Corticosteroid Injections 101: Understanding Steroid-Based Pain Management

The Inside Scoop on Corticosteroid Injections

According to the CDC, approximately 20% of U.S. adults experienced chronic pain between 2019 and 2021, leading millions of Americans to seek treatments and therapies for relief. Corticosteroid injections are one such therapy that many physicians and patients turn to for managing musculoskeletal and soft tissue pain.

Corticosteroid injections, often called cortisone shots, are anti-inflammatory injections administered by trained healthcare professionals to help alleviate pain. These injections target inflammation and swelling at the injection site, providing relief for conditions like arthritis, joint pain, tendinitis, sciatica, and inflammatory bowel disease. By delivering corticosteroids directly to the inflamed area, these injections can reduce pain and stiffness in targeted muscles and joints.

How Do Corticosteroid Injections Work?

Corticosteroids represent a class of steroid hormones. Acting as the body’s chemical messengers, hormones are produced in glands and communicate with various organ systems. Cortisone, hydrocortisone, and prednisone are common corticosteroids that are naturally produced in the adrenal glands and help regulate inflammation.

The Chemistry Behind Corticosteroid Injections

Corticosteroids are chemically similar to cortisol, the body’s primary stress hormone. This similarity allows them to turn off specific inflammatory genes within cells and reduce inflammation at the source. When a corticosteroid is injected into an inflamed joint, for instance, it triggers reactions that turn off inflammatory genes and activate anti-inflammatory ones, resulting in reduced inflammation at the cellular level.

Corticosteroids also interact with the immune system, a key contributor to inflammation. They can decrease the number of immune cells like lymphocytes, granulocytes, and macrophages, which in turn reduces inflammatory responses and alleviates systemic inflammation.

Common Steroid Treatments for Pain

Corticosteroid injections can be tailored to address pain in various regions of the body, offering targeted relief for different tissues and conditions.

Epidural Steroid Injections (ESIs): Used to relieve back pain, ESIs involve injecting corticosteroids into the fat-filled area around the spinal cord to reduce pain and inflammation.
Joint Injections: Corticosteroids are frequently injected into joints to provide targeted relief from pain and inflammation in conditions like arthritis and sciatica. Conditions such as Inflammatory bowel disease (IBD) may also benefit indirectly from these injections and any systemic impacts.
Trigger Point Injections: Designed to alleviate muscle pain, trigger point injections typically include a local anesthetic to numb the area, and corticosteroids may be added to further reduce inflammation. These injections target specific tight or knotted muscle areas, helping to relax the muscle and relieve pain effectively.

Advantages and Disadvantages of Corticosteroids

Corticosteroid injections are highly effective for short-term relief, often working faster than over-the-counter anti-inflammatory drugs like ibuprofen. However, it’s essential to note that these injections provide temporary relief, with pain symptoms usually returning after a few weeks or months.

While corticosteroids can effectively reduce inflammation, long-term use can lead to side effects, particularly with repeated, high doses. Some potential side effects include:

Altered stress responses
Blood sugar fluctuations
Reduced bone density
Weight gain
High blood pressure

Extended use of corticosteroids can also result in adrenal suppression, where the adrenal glands reduce their natural cortisol production, making the body increasingly dependent on the medication. Due to these risks, corticosteroid injections are generally recommended for short-term use only.

Imaging-Guided Interventions for Accuracy

Imaging such as MRI scans are often acquired before administering corticosteroid injections to accurately identify the inflamed areas and guide treatment planning. During the procedure, real-time imaging methods like ultrasound or fluoroscopy help ensure precise placement of the injection. By using live imaging guidance and ensuring the medication targets the correct area, the trained providers can improve the safety and effectiveness of each injection.

Take the Next Step

If you’re experiencing chronic pain and exploring treatment options, corticosteroid injections might offer you significant relief. At Ospina Medical, Dr. Matthew Kohler and our team are dedicated to providing high-quality care tailored to your specific needs. Schedule a consultation with us to learn more about your options and take the first step toward a pain-free life!

Written By: Sudheshna Thirunahari

Edited By: Camden Rowe

Medically Reviewed By: Matthew Kohler, MD