Why I Hate Steroids (and You Should Too):
Traditionally corticosteroids, often referred to as 'cortisone shots' have been the drug of choice for injections to treat musculoskeletal pain. Steroids have been used for many years and were thought to be strong anti-inflammatories. But the ability of corticosteroids to produce the desired results is often short-lived. Indeed some very large controlled trials with corticosteroids have shown them to be only about 50% (a coin flip) effective.
Quick Fix? Or Destroying Tissue
After decades of literature documenting that there are definite problems with Corticosteroids, they have come under under the scrutiny of the FDA. They have been shown to break down proteins and disrupt the formation of the building blocks (collagen) of cartilage and tendons. If Corticosteroids are given repeatedly, tendons weaken and are even at risk of rupture. For instance, the biggest concern in injecting around the rotator cuff is the risk of additional tendon rupture and tendon damage. If injected around the heel or plantar fascia, steroids placed into fat can cause the fat to dissolve making symptoms even worse.
Way Beyond the Body's Response
The body does have its own way of releasing steroids when an injury occurs. However, cellular biology has shown that the milligram (mg) doses that are produced to make synthetic injectable corticosteroids exceed the the body's natural dose by about 1,000,000 times normal. In fact, human cells naturally produce corticosteroids in the nanogram (ng-billionth of a gram) to picogram (pg) range.
Orthobiologics—A New Paradigm
Instead of blasting a joint or tendon with steroids, a better goal can often be stimulating the body's own internal signals for recovery by using either prolotherapy, PRP (platelet rich plasma), or BMAC (bone marrow aspirate concentrate). We call this group of therapies: Orthobiologics, and for this reason, we try to avoid the use of steroids before and after such procedures, which could otherwise blunt the healing response.
How Georgia Bone & Joint Can Help