The Dangers of Long Term Steroid Use for Joint Pain

Many doctors prescribe steroid injections for joint pain and arthritis. Steroid shots can quickly reduce inflammation and ease discomfort. However, frequent or long term use of steroids can actually damage your joints and muscles over time. Steroids work by slowing down your body's ability to heal itself. While this may temporarily relieve symptoms, it allows damage to accumulate in your tissues.

Your body is constantly breaking down old or injured cells and replacing them with new ones. This process is called apoptosis. In normal amounts, apoptosis is healthy and helps your body work properly. However, high doses or long term use of steroids can cause too much apoptosis. This means the body breaks down more cells than it can replace. For joints and soft tissues, this can lead to tissue degeneration, weakening of tendons and ligaments, and bone loss.

Signs and symptoms that long term steroid use is causing harm include:

• Increased pain or swelling in the joints. The steroids may temporarily reduce inflammation, but the underlying damage continues to worsen.
• Weakness or instability in the joints. As tissues break down over time, joints become looser and less stable.
• Muscle atrophy. Apoptosis can break down muscle cells, leading to loss of muscle mass and strength.
• Weight gain and mood changes. Long term steroid use may cause fluid retention, increased appetite, and effects on mood and energy level.
• Slower wound healing. High doses of steroids over a long period of time can slow down the body's ability to heal cuts, tears, and fractures.
• Higher risk of infection. Steroids impact the immune system and can make people more susceptible to illnesses and infections.

Steroids work by reducing inflammation in the tissues. However, inflammation is a necessary part of the body's healing process. Long term steroid use can inhibit the body's ability to heal itself and repair damage. One of the ways steroids interfere with healing is by inducing apoptosis or programmed cell death. As previously mentioned, apoptosis is a normal process where old or damaged cells die and are replaced. But too much apoptosis caused by steroids can lead to tissue degeneration.

While steroid shots seem like an easy fix, long term use or high doses can be detrimental to joint and soft tissue health.The temporary relief they provide is not worth the potential long term damage. Recent medical research shows that frequent steroid injections may actually worsen joint and tendon damage over time. Several studies have found a link between frequent steroid injections and increased cartilage loss in joints. Tendons can also weaken and rupture more easily. The more often steroids are injected into an area, the higher the risk of permanent damage.

The good news is there are alternative treatment options for arthritis and soft tissue injuries that do not pose the same risks as steroid overuse.  Treatment options include:

• Physical therapy - Exercise and physical therapy are very effective for both pain relief and mobility. A physical therapist can provide targeted exercises to strengthen muscles and improve joint function.
• Bracing - Braces, splints, or other supports can help reduce pain from movement or impact. They provide stability and relief without the side effects of steroids.
• Icing and heating - Applying ice packs to reduce inflammation and heat to relax muscles can provide relief from discomfort.
• Non-steroidal anti-inflammatory drugs (NSAIDs) - Oral medications like ibuprofen are anti-inflammatory and can ease pain. They do not have the tissue degeneration effects of steroids when used properly.
• Platelet-rich plasma (PRP) injections - For some conditions, injections of a patient's own plasma can help reduce inflammation and promote healing. PRP contains growth factors that stimulate tissue repair.

In summary, while steroid injections can provide temporary relief from pain and inflammation for arthritis and soft tissue injuries, long term use of these injections should be avoided. There are alternative treatments that can provide relief from chronic pain without hurting your joints and muscles in the long run. Avoid repeat steroid shots whenever possible for the health of your body. Short term gain just isn't worth long term pain!

Want to find out more? Scheudule a consult or free introductory call to discuss your treatment options.