Have you been recommended steroid shots for the pain?
While the shots do an excellent job at reducing immediate inflammation, they might be causing more damage in the long term than they are worth.
In a study conducted in 2015 (published in the Journal of the American Medical Association in May 2017), 140 patients with confirmed osteoarthritis with joint inflammation (synovitis). The patients were divided into 2 groups, saline injections and corticosteroid injections, every 12 weeks, for 2 years.
At the end of the study, both groups had no significant difference in pain with either class, but there was significant cartilage volume loss in the steroid injection group. That point can’t be stated enough.
After steroid injections every 12 weeks for 2 years, there was no difference for pain, but there was cartilage loss as compared to basic saline solution.
While painful OA might be very troubling to deal with, the most common treatment is steroid injections, and these will only make the case worse in time. Clearly, if you suffer from a lack of cartilage, treatments that will further destroy the cartilage are not ideal. This statement does not undermine the use of steroid shots, but against treatments of OA that are solely steroid shots.
As I’ve previously mentioned, osteoarthritis can be maintained or slowed once it’s created. It’s similar to rust on hinges. Joints with frequent proper movement are much less likely to get OA, while stationary or injury prone joints are very likely to get this condition. The best treatments for this condition are to start rehabilitating the poor muscle function or movement patterning. Reducing inflammation is an important step in starting this treatment, as rehabilitating the poor movement that is causing OA won’t be possible with substantial joint pain.
If you’re interested in reducing the inflammatory damage of osteoarthritis, in any joints of the body (not just the knee), encompassing treatment plans are imperative. Nutritional triggers need to be addressed, movement patterns need to be corrected, muscular strength needs to be improved and poorly functioning joints associated with the poor movement patterns also need to be addressed. One treatment cannot resolve this issue without all causes being addressed together.
If you check the other article on OA linked above, I stated there, and here, that there is always a poor movement pattern linked to OA. This is either in compensation (movement changes due to pain) or due to structural changes from abnormal bone growth. This is always present, and in most cases, present prior to the boney changes associated with OA.
Here at HFC, we highly recommend an anti-inflammatory diet, spinous adjustments, rehabilitory exercises starting with core reconditioning and working outward toward the most troubled areas as well as low level laser therapy or therapeutic ultrasound (depending on which joint is being treated). Any treatment plan that includes less than this extensive of a list, is not optimal to properly resolving arthritic conditions.
Of course, the more complicated the case, the more professionals are required to treat. There is not one single practitioner who should be taking on all of these treatments. As your doctor, I strive to be an integral part of your healthcare team, not the last stop you make in healthcare.
If you’re interested in having Dr. Herrington become part of your healthcare team, call to schedule your appointment today! 716-308-2881
Mcalindon, T. E., Lavalley, M. P., Harvey, W. F., Price, L. L., Driban, J. B., Zhang, M., & Ward, R. J. (2017). Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis. Jama, 317(19), 1967. doi:10.1001/jama.2017.5283