Are steroid injections your only option?
Corticosteroids or cortisone shots, as they are also known by, are regularly over-used when it comes to musckuloskeletal pain. Patients often are unaware or don’t understand the risks involved with these injections. If you are someone who watches professional sports you have no doubt seen a player leave the game with a tweaked knee and return later after receiving a steroid injection. You may be surprised by how many people pursue injections because of how this treatment is portrayed during professional games. These injections stop the inflammatory process and allow you to quickly return to activity, and for someone who has to perform athletically for their job, the benefits may outweigh the risks. While corticosteroids decrease inflammation and pain, they also degrade soft tissue structures such as muscle, cartilage, and ligaments. Patients who regularly receive these injections have a much higher risk of osteoarthritis and needing orthopedic surgery. As a chiropractor these treatments are outside of our scope of practice, which they should be since we rely on conservative management of pain. I am seeing more offices starting to use trigger point injections for no other reasons than it attracts patients and increases their average cost per visit. There is no evidence that shows these injections are more successful than manual therapies but they have that “wow factor” that grabs everyone’s’ attention. Most often these injections are not followed up with thoroughly. Therapy patients are told to take it easy but that they can return to regular activity when they feel up to it. This leads to a very high risk of recurrence of injury. As a sports chiropractor I often get asked if I ever refer out for these injections, which I typically respond that I am very reluctant to do so.