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Do Steroid Injections Melt Bones and Weaken Joints?

When knees or hips hurt, life gets hard. Climbing stairs is challenging. Hiking hurts. Steroid injections are tempting. Do they cause damage?

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. 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). 

Steroid Injections into the Hip and RPIA:

RPIA stands for “Rapidly Progressive Idiopathic Arthritis.” In other words, severe inflammation of the hip joint from unknown causes. An article in Skeletal Radiology, May 20, 2021 suggests that steroid injections into the hip joint could be contributing to this condition. The authors conclude:

“We found that approximately 7% of patients undergoing steroid hip injection developed RPIA.”

This isn’t the first time steroid injections into the hip have been linked to serious complications. These authors call it RDOA (rapidly destructive osteoarthritis) of the hip (Arthroplasty Today, Feb. 2, 2018). They describe it this way:

“RDOA of the hip is a phenomenon that is not well understood. It is a debilitating condition that results in rapid destruction of the femoroacetabular joint, leading to pain and decline in function, ultimately resulting in THA [total hip arthroplasty]. 

“The results of our data set suggest that 21% of patients who have an intra-articular steroid hip injection develop RDOA of the hip.”

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. If you prefer to hold a book in your hand, we have also created a 104-page booklet. You will find it at this link

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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