People with osteoarthritis in their knees sometimes opt for corticosteroid injections to ease the pain and inflammation. Is that a good idea?
The study involved 140 middle-aged and older adults (average age 58) who had pain and inflammation, called synovitis, from knee osteoarthritis. They were randomly assigned to get an injection in their knee joint of a corticosteroid (triamcinolone) or a placebo (saline) every three months. All participants had MRI scans periodically to assess their knee structure and measure progression of the disease. After two years, there was essentially no difference in knee pain between those who had gotten steroid injections and those who had not; pain had declined slightly in both groups. However, loss of cartilage, indicating progression of the condition, was greater among those who had gotten the steroid injections.
People with knee osteoarthritis, which is caused by the breakdown of cartilage that normally acts as a shock-absorbing cushion in the joint. Most often this is due to normal wear-and-tear on the knee, but it can stem from injury, too. The result is pain, swelling and stiffness that can inhibit movement. Treatments include exercise, pain medicine and possibly surgery. Whether steroid injections are helpful or harmful has been debated for years.
Data on pain came from the participants’ responses on periodic questionnaires. The researchers noted that “it is possible that the dose or frequency [of steroid injections] was insufficient to generate sufficient anti-inflammatory effect to reduce pain in the long term.”
May 16 issue of JAMA (jama.com).
The research described in Quick Study comes from credible, peer-reviewed journals.