What are Some of the Dangers of Steroid Injections?
As most of us know from recent extensive news coverage, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are coordinating a multi-state investigation of fungal meningitis among patients who received an epidural steroid injection. Several of these patients also suffered strokes believed to have resulted from their infection. As of mid-October, 24 deaths had been reported.
Any time you have any kind of injection, you are at risk of complications. Steroid injections create additional complications as well as the risk of infections. The real question is “Are there alternatives to these injections?”
Are PEMFs A Viable Alternative Injury Recovery Therapy?
Several months ago, I twisted my knee getting out of my seat on an airplane. It was immediately sore, and I started using my PEMF (Pulsed Electromagnetic Field) therapy as soon as I got home. I even walked every day – 3 miles, as I usually do, using a MicroPulse under a knee brace. About a month later, I still had discomfort when I placed any pressure on my knee, so I went in for an MRI, which revealed a mild ACL strain and a slightly torn lateral meniscus.
I saw a well known orthopedic surgeon, who told me not to do anything strenuous. He offered me a steroid injection for my knee. I declined, saying I would continue with my PEMF therapy instead. As expected, he scowled at my choice.
Nevertheless, I left without the injection, and continued to use my PEMF for the next month, with my knee now feeling essentially normal. Obviously, my body has not yet repaired my ACL or meniscus, but I did not get or need the injection to relieve the pain.
Why did I refuse the steroid injection? Because, as a doctor, I knew better. I have given steroid injections throughout my career, just as most other doctors do. But it always bothered me that the risks probably outweighed the benefits a large part of the time. At that time, these were the only options I had available. This is one of the reasons I began searching for other alternatives for pain management, and in the end, found PEMFs.
What Are Steroid Injections And How Do They Work?
Getting back to one of the two main points of discussion for this post, many people who are looking into some type of treatment or therapy for the first time aren’t even clear on exactly what steroid injections are or how they work. In fact, ‘what is a cortisone shot?’ is one of the first questions that doctors who offer those types of treatment often get when meeting with a new patient for the first time. So with that in mind, let’s take a moment to cover the basics:
Steroid injections are vials filled with cortisone that are injected into whichever part of the body is in need of pain relief or management. Typically, they are injected directly into the joint which you are experiencing trouble with. This includes knees, hips, ankles, elbows, wrists, spine or shoulder injections. Some people who have chronic arthritis of the hands or feet may even get them in the small joints on their fingers and toes.
A slightly less common but still frequently used option is that of an epidural, which is typically a procedure focused solely on the lower back. In this method of therapy, the cortisone is injected much closer to the nerve roots and spinal cord. The goal is to provide relief to the pressure on the nerves. Unfortunately, this procedure requires the use of a local anesthetic which, while providing short term relief to the pain during the procedure and shortly thereafter is also very painful and can be quite sore for a few days following after. And even after all of that, it could still take a few weeks to begin experiencing real, noticeable results.
In addition to all this, there is also the increased risk of infection and, of course, fungal meningitis. This is due to the fact that the local anesthetic must be injected into an area which may already be suffering from severe inflammation. Regardless of whether you opt for an epidural for back pain or a joint injection, the risks can be much greater than the actual reward. The bottom line is, as you will see as you read on further, is that cortisone shots can not only create new and serious health complications, they can also actually make the one they are meant to be treating worse in the long run!
How Long Before Steroid Injections Begin To Take Effect?
There are a number of different variants that impact the timetable as far as when you can expect noticeable results from your treatment. These factors include such things as your overall health and wellness, your daily activity levels, age and many, many others. As was just briefly mentioned, it can take up to a few weeks before you begin to really notice the results that a steroid shot for back pain may have on you. There are also some patients who begin to experience some benefits in as little as a week. In some cases, it may take up to six weeks before you see the full effects.
How Long Do Steroid Injections Last?
This is something else that also depends greatly on the individual patients and their unique situation. The fact of the matter is that there is an overwhelming amount of evidence mounting that the longer and more frequently you take these injections, the more long-term problems they actually create. So when people are undergoing this kind of therapy, it is critical that they don’t “overdue” it.
Medical experts and doctors also disagree on exactly how many times per year these types of steroid injections are even advisable. Opinions vary from 3 to 6 cortisone shots over a 12 month period as being acceptable. I don’t know about you, but with something as serious as steroid injections and with all of the possible detrimental effects it could have on my body, I would certainly want a more reliable range than “half to double” the risk of detrimental effects.
Regardless of which medical school of thought is correct on the number of shots that you could or should get in a year, a recent study in the Journal of the American Medical Association proved that after two years, they have virtually no further effect on pain. In fact, in many cases, they end up making it worse. But as far as a reasonable timeframe for experiencing the benefits that may come from steroid therapy, up to 3 months is most commonly the longest. However, many patients experience a shorter period of relief from the pain and inflammation associated with these kinds of treatment regimens.
What Are The Risks of Steroid Injections for Recovery and Pain Relief?
I know these injections do not cure anything. In fact, they do create risks, not the least of which is the risk of infection. Steroid injections into tissues always (let’s repeat that—ALWAYS) thin out the tissues into which they are injected. That is why doctors will typically tell you that you can only get 1 or 2 steroid injections in the same area.
If you do a steroid injection into a ligament, it increases the risk of rupture. If you inject them into the skin, you almost always will get a little pock mark. These are potent anti-inflammatory and tissue destroying injections. Yes, they decrease inflammation and improve comfort, but only temporarily.
So, knowing this, why do doctors continue to use them? Because they don’t know other alternatives – and since they bought the steroids and have them in their fridges, they at least need to get their money back, because they expire if not used in time.
Are There Any Additional Risks Associated With Steroid Injections?
Unfortunately, it would take this entire post and several more just like it to truly cover all of the various concerns and dangers which accompany steroid therapy. However, that doesn’t mean that it isn’t worth the time to go over some of them anyway. After all, if you are going to put yourself and your physical health and wellbeing into the hands of someone who is recommending this method of treatment, then you should at least know some of the negative factors associated with it as well.
Of the many possible steroid shot side effects that you experience, some of the more alarming and serious one are such conditions as cartilage damage, nerve damage, death of nearby bone, joint infection, weak or ruptured tendons, osteoporosis, thinning of the skin and/or tissue around the injection area and numerous others. And even with all of this you still have the most serious risk of all, mentioned in the opening; fungal meningitis. When you start adding up all of the many disturbing health issues that could arise as a result of these procedures, it really makes sense as to why so many people like you are looking for an alternative method of treatment such as PEMF.
When you stop to consider not only the major risks that go along with cortisone shots and epidurals, but also the dozens, if not hundreds, of minor to moderate concerns as well, it really makes no sense to not at least look into alternative options…
What About Alternative Recovery and Pain Therapies Using PEMFs?
At www.drpawluk.com, we offer alternatives to steroids – alternatives that are safe, noninvasive, and non-toxic. In addition, they actually help with the healing of the underlying tissue when possible. When it is not possible, even the steroids don’t help. PEMFs almost always help at some level with the underlying problem. More importantly, you don’t need to see a doctor for this therapy, after you have your diagnosis and have been recommended a treatment plan. You can do PEMF treatments at home, on your own, at your convenience, and with virtually no risk. And, other people in the household can benefit as well.
Sometimes, steroids are a good idea. There are major infections and conditions that steroids provide important help with. In these cases, steroids should be strongly considered. Conditions like these include bad poison ivy rashes, major infections called sepsis, severe asthma, severe flares of rheumatoid arthritis and other autoimmune conditions which can be disabling or life-threatening. Rarely are orthopedic steroid injections medically necessary, whether epidural or into joints or ligaments.
Steroid injections can be placed into the skin or muscle directly, into ligaments or tendons, into joints, including spinal joints, or into the space overlying large nerves, including the spinal cord. This is considered the epidural space, where these meningitis-causing injections were given. Epidural injections are frequently given for chronic back pain. They may or may not work, and are very uncomfortable. Obviously, they carry the risk of infection into the nervous system, plus other potential complications including bleeding and paralysis.
What is The Process of Recovering From Injury Using PEMF Therapy Like?
So, in my medical experience, I will now always try to do the noninvasive, non-toxic, safe approach to treating pain before I ever resort to injections. Additionally, my goals are to have you be able to do your own treatments at your own convenience, with the additional expectation that we will actually have the hope of helping to heal the underlying tissue and cause of the pain. This is one of the reasons the Dr. Oz show supported the use of PEMFs—to help heal the underlying cause of the pain instead of simply treating the symptom.
Clearly, tissues need time to heal. Anything that gives you immediate relief for a chronic problem is either a drug, procedure or surgery. These approaches frequently don’t work for long, or have complications. The complications may be permanent and irreversible, and are usually unpredictable. Again, this is why I always try to do a more conservative approach first, typically using PEMFs.
PEMFs have been found to decrease inflammation too, and very well at that. Maybe they don’t do this as dramatically or quickly, and that’s the seduction of steroid injections. You will usually know within a week whether the steroid injection is actually working. Even then the benefits do not last for long if the underlying cause is not managed as well. In addition, PEMFs have the potential to reduce swelling, improve circulation and stimulate tissue healing. They also have the additional benefit of being able to actually reduce pain directly, called anti-nociception. In fact, in animals and humans they have been found to be equivalent to about 10 mg of morphine, without using the morphine.
How Does PEMF Therapy Work For Pain Relief and Recovery?
As discussed on the Dr. Oz show, most doctors do not know about these alternatives for pain management. Even if they did, doctors typically keep doing what they are doing unless forced to change. Sometimes a change happens because doctors make mistakes or end up with complications and have to learn different approaches. Sometimes the finances of the procedures drive doctors to use particular approaches. Sometimes change happens only because everyone else begins doing something different, and the doctors don’t want to stand out. In the end, doctors are typically creatures of habit. And as we all know, habits are hard to change.
As you can see, the rationale for why certain treatment approaches are offered may have nothing to do with the patient’s best interests or the most effective approach to the problem. PEMFs are a very rational, safe approach to chronic pain management, potentially offering a significant solution to the problem, reducing the pain a large percentage of the time with no complications and potentially healing the underlying cause of the pain, for relatively little cost and great convenience.