Corticosteroids (intra-articular) for osteoarthritis

Examples

Injected

Generic Name	Brand Name
betamethasone acetate	Celestone
methylprednisolone acetate	Depo-Medrol
triamcinolone acetonide	Kenalog
triamcinolone hexacetonide	Aristospan

Intra-articular corticosteroids or steroids are medications injected directly into the joint space of a painful, inflamed arthritic joint. Steroids taken by mouth (orally) are not used for osteoarthritis.

How It Works

Steroids are similar to natural substances produced by the body (hormones) that help reduce inflammation. If inflammation is not a symptom of your osteoarthritis, steroids are less likely to be helpful.

Steroids may be used to reduce inflammation in tendons and ligaments in osteoarthritic joints.

Why It Is Used

If a person has not improved with treatment using analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs), an injection of corticosteroid into the joint can sometimes be helpful for short-term pain relief.

How Well It Works

Corticosteroids may relieve pain caused by osteoarthritis for a short amount of time (weeks to months).¹

If corticosteroid injections are helpful, symptoms may improve for weeks to months. Some people get long-term relief of 6 months or more with a single cortisone shot. If you have a moderate amount of fluid in the joint, your chances of responding are probably better.

Side Effects

Common short-term side effects include:

• Mood swings.
• Nervousness.
• Insomnia.
• Weight gain.
• Fluid retention.
• Very rounded (moon) face.
• Poor wound healing.
• Increased risk of infection.
• High blood pressure.
• Diabetes.

Uncommon short-term side effects include:

• Muscle weakness.
• Glaucoma.
• Stomach ulcers.
• Acne.

Long-term side effects include:

• Osteoporosis.
• Cataracts (uncommon).
• Damage to the hip, shoulder, or knee joints (uncommon).

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

There are several issues to consider with steroid injections for osteoarthritis.

The standard of practice is that steroid injections should be given only 3 or 4 times per year in a single joint area.

A small study suggests that injections every 3 months for up to 2 years is safe and effective in decreasing symptoms of osteoarthritis.²

Injection of any substance into a joint or tendon has a very small risk of harm, including damage to a tendon, ligament, or nerve; bleeding into the tissue; or infection. Although these rarely happen, your health professional will probably mention the possibilities to you before an injection into a joint.

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Author:	Robin Parks, MS	Last Updated: April 20, 2007
Medical Review:	E. Gregory Thompson, MD - Internal Medicine Stanford M. Shoor, MD - Rheumatology
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