Steroid Injections

Understanding Steroid Injections

Corticosteroids are synthetic forms of cortisol, a hormone produced by your body to manage stress and control inflammation. When injected, these medications rapidly suppress the activity of the immune system locally, around the site of pain. This blocks the release of substances that cause swelling and pain.

Steroid injections are often used as a short-term measure to relieve pain during flare-ups or while awaiting more targeted care, but they’re not typically a long-term solution. For instance, in people with rheumatoid arthritis, corticosteroids help reduce pain before getting access to disease-modifying antirheumatic drugs (DMARDs).

Because corticosteroids suppress certain immune functions, they may also impact the activity of immune cells, which can increase the risk of infection in some cases.

Over time, repeated corticosteroid use has been associated with side effects such as cartilage breakdown ^[1] and adrenal insufficiency.^[2] This condition occurs when the body is unable to produce enough cortisol in response to stress, resulting in fatigue, weakness, and difficulty handling physical or emotional challenges.

Typically, healthcare professionals specializing in orthopedic or sports medicine administer corticosteroid injections, employing sterile technique and often utilizing image guidance for accuracy.

You may also hear these referred to as “cortisone shots,” “corticosteroid injections,” or “glucocorticoid injections.” Steroid shots are not the same as “anabolic steroids,” which relate to testosterone and are used to build muscle rather than treat inflammation or pain.

Types Of Steroid Injections

Different types of steroid injections include:

• Hydrocortisone is a fast-acting steroid often used to control inflammation in the short term, especially in mild to moderate cases. It quickly reduces swelling and relieves pain, but its effects tend to wear off sooner. It’s useful when immediate but temporary relief is needed before starting longer-term care.
• Triamcinolone has a longer duration of action, making it particularly useful for joint and soft tissue injections. It works by limiting the activity of certain inflammatory cells and reducing the release of pain-causing compounds. This extended effect can help manage symptoms over several weeks.
• Methylprednisolone offers a balance of strength and duration. It helps reduce white blood cell activity in inflamed areas and blocks inflammatory signals, making it effective for both acute flare-ups and more persistent pain.

While these medications may provide short-term relief, it’s important to understand their limitations and the other options available to support long-term recovery.

When Steroid Shots May Help Manage Pain

Some of the reasons why steroids are frequently used in pain management include:

• Reduces Pain and Inflammation: Corticosteroids can lower the release of chemicals like prostaglandins and cytokines that drive swelling and discomfort. These effects often develop within a few days.
• Helps Regulate Immune Responses: In autoimmune conditions such as rheumatoid arthritis, corticosteroids may help control excessive immune activity that causes joint damage.
• Can Help Autoimmune Conditions: By blocking immune cells, steroid injections help manage flare-ups in conditions like lupus. This may help limit inflammation-related joint damage.
• Provides Quick Relief: Many people report symptom improvement within 24–72 hours of an injection. This relief may enable participation in physical therapy and other recovery activities.

How Steroid Shots Help Reduce Inflammation

Steroid shots are commonly used anti-inflammatory treatments that work by lowering immune activity and reducing the chemical signals responsible for swelling and pain.

What To Expect

Knowing what to expect from a steroid injection can help reduce anxiety and prepare you for the process and possible side effects. The procedure is quick and designed to minimize discomfort. Following instructions before and after helps improve outcomes.

Preparing For The Procedure

Before your appointment:

• Follow pre-procedure instructions. Your provider may advise you to avoid certain medications (such as blood thinners), supplements, or foods, or to fast before the procedure, depending on your health history. You should also bathe before the injection, but avoid using lotions or perfumes.
• Review your current health status. Inform your provider about new symptoms, allergies, infections, fevers, or unexpected changes in your health since your last visit.
• Bring a list of medications you are currently taking. Include prescription drugs, over-the-counter medications, vitamins, and supplements to help prevent adverse interactions or side effects.
• Dress comfortably and wear clothing that allows easy access to the injection site. For example, wear shorts for knee injections or a loose-fitting shirt for shoulder injections. Loose clothing will also prevent pressure on the injection site after the procedure.

What Happens During The Procedure

The injection itself is straightforward:

• The injection site will be cleaned and numbed with a local anesthetic. Your physician will clean and disinfect the injection site, then apply a local anesthetic to minimize discomfort.
• The steroid medication is injected. Using a fine needle, your provider delivers the steroid directly to the target area. They may use ultrasound or X-ray guidance for accuracy.
• You may feel slight pressure or discomfort: This sensation is typically mild and lasts only a few seconds while the medication is administered. Most people experience only brief discomfort; intense pain is rare but should be reported.
• The procedure typically lasts only a few minutes. The entire process, from preparation to completion, is quick, usually lasting under 10 minutes.

Post-Procedure Expectations

After the procedure, certain steps can help reduce side effects and improve outcomes. They include:

• Rest the injected area for a short period. This helps reduce the risk of irritation and allows the medication to start working in the tissues. It also allows the physician to monitor for adverse effects.
• Experience some pain or swelling at the injection site. Localized discomfort, redness, or swelling is common and usually resolves within 24–48 hours without treatment.
• It may take days to take effect fully. While some patients feel improvement within hours, relief may take up to a week.
• Use ice packs, if needed, to reduce swelling. Ice can help ease swelling and pain by lowering excessive blood buildup in the affected area. Apply an ice pack to the area for 15–20 minutes at a time.
• Avoid strenuous activity unless cleared by the doctor. Wait until your provider says it’s safe to resume exercise, heavy lifting, or sports to protect the treated area and prevent further injury.

Conditions That Steroid Shots May Address

In the short term, steroid injections can reduce the symptoms of musculoskeletal and nerve-related conditions where inflammation plays a major role. By reducing swelling and irritation, these injections may improve function and movement in conditions that affect the joints, spine, and soft tissues. However, lasting improvement often depends on addressing the underlying causes of pain through a broader treatment strategy.

Corticosteroids are typically not a long-term solution for resolving the root cause of pain. They are best used as one component of a broader care plan, ideally one that supports your body’s natural healing and long-term function.

• Adjacent Segment Disease: Adjacent segment disease refers to a condition where spinal segments near a previous fusion may experience increased stress, leading to stiffness or discomfort. Read more about Adjacent Segment Disease.
• Shoulder Bursitis: Shoulder Bursitis refers to inflammation of the bursa sac, often leading to pain and restricted shoulder motion. Read more about Shoulder Bursitis.
• Facet Cysts: Facet cysts refer to fluid-filled sacs that form near spinal joints, sometimes pressing on nearby nerves.
• Frozen Shoulder: Frozen shoulder refers to stiffness and pain in the joint that limits movement, often developing gradually. Read more about Frozen Shoulder.
• Rotator Cuff Tear: Rotator cuff tear is damage to the tendons in the shoulder, which may occur due to repetitive strain or injury. Read more about Rotator Cuff Tear.
• Shoulder Arthritis: Shoulder arthritis is joint inflammation that may result in symptoms such as pain, stiffness, or limited range of motion. Read more about Shoulder Arthritis.
• Shoulder Labral Tear: Shoulder labral tear is damage to the cartilage rim in the joint, causing pain or instability. Read more about Shoulder Labral Tear.
• Slipped Disc: Slipped disc is a common term for a spinal disc that bulges or shifts out of place. It may press on nearby nerves and contribute to discomfort or weakness. Read more about Slipped Disc.
• Spinal Stenosis: Spinal stenosis is a condition involving narrowing of the spinal canal, which may lead to nerve compression and symptoms such as leg discomfort or weakness. Read more about Spinal Stenosis.
• Thoracic Radiculopathy: Thoracic radiculopathy is a condition involving nerve irritation in the mid-back region that may result in symptoms such as tingling, numbness, or discomfort around the ribs or chest. Read more about Thoracic Radiculopathy.
• Torn Discs: Torn discs refer to spinal discs with internal damage that may bulge or leak, potentially affecting nearby nerves and contributing to discomfort. Read more about Torn Discs.
• Sciatica: Pain along the sciatic nerve, running from the lower back through the buttocks and down each leg.
• Inflammatory Bowel Disease (IBD): IBD refers to conditions that cause inflammation in the digestive tract.

Potential Risks To Consider

Like any medication, corticosteroid injections carry potential risks, especially with frequent or long-term use. These may include:

• Injection site reaction: Mild redness, swelling, or tenderness can occur at the injection site as the body responds to the medication. These effects are usually short-lived.
• Temporary spike in the blood sugar: Steroids increase glucose production in the liver and reduce how effectively your cells use insulin.^[3] This can cause a short-term rise in blood sugar, especially in people with diabetes.
• Risk of infection: Because steroids suppress local immune responses, they can slightly increase the chance of infection at the injection site.
• Damage to the tendon or cartilage: Over time, repeated steroid use in the same area may slow tissue repair or impact collagen structure, especially in tendons and joints.
• Hormonal side effects: In some cases, injected steroids can temporarily affect glands like the adrenal glands. This may result in symptoms such as mood changes, facial flushing, or menstrual changes. These effects are usually self-limited and monitored by your care team.

Why Regenerative Medicine May Be A Better Long-Term Solution

While steroid injections may offer short-term relief during flare-ups, they don’t address the root cause of many orthopedic conditions. These injections can help manage symptoms, allowing you to stay active and participate in physical therapy, which supports overall well-being. However, they are often best used as part of a broader treatment plan.

In contrast, regenerative medicine works with your body’s natural healing processes that may support long-term improvements in tissue function, often with a lower risk of complications. Here’s how regenerative treatments differ from steroid-based care:

Addresses The Root Cause

Regenerative treatments, such as platelet-rich plasma (PRP) or bone marrow concentrate containing your stem cells, work by using your own body’s healing factors to repair and rebuild damaged tissues at the cellular level.

Rather than only suppressing inflammation, they target the underlying injury or tissue degeneration by stimulating the activity and growth of new, healthy cells in the affected area. A 2020 study found that, compared to corticosteroids, PRP promotes tissue repair in knee osteoarthritis, offering similar early pain relief as steroid injections but resulting in better long-term improvements in pain, function, and joint health.^[4]

Supports Natural Healing

Regenerative orthopedics leverages your body’s natural healing processes, using biologic materials derived from your own blood or bone marrow.

These treatments deliver concentrated growth factors and other cells involved in the regeneration of damaged tissues to the affected site, enhancing repair, potentially reducing recovery time, and supporting the regeneration of normal tissues’ structure and function.

Lower Risk Of Long-Term Side Effects

Unlike repeated steroid injections, which can weaken tendons, cartilage, and suppress hormonal balance, regenerative treatments work locally and are made from your own biological materials. According to research, even a single PRP injection can lead to significant improvements in pain and function in those with knee osteoarthritis.^[5]

Additionally, since regenerative orthopedic treatments use your own growth and healing factors, they reduce the risks of tissue damage, side effects, and complications related to hormone disruption or infection.

Improves Function Over Time

Regenerative orthopedic treatments can offer gradual and sustained improvements in joint stability, mobility, and pain levels. Findings indicate that corticosteroid injections may provide faster pain relief in the short term, but PRP offers more substantial benefits for long-term recovery.^[6] Over time, patients treated with PRP experience better improvements in pain, function, and joint health.

By targeting the underlying cause of tissue damage, these treatments may reduce long-term medication use and promote functional recovery.

Personalized To Your Condition

At OrthoAdvanced & Spine (OAS), regenerative treatments are customized to your specific condition, activity level, and care goals. Through advanced diagnostics and image-guided precision, we offer a patient-centered path to recovery that emphasizes long-term results.