Corticosteroid injections into joints have been used for a very long time. Their anti-inflammatory and pain relief properties made their use a common practice within the medical community. Although these practices are common, randomized trials have failed to produce evidence for their effectiveness and whose long-term usage will make the patient’s condition worse.
-disrupt/suppress the healing environment of the joint.
-increases cartilage destruction and accelerates osteoarthritis progression.
-increase the chances of undergoing joint replacement surgery and possibly higher risk for post-surgical infections in the joint.
– can predispose a joint to infection, because of the immune system suppression characteristic of steroids. (That’s why the surgeon tries to avoid replacement surgery for joints injected with steroids for at least 3 months).
-subchondral bone insufficiency fractures(stress fractures that occur beneath the cartilage).
-osteonecrosis(death of bone tissue).
-also has a harmful effect on soft tissue healing.
(Oral steroids have many more complications)
The dangers of cortisone injections have long been known. But the sad truth is that many doctors don’t discuss these possible complications with the patients.
Let’s be fair, people do get relief from steroid injections (as they successfully mask the pain) for a short period of time. Unfortunately, many, excessive steroid treatments lead to a worsening of chronic pain and actually make the problem worse in the long run. Steroids have their place, for certain conditions to get instant relief, and the dangers were accepted as part of the treatment. For me, steroids are clearly not part of the future directions for the management of pain in osteoarthritis.
How does Prolotherapy repair a joint in ways cortisone cannot?
Prolotherapy also knows as regenerative injection therapy(RIT).. It is a well-recognized nonsurgical orthopedic procedure that stimulates the body’s natural healing processes by initiating a local inflammation cascade, which triggers the release of growth factors and collagen deposition.
This therapy technique involves an injection of a solution to the site of painful and degenerated joints, ligaments, tendon insertions, and in adjacent joint spaces in order to promote the growth of normal cells and tissues. Prolotherapy, with its unique ability to directly address the root cause of the disability, can repair the weakened sites and result in the restoration of proper function by proliferating new ligamentous tissue.
Prolotherapy promotes genuine, natural body healing and uses no artificial substances, no medications, and nothing that can cause adverse future side effects. The great advantage of Prolotherapy is that it is Safe.
In other words, Prolotherapy naturally promotes tissue Rejuvenation.
Local Steroid Injections for Tendinopathy:
Tendinopathy is a broad term encompassing painful conditions occurring in and around tendons in response to overuse or injury.
However, biopsies of previously so-called chronic tendonitis tissue have shown typically very few inflammatory cells but rather collagen degeneration(breakdown) occurring. For this reason, in recent years the word tendinosis (“oasis” meaning diseased or abnormal condition) then used the term tendonitis (“itis” meaning inflammatory process).
Since the basic problem is not inflammation, steroids typically help only temporarily. In fact, worsening of symptoms, and even spontaneous tendon ruptures in the long term.
They compromise tendon and ligament strength, a scary finding considering that many athletes return to the game or the sport shortly after an injection.
Therefore, treatment should target the stimulation of collagen production rather than the elimination of inflammation, which may not even be present.
Prolotherapy(traditional dextrose or bio cellular) is a more reasonable treatment option in that the focus is to stimulate the proliferation of fibroblasts which then stimulate collagen repair and proliferation. This treatment addresses the root cause of the disease and not just masks pain as in steroid injections or painkillers. Ultimately the outcome will be a long-term/ permanent resolution of pain and improved function.
In summary, while steroid shots weaken an injured area even further, Prolotherapy stimulates the body’s healing processes to repair it. Prolotherapy stimulates blood flow to the area, protein synthesis, fibroblast proliferation, and ultimately collagen formation. The choice is simple: steroid shots that lead to a worsening of the problem in the long run OR Regenerative Injection Therapy (Prolotherapy) that addresses the root cause of the problem and can help to improve function in the long run.
Dr. Vikram Rajguru is India’s first Interventional Regenerative Orthopedic and OrthoBiologic Surgeon. He is one of a small bunch of specialists in the nation that is both an Orthopedic Surgeon and a master in the field of Interventional Regenerative Orthopedics and Sports Medicine. This mix of degrees gives Dr. Vikram Rajguru an expansive subject matter and ability that benefits his patients generally. Through his aptitude, he has assisted numerous patients with returning to a dynamic way of life by giving agony resolution and recapturing lost portability through noncareful just as careful treatment. He accepts to consistently give guidance that is equivalent to that which he would suggest for ourselves or our own family.