Steroid Injection Risks: STOP INJECTING PATIENTS WITH STEROIDS!!! - Regenexx®


steroid injection risks

I love blogging about my experiences in clinic, especially the ones that make my blood boil. One of those blood boiling issues is steroid injection risks. This past week, while seeing patients at our licensed, advanced stem-cell-culture site in Grand Cayman, I saw a guy whose hip MRI from December wasn’t that bad. In fact, it didn’t fit with his quickly declining function and elevating pain. A quick preprocedure X-ray confirmed what I had feared—two steroid shots he had in that hip a few months back had accelerated his arthritis like pouring gasoline on a bonfire. So this post is aimed squarely at the legions of physicians who continue to use steroids…

Steroid Injection Risks Are Nasty

Physicians around the country inject high-dose corticosteroids in joints like it’s holy water. The dose they use is based more on medical tradition than on science. You see, while the milligram-dose range used sounds small (after all, it’s only a thousandth of a gram), to the body it’s massive. In fact, it’s a million times too much as the joint and cells of the body are used to seeing a billionth of grams (nanograms).

What happens when you dramatically overdose tissues used to seeing nanograms of steroid with milligrams? Bad stuff!

Why, Then, Are We Still Injecting Patients with High-Dose Steroids?

Steroids are an inconvenient truth. They can make a patient feel better for a while, but they also likely cause more long-term harm than good. So why do we use them? First, many physicians don’t have anything better to offer. Let’s be honest here. In a world where regenerative-medicine solutions are exploding, that’s just a simple lack of imagination and knowledge on the part of the physician. Second, they’re covered by insurance, and many physicians have a hard time thinking outside of the insurance box, even if what’s in that box is not in the best interest of the patient.

How We Can Keep Our Insurance Overlords Happy and Help the Patient

When we first began using stem cells in 2005, the research was clear that nanogram-dose (ultra-low-dose) steroids was what the body was meant to experience. Meaning when you look at in vitro studies where cells are exposed to corticosteroids, the appropriate dose range to get an effect is in the tens- to hundreds-of-nanogram range. This is more than enough to activate receptors. In fact, steroids in this dose range can do some cool things, but steroids in the much higher milligram-dose range (one million times more) kill cells. Hence, the solution would seem to be simple: given the steroid injection risks, if you have to use steroids, why not just use them in the appropriate dose range for the body?

We’ve been using nanogram steroids for a decade now, and I can tell you that they work very similarly to their bigger milligram-dose cousin. You observe the same suppression of inflammation, and you’re not killing cells. In fact the only time I’ve seen them not work is in a patient with severe inflammation due to a systemic disease or in a patient whose body has gotten used to the sledgehammer effects of high-dose steroids.

The upshot? Ladies and gentleman, madams and monsieurs…it’s time to ditch the high-dose steroids! Just use the low dose version to protect your patients!

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.
Read 20 Comments
  1. This makes total sense to me! I’ve been getting steroid injections for years due to my knee issues. They don’t even work anymore in fact I had a euflexxa injection, it was supposed to be 1 out of 3 when they first came out when they used chicken combs and had a massive reaction where my entire leg swelled and I couldn’t walk for a week. Needless to say I didn’t finish that series. Since then I’ve had multiple injections of other steroids. 18 months ago I still had cartilage in my knees, not much but some. I just had 3 MRIs 2 months ago and have NO cartilage left, which I was left with the option of you guessed it… A 35 year old with partial knee replacements. I am not overweight at 5’6″ 130lbs and am very active so I shouldn’t have declined so rapidly. I haven’t done replacements for one I’m 35 and two bc I saw your postings and now know what I want to try. Of course, that takes $ that I have to make, but hopefully in time I will be able to have stem cell injections and not be on pain pills as I am a nurse and have to grin and bare it through a 12 HR shift without my pain meds.

  2. I KNEW IT!!! Last January I was evaluated by a PA at Kaiser who said I had mild arthritis in both hips. He recommended a steroid injection to help with the pain. I got it in my right hip and it felt great for a week. Then the pain returned but it was twice as bad. So bad I’ve had to walk with a cane for the last 7 months. It hasn’t gotten much better despite physical therapy and regular water aerobics. A recent MRI indicated I now have moderate to severe arthritis in the hip that was injected…how did I go from mild to severe arthritis in 7 months? When I’ve asked the medical people involved with this if maybe the steroid had made things worse for me they play dumb and act as if I’m loony for suggesting it. I’ve just had PRP and hope I’ll see some improvement. JUST SAY NO TO STEROID INJECTIONS!

  3. Epidural Steroid Injections are the number one cause of Spinal Arachnoiditis. I know because I have it!!! How can physicians keep injecting this poison into our bodies even know the FDA has a warning on the box stating that it is NOT to be use in the spine???

  4. I have a suspicion, after reading many of your notes on injectable steroids, that I seem to have developed a type of “tendonitis” in my upper arms due to multiple elbow steroid injections. I have had 4 in my left elbow (worst arm) and 2 in my right, about 5yrs ago. I have been having this tendon problem for about one year now, and not one doctor can figure out what’s wrong. One actually said “it seems like tendonitis”, but no cause or cure was suggested. The steroid injections is the only common denominator here. The right arm is affected as well, but not nearly to the degree of the left (and I’m right handed, so maybe the strong arm is less affected, plus I only had 2 injections there). Is there hope for acute tendonitis in my bicep/tricep area?

      1. I do not have MRI’s for my arms. I have had every other test known to man but nobody thought an MRI was appropriate for the “problem”…..which by the way, they couldn’t figure out. I live in the Detroit area, is there a clinic nearby to visit?

  5. You post an isolated incident… what about the millions of people who continue to have a reasonable quality of life with steroid injections. Until a reasonable, affordable alternative is found, this is one of our best options. Like it or not, our options are limited. With that said, I do respect the work you are doing and look forward to seeing your successes in the future.

    1. Thanks Robert. We see this in clinic all the time. Our problem with steroid shots is the damage they do to patient’s joints. They breakdown cartilage, can damage tendons and they’re lethal to the stem cells living in the joints. When possible, hylauronic acid (Supratz, Synvisc, etc.) which is basically a lubricant and does no damage can often help for a few months at a time. Many people find Curcumin helpful for pain and inflammation. Please see:

  6. Was glad to find this article when researching dangers of cortisone injections in joints. I worked with thoroughbred race horses for 15 years and saw the damage to their joints over time with cortisone injections. Their joints seemed to become much more painful (breakdown of cartilage) over time until finally they’d be retired if worth anything as a stud or put down if no rescue organization stepped in.

    I’ve been anti-steroids (both oral or injections) all my adult life. I can’t imagine anything good coming from suppressing our immune systems.

    I’ve recently been diagnosed with osteoarthristis, and psuedo-gout. I went to get a Supartz injection (the most painful thing I’ve ever experienced) and specifically told the doctor no cortisone. Of course when I asked for a copy of my medical record, he had indeed injected cortisone in my knee.

    I see a Rheumatologist tomorrow and all my research on pseudo-gout says cortisone injections for the pain. I’m gathering facts to present as to why cortisone injections are dangerous and I refuse that procedure so they don’t just call me a kooky senior.

    Thank you for this article so I can provide documentation to the doctor. My comparison to the damage I’ve seen cortisone injections cause in racehorse never seems to get the point across, but I’ll go in armed with what I’ve learned from this article. And I see you have a clinic in Chicago. Do they treat osteo arthritis and pseudo-gout?

  7. I have had 5 shots for my spinal stenosis and the shots help some. I realize how much when they wear off. I am afraid of steroids but the pain sends me to the Doctor everytime. If not steroid shots what other options are there? I do excerises that I was taught in therapy. I try not to do anything to stress my back. The pain is only relieved by sitting in my chair and that is not good for me or healthy at all.

  8. Hi, this is interesting! I had a steroid injection into my shoulder joint about 3 months ago and I’ve been so unwell ever since with all sorts of hormonal problems that no one can get to the bottom of. Can I ask what you mean by the cortisol -pituatry axis? When I googled my symptoms it takes me to Cushing’s syndrome, which talks about cortisol. Any help/advice be great x

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