A common form of relief for arthritis sufferers may make the condition worse, two new studies have found.
Both studies, presented at the Radiological Society of North America (RCNA) annual conference last month, found that corticosteroid injections – used to relieve the pain of knee osteoarthritis – were actually associated with progression of the disease.
One study was carried out by researchers at the University of California, San Francisco (UCSF), and the other was presented directly to the RCNA annual meeting.
Read: How to manage knee osteoarthritis
In the first, the UCSF researchers looked at data from participants in a long-term study called the Osteoarthritis initiative. They compared MRI data from patients receiving either corticosteroid injection or a hyaluronic acid injection to data from a control group receiving neither treatment.
Analysing MRI images captured at the time of treatment and two years later, they observed clear evidence that those receiving the steroid injections had greater progression of osteoarthritis in the knee compared to the other groups.
The second study used a similar methodology, taking images two years apart, but using X-ray imaging to make the comparisons. This method yielded similar results, finding greater disease progression in the patients receiving corticosteroid injections. Conversely, potential long-term treatment benefits were seen in patients receiving hyaluronic acid injections.
Dr Upasana Upadhyay Bharadwaj, from the UCSF department of radiology, hailed the study as the first direct comparison of corticosteroid and hyaluronic acid injections using MRI.
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He said: “While both corticosteroid and hyaluronic acid injections are reported to help with symptomatic pain relief for knee osteoarthritis, our results conclusively show that corticosteroids are associated with significant progression of knee osteoarthritis up to two years post-injection and must be administered with caution.”
It should be noted that neither of the two studies have yet been peer reviewed or published in a medical journal. Nevertheless, the similar findings of both suggest that Dr Bharadwaj’s call for caution is sound.
Dr Jonathan Samuels, a rheumatologist at NYU Langone Health, says it’s too soon to definitively say corticosteroid injections are harmful.
“We don’t have the biology to prove that the injection itself is causing accelerated damage,” he said. “It’s hard to connect the dots from injection to damage from this preliminary data. But it’s an important question, because it’s such a common practice to be injected with steroids.”
Read: Can supplements or diet reduce symptoms of arthritis?
As concerning as the findings are with respect to corticosteroid injections, the news for hyaluronic acid injections appears to be positive. Also known as hyaluronan, hyaluronic acid is produced in the body as a lubricant, and oral supplements are thought to be a helpful treatment for osteoarthritis.
Previous studies have indicated that a combination of oral hyaluronic acid supplements with injections could significantly reduce knee pain in people with osteoarthritis, particularly for those in the 40- to 70-year age group, and may prolong pain relief, allowing for a longer timeframe between injections.
Osteoarthritis is the most common form of arthritis, with figures taken from the government’s 2018 National Health Survey indicating that 2.2 million (9.3 per cent) Australians suffer from the condition.
Do you suffer from osteoarthritis? Have you been having cortisone treatments to manage the pain? Why not share your thoughts in the comments section below?
And what do you think about taking steroids, how positively do they affect the treatment of arthritis? I just know that many doctors prescribe steroids to treat joint problems.