Injectable Corticosteroids

Corticosteroids are potent drugs used to reduce inflammation in the body's tissues. They are different from anabolic steroids, which some athletes use illegally to increase muscle tone.

Corticosteroids can come in several forms: pills, liquids, creams, ointments, medications sprayed into the nose, and injectable medications.

Corticosteroid injections can treat a variety of skeletal, muscular, and spinal conditions. Some of these injections can be done by your health care provider during a routine clinic visit; others require a referral to a pain specialist.

Here are some of their most common uses:

• Osteoarthritis. People with osteoarthritis often develop pain and inflammation in their joints. An injection of corticosteroids into the affected joint can provide temporary pain relief for several weeks or months. After the treatment, you'll need to rest the joint for at least 24 hours for the best results.

• Low back pain. Lower back pain from muscle strains, ruptured disks, spinal stenosis, and other conditions may be treated with injectable corticosteroids to provide some relief. Lumbar radiculopathy is pain in the buttocks, hips, or legs that comes from a pinched nerve in the lower back. This type of pain can often be treated with corticosteroid injections near the pinched nerve. In cases of extreme pain, the drugs may be sent to the spinal cord area through a catheter. Sometimes other drugs like local anesthetics or narcotics are given in conjunction with the corticosteroid.

• Cervical radiculopathy. This is neck pain that radiates to the shoulder and arm. It happens when the vertebrae in the spine move closer together, pinching a nerve in the neck. Injecting corticosteroids near the pinched nerve may reduce swelling and relieve pain, giving the nerve some time to heal.

• Bursitis and tendonitis. Bursitis is a common condition that occurs when the fluid sac that normally cushions your joint spaces becomes inflamed and painful. Tendonitis is a common condition in which the tendons around muscles and bones become inflamed. The areas most often affected are the elbow, knee, shoulder, wrist, and hip. Injected corticosteroids can calm down the inflammation. But you must be careful because steroid use can cause the tendon to weaken or even rupture.

• Carpal tunnel syndrome. This condition occurs when a nerve in the wrist becomes compressed or pinched, causing pain and weakness in the hand. Injecting a corticosteroid into the wrist can provide immediate, though temporary, relief. An anesthetic like lidocaine may also be given in conjunction with the steroid.

Cautions about corticosteroids

Corticosteroids can have a number of side effects, including high blood sugar levels. For this reason, people with diabetes are advised to tell their doctors about their condition before taking any steroid medications.

Using injectable corticosteroids for a long period of time is not advisable because of additional undesirable side effects that can occur. These include osteoporosis, cataracts, delayed growth, stomach ulcers, and high blood pressure. You may experience short-term side effects such as local pain or infection at the injection site. Your provider will usually limit your total number of corticosteroid injections to three to four a year.

If you are considering taking corticosteroids to treat a muscular or skeletal condition, be sure to talk with your doctor about all the benefits and risks.