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Do Steroid Injections Melt Bones and Weaken Joints?

When your knees hurt, life gets harder. Climbing stairs can be challenging. Hiking hurts. Steroid injections are tempting, but do they cause lasting damage?
Close-up Of A Cosmetologist Wearing Blue Surgical Gloves Makes Rejuvenation Beauty Injection On Woman’s Knee

Years ago, a physician shocked us by stating on our radio show that corticosteroids melt bones. We thought he was exaggerating. It turns out, however, that both oral corticosteroids and steroid injections are not good for either bone or connective tissue. You can read more about such complications at this link. This reader of our syndicated newspaper column reinforces that message.

Steroid Injections Are “Good for Business”

Q. Two decades ago, my mother’s orthopedic surgeon said rheumatologists are good for their business. The arthritis doctors often inject joints with corticosteroids. Then their patients find themselves consulting an orthopedic surgeon for joint replacement due to the destruction of cartilage in the injected joint.

I too have osteoarthritis, but for the last ten years I’ve have opted to treat mine with daily curcumin supplements. Annual X-rays show the destruction of cartilage in my joints has been arrested, and I am pain-free with full mobility.

A. Your mother’s orthopedic surgeon was ahead of the curve. Just last June, a study demonstrated that corticosteroid injections into the knee are associated with more rapid progression of knee osteoarthritis (Osteoarthritis and Cartilage, June 2019).

Curcumin is the active ingredient in the yellow spice turmeric.

A review of randomized controlled trials (RCTs) concluded:

“…these RCTs provide scientific evidence that supports the efficacy of turmeric extract (about 1000 mg/day of curcumin) in the treatment of arthritis” (Journal of Medicinal Food, Aug. 2016). 

More Stories About Steroid Injections:

Sharon shared this experience with her knees:

“At 55 years of age both my knees were getting very painful after working as a licensed massage therapist for nearly 20 years. I was in so much pain at one point I had to have some relief. I agreed to ‘the shots.’ I had them in both knees at once, and things went DOWNHILL after that! I should have known better! The steroid injections never gave me any relief.

“I had my left knee replaced when I was 57. That was 5 years ago. I went to three different PTs trying to get better, to no avail! The PT mentioned how damaging steroid injections are. My knee only bends to 88 degrees, and the surgeon feels that is ‘sufficient for daily living!’ Wrong! It is nowhere near enabling me to live a normal life without pain!”

Frank had a somewhat similar experience:

“I was getting those shots for about two years or so. They only helped a short time. I think I did get worse much sooner with the steroid injections. I had to have total knee replacement of both knees.”

Can Diet Fight Inflammation?

Brandy says that a different diet made a difference for her:

“Four years ago my knees were so bad I had trouble walking up stairs. Even walking around the block was challenging. I had the steroid injection. They offered temporary relief. The orthopedic surgeon said the only answer was full knee replacement. The joint had advanced osteoarthritis and bone on bone with ‘no cartilage.’

“I started looking for alternatives. I committed to a whole food, plant-based diet with limited sugar and oils and regular exercise. Today, at 65 years of age, I am heading out for a 50-mile bike ride. Yesterday I was hiking 5 miles in steep territory, and the day before I swam a mile. I wouldn’t believe it if you told me this would be possible 4 years ago.”

Not everyone benefits from such a dietary change. But anti-inflammatory foods can make a difference for people suffering from pain and inflammation. So can the active ingredient curcumin, found in the yellow spice turmeric.

Curcumin and Arthritis:

Paul offers the following anecdote:

“I started taking Turmeric Curcumin pills after reading about its possible effects on pain. I work sitting in front of a computer all day. I had terrible pains in my hip, leg, and back. After a few weeks of taking one pill a day my pain was greatly relieved. I’ve been taking three pills a week and have had no recurring back problems for three years now.”

Pamela also found curcumin helpful:

“Motrin was my go to drug for all aches, pains, cramps and headaches for 17 years. The last couple of years I developed peripheral edema that eventually crept past my knees. I heard a doc say that all NSAIDs cause salt retention and therefore water retention. I stopped the Motrin, lost 35 lbs, and resolved the edema. I often wonder if it didn’t play a role in the development of my high blood pressure.

“I eventually found curcumin to be effective but I was taking the max in capsules. I have now found that I can add black pepper and coconut milk to powdered curcumin. It works very well, and I have been able to reduce my dose.”

Laverne reports that curcumin saved the day after steroid injections:

“Several years ago I was getting a steroid injection for pain every 5 months in my left knee. I had been diagnosed as having ‘advanced arthritis.’ After four or five shots, I started taking a good quality capsule of curcumin, the active ingredient in turmeric. It started helping in a few weeks and is still working years later if I don’t overdo being on my feet. What a blessing! I hope I’ll never need a knee replacement.”

One word of caution: both turmeric and curcumin might interact with anticoagulant drugs to contribute to dangerous bleeding. To learn more about medications and nondrug treatments for joint pain, you may wish to read our eGuide to Alternatives for Arthritis. There is a section on curcumin and trustworthy products. This online resource is available in the Health eGuide section of this website.

Share your own story about steroid injections in the comment section below. 

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I started taking tumeric for back pain. After a few days, I noticed I was having problems with constipation. The longer I took the tumeric, the worse it got. Once I stopped taking it, the constipation got better. The tumeric did help my back pain but wasn’t worth the abdominal issues it caused.

For knee inflammation I was taking a curcumin tablet. I did not see noticeable benefit out of it. While shopping at Costco, there was a demo on liquid curcumin. I tried it, and it was tasting good. I immediately bought a bottle and have been taking for 2 months, and it seems to be working well. I think the liquid version is better absorbed.

The beginning of the article mentions all steroids, not just injection. My husband’s severe asthma requires oral steroids to get it under control. What are his options? Take the steroids or have coughing and limited oxygen intake?

This is interesting about knees, but is there info about epidural steroid injections for osteoarthritis? Has anyone had the same side effects?

They tell me my knees are bone on bone with no cartilage. I have had a problem with them for many years. This last summer I had the cortisone shot in both knees. One knee it didn’t hurt much but the other one was super sore and it about put me under the table.

They told me to try it for a couple months and I could come back for the ‘chicken comb’ type of injection in a couple months if I wanted to. I remember them saying however that after the chicken comb injection it would be nothing but the whole knee replacement for improvement. That made me uneasy.

I noted that the cortisone injections maybe helped for a couple weeks but I was in no hurry to return. I do NOT want to have the knee replacements. I have been taking curcumin for several years so decided to just continue with that and do the best I could. I can’t seem to increase what I am taking or I begin to have bloody stools and nosebleeds so I think I am at my max for that.

I seem to be doing ok as in not getting worse so hanging in there and still not planning on a knee replacement. I also take a few other supplements too so will keep doing what I am and hope for the best.

Beware: even natural supplements can have side effects for some people. After reading an earlier article recommending curcumin/turmeric supplements for knee pain, and clearing it with my ortho doctor, I started taking it once a day. Within the first week, I began having debilitating dizziness and balance problems. Since the turmeric was the only new addition to my regimen, I looked up its side effects online and found a warning about severe dizziness in some patients. Stopped taking it. Dizziness and balance problems gradually subsided, then disappeared completely.

I have RA and six years ago I had a terribly swollen knee with a Baker’s cyst. My Rheumatologist drained it and injected a steroid. All those years on I am still good at 72 and cycle or walk every day. In fact it is my better performing knee! So it’s not all bad news. I also am lucky to do well on my meds.

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