Dosage and side effects of corticosteroid injections introduction Almost all sports medicine and orthopedic providers utilize locally injected corticosteroid injections as treatment options.
Dosage and side effects of corticosteroid injections introduction Almost all sports medicine and orthopedic providers utilize locally injected corticosteroid injections as treatment options. It is important to understand and stay up to date on the evidence supporting the dosage and volume. Providers should also be aware and comfortable with common side effects following this treatment option.
Corticosteroids have antiinflammatory effects that allow for their benefit in inflammatory conditions. However, the mechanism of benefit in osteoarthritis is still unknown. A recent study used enzyme-linked immunosorbent assay (ELISA) and Western Blot in order to understand a potential mechanism.
Ultimately, it was hypothesized that corticosteroids protect against osteoarthritis through inhibition of IL-6 and IL-8, suppression of NF-κB and STAT3, and reduction of collagen I, MMP-1, and MMP-13 expression. Though the mechanism is still unclear, this pathology is likely the most studied and most targeted by corticosteroids. Locally injected corticosteroids are commonly used in clinical practice for reducing pain secondary to the inflammation associated with various musculoskeletal pathologies.
Indications include symptomatic osteoarthritis, inflammatory arthropathy, tendinopathy, bursitis, adhesive capsulitis, neuritis, and radicular pain. Formal guidance regarding the dosing or duration of corticosteroid injections is currently lacking, with conflicting recommendations by orthopedic surgery and rheumatology societies, particularly regarding injections to treat tendon pathology. A key factor when selecting a corticosteroid for injection is whether the preparation is particulate (i.e., insoluble) or nonparticulate (i.e., soluble).
Particulate corticosteroid preparations contain corticosteroid esters that require cellular hydrolysis to occur to activate and therefore last longer in the injected tissue in comparison with nonparticulate preparations that are freely absorbed and exhibit more rapid onset but theoretically shorter duration of action. The nonparticulate corticosteroid dexamethasone sodium phosphate (Decadron) is significantly smaller than an RBC and appears as a clear solution. In comparison, the corticosteroid triamcinolone acetonide (Kenalog) has a particulate size that, although less than 10 μm, is 12 times larger than an RBC.
If you are experiencing symptoms that may be related to dosage and side effects of corticosteroid injections, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
Connect with a doctor, physical therapist, or imaging center near you.
Find a Provider Near You →