it is falling below.

 

If you are thinking of the “steroids” taken by athletes, you are instead thinking of Anabolic steroids. These, instead of helping inflammation by imitating cortisol, imitate the male hormone testosterone, in order to increase muscle mass. These are often used illegally and are prescription-only medicines that are sometimes taken without medical advice. Anabolic steroids usually have limited medical use and are not often prescribed, unlike the corticosteroids we’re discussing in this article. Now that we’ve cleared this up, we want to make it clear that the steroids mentioned in this article are corticosteroids, not anabolic steroids.

 

Steroid injections therapy

Steroid injection therapy is the use of corticosteroids, injected into the body in order to reduce swelling and inflammation. As mentioned, steroid injection therapy can be used for a myriad of ailments and needs, but in the orthopedic world, they are used for joint pain, joint discomfort, and joint conditions.

 

How it works

During steroid injection therapy, corticosteroids are injected into the joint or muscle which is experiencing the pain. The steroid then helps reduce the swelling, inflammation, and pain. Injections are effective because they deliver a high dose of medication directly to a problem spot in your body, unlike other forms of medication that have to travel. This is often a really great approach to target pain in a direct way, especially if the pain is persistent, and has become a repetitive issue for you in the past.

 

Conditions

While steroid injection therapy is used as a treatment for many different conditions, it is used for joint pain in the orthopedic field. Here at Integrated Orthopedics, steroid injections are most often used to treat some conditions like:

 

  • Rheumatoid arthritis
  • Gout
  • Inflamed bursae (bursitis)
  • Around inflamed tendons (tendonitis) near the shoulder, elbow, hip, knee, hand, or wrist

 

Risks

When it comes to risks, the side effects and risks really depend on how often steroid injection therapy is used on you. With larger doses and repeated use, risks are side effects may be more likely to occur. Doctors will usually limit the number of cortisone shots into a joint in order to avoid these risks. Some documented side effects may include:

 

  • Cartilage damage
  • Death/injury of nearby bone
  • Joint infection
  • Nerve damage
  • Temporary facial flushing
  • Temporary flare of pain and inflammation in the joint
  • Temporary increase in blood sugar
  • Tendon weakening or rupturing
  • Thinning of nearby bone (otherwise known as osteoporosis)
  • Thinning of the skin and the soft tissue around the injection site
  • Whitening or lightening of the skin around the injection site

 

Recovery

In terms of recovery, it can also depend on how often or how many cortisone shots you have recently received. After receiving a cortisone shot, some people experience redness and a feeling of warmth in the chest and face, this is normal and can be expected. For patients who have diabetes, a cortisone shot might cause other implications like temporarily increasing their blood sugar levels. During the recovery process, your doctor might recommend that you:

 

  • Protect the injection area for around two days
  • Avoid heavy lifting
  • Stay off your feet (if the injection was near your legs, feet, or ankles)
  • Apply ice to the injection location
  • Avoid bathing, hot tubs, heating pads or whirlpools for several days after injection
  • Keep an eye out for signs of infection, such as swelling, redness and pain 

 

Success rate

Steroid injection therapy is usually a successful treatment option, and the results can last for months afterward. Though, you should be aware that steroid injection therapy might cause a slight inflammation for a few days after, but then, it should go down and the pain should disappear. Often, patients might think it has failed because of the temporary flare, but it is just the way the shot works. After this, your pain will likely diminish or even go away completely for months, and inflammation and redness should also fade. In treating acute and chronic pain, steroid injection therapy is one of the most effective methods because it is able to target specific pain areas.

 

Non-Steroid injections therapy

Now that we’ve discussed steroid injection therapy, it’s time to look at non-steroid injection therapy. Non-steroid injection therapy comes in many forms and goes by many different names. Here are a few: chicken shots, rooster shots, gel shots, jelly shots, and lube shots. The naming really depends on where you’re from, but they are all the same. Basically, when non-steroid injection therapy is used, an injection is inserted into a joint or muscle in order to provide lubrication. At Integrated Orthopedics, the main non-steroid injection therapy we use is a hyaluronic acid treatment known as Hymovis®

 

How it works

If you have a condition like osteoarthritis, your body might be losing its natural hyaluronic acid, which provides your joints lubrication. Because of this, non-steroid injection therapy is used to provide your body with the lubrication and the fluid it needs to move safely. This hyaluronic acid mimics your body’s normal joint fluid and attempts to recreate a healthy joint. They are often used for patients who don’t respond very well to pain medication or those who can’t take them. They are often used for patients who are not yet ready for total knee replacement surgery.

 

Conditions

When it comes to the conditions that are treated by non-steroid injection therapy, osteoarthritis, and knee osteoarthritis, specifically is the most common. HYMOVIS® specifically is indicated to treat osteoarthritis (otherwise known as OA), who have failed to respond to other forms of treatment, such as non-pharmacologic therapy or simple analgesics. 

 

Risks

Hyaluronic acid injections have been being used in orthopedic medicine and practice with major success for the past 20 years. In many cases, the outcomes of non-steroid injection therapy are successful, impactful and can defer joint replacement surgery. Much like a cortisone shot, some people experience inflammation and pain in the surrounding area at the injection site, this is normal and can be expected.

 

The use of Hymovis® is not intended for patients with known hypersensitivity (allergy) to hyaluronate preparations or those who have infections or skin diseases in the area of the injection site or joint. It has also not been tested on pregnant women, nursing mothers, or children. In the clinical study for HYMOVIS®, no serious adverse events or pseudo sceptic reactions were reported. 

 

Recovery

After receiving non-steroid injection therapy, you may experience arthralgia, transient pain, or swelling. During the recovery process, your doctor might recommend that you:

 

  • Protect the injection area for around two days
  • Avoid heavy lifting
  • Stay off your feet (if the injection was near your legs, feet, or ankles)
  • Apply ice to the injection location
  • Avoid bathing, hot tubs, heating pads or whirlpools for several days after injection
  • Keep an eye out for signs of infection, such as swelling, redness and pain 

 

Success rate

In the clinical study done on HYMOVIS®, long-lasting pain relief was felt by patients. 47% of patients reported that around 50% of their pain was gone after 90 days. Throughout the next 90 days, patients felt relief from their pain. HYMOVIS® can be injected several times, if your doctor sees it necessary, which will help with ongoing pain for OA. 

 

Steroid injections therapy vs non-steroid injection therapy

When it comes to choosing which is right for you, there are many things to consider and to discuss with your doctor. You should think about the side effects and risks related to both, your past history with OA, joint disease and injuries and your potential allergies. You might also want to look into other portions of your medical history like if you are diabetic, if you have had any major illnesses, surgeries, or treatments in the past and more. Let’s look at a few things you should be discussing with your doctor and thinking about before you commit to either version of injection therapy.

 

Allergic Reaction

If you have had an allergic reaction to cortisone in the past, it may not be an option for you when you’re researching injection therapy. While it is the typical form of injection used for OA and other joint pain treatment, those with an allergy to cortisone will need to find an alternate route. This is just one of the reasons why you might be more interested in non-steroid injection therapy, like the use of HYMOVIS®.

 

The Need for Repeated Use

If you will need repeated use of injection therapy, your doctor might lean toward a non-steroid option. This is because, with repeated use of cortisone shots, there is a higher chance of these risks (as mentioned above):

 

  • Cartilage damage
  • Death/injury of nearby bone
  • Joint infection
  • Nerve damage
  • Temporary facial flushing
  • Temporary flare of pain and inflammation in the joint
  • Temporary increase in blood sugar
  • Tendon weakening or rupturing
  • Thinning of nearby bone (otherwise known as osteoporosis)
  • Thinning of the skin and the soft tissue around the injection site
  • Whitening or lightening of the skin around the injection site

 

Diabetic Patients

As mentioned, cortisone shots have caused diabetic patients to experience a temporary rise in blood sugars for hours to days after the therapy has been completed. A 2015 study found that 80% of patients who received cortisone reported elevated blood sugar and this rise in blood sugar corresponded to the severity of diabetes the patient had (as measured by hemoglobin A1C). Because of this effect, your doctor might suggest you use non-steroid injection therapy instead of using traditional cortisone shots for your pain management and treatment. Depending on the severity of diabetes, your doctor might choose cortisone treatment for you but will warn you to be aware of the rise in blood sugar over the next few days.

 

Comparability

This 2018 study and many others have shown that both types of injection therapy have similar results. This study looked at several other studies done on the subject and found that the two options were comparable, and at times, non-steroid options worked better for patients. “The studies reviewed, while limited in quantity, show that NSAIDs (non-steroidal anti-inflammatory drugs) provide equivalent, if not better, pain relief from the musculoskeletal ailments assessed.” 

 

Is Steroid Injection Therapy and Non-Steroid Injection Therapy Offered at Integrated Orthopedics?

Steroid injection therapy and non-steroid injection therapy are offered at Integrated Orthopedics. If you are experiencing OA, joint pain, a joint condition or pain around your ankle or knees, give Integrated Orthopedics a call today or schedule an appointment here. Our doctors are trained professionals who will be able to walk you through treatment with ease and comfort. At your appointment, your doctor will be able to decipher the pain you are feeling and help you navigate what treatment plan you should take. They will be able to uncover which injection therapy would be right for you and give you the treatment you need.

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