Overview
Steroid injections are artificially produced in a laboratory and mimic the naturally produced hormone known as cortisol.
When given according to the proper dosage and administration, steroid injections may be beneficial in treating various medical conditions. However, when administered inappropriately, adverse effects can occur.
Steroids are not available over the counter; therefore, a doctor’s prescription is necessary before use. Otherwise, it may cause life-threatening effects too.
This article provides comprehensive knowledge of steroid injection, including its dose, benefits, side effects, and risks.
What Are Steroid Injections?
Steroid injections are manufactured in laboratories in a similar way to the adrenal gland that makes cortisol. The term “steroid” refers to corticosteroids, which are not hormone-related like some athletes take. The injections are also called cortisone shots, cortisone injections, steroid shots, or corticosteroid injections. It decreases inflammation and suppresses your immune system when you take steroids. Inflammatory conditions can be treated with them.
Rheumatoid arthritis patients who take more than 10 milligrams of prednisone per day are 2.05 times more likely to be hospitalized. Some steroids can potentially cause the antiviral drug Remdesivir to be removed from the body more quickly. It makes the drug less effective at treating COVID-19.
The Route of Administration for Steroids
In terms of how easily they dissolve or how long they last in the body, steroids come in many different types. The administration of steroids may be systemic, throughout the body, or local, at the exact location where a problem exists.
A systemic steroid can be administered intravenously, intramuscularly, or orally. Local steroids are in the form of eye drops, ear drops, creams, injections into joints, bursae (lubricating sacs between tendons and bones), or around tendons and other soft tissues.
Syringes and small needles inject the steroid into the targeted area. Before the procedure, lidocaine or a spray is usually used to anesthetize the patient. It is common to experience temporary and typically minor pain during the process. Depending on the location of the shot and the patient, the pain may vary.
When deciding whether to prescribe steroids, your doctor will consider your age, physical activity level, and any other medications you take.
What Conditions do Steroid Injections Treat?
A wide range of conditions can be treated with corticosteroid injections, including:
- Inflammatory bowel disease (IBD)
- Asthma
- Arthritis
- Inflammatory rhinitis, hay fever, and hives
- COPD (chronic obstructive pulmonary disease)
- Painful and inflamed joints, muscles, and tendons
- Symptoms of joint pain
- A sciatica injury
- COVID-19
- Multiple autoimmune diseases, such as lupus and MS (multiple sclerosis),
- Some types of cancer
Steroid injections for painful muscles and joints
A steroid injection is commonly used to reduce inflammation and pain around joints, such as in arthritis, and to treat muscles and soft tissues.
Injuries and arthritis often cause painful, swollen joints that need hydrocortisone injections. Among others, hydrocortisone is prescribed to treat bursitis, muscle pain, and tendon injuries. Triamcinolone and methylprednisolone are other steroids that can be used to treat painful joints.
Steroid injections for cancer
When people are diagnosed with cancer, their doctors may prescribe steroids, sometimes by injection. Cancer itself might be treated with this method in some cases. Cancer patients may be prescribed steroids as part of their cancer treatment to alleviate the side effects of the cancer treatment or pain management program.
These medications are beneficial and versatile and can be used in various settings and for various conditions. Steroid injections help deal with specific comorbidities and conditions in cancer.
Some conditions are:
- Manage other medication reactions
- An increase in appetite may result from sickness
- Reduce inflammatory response
- Suppress Immune responses
Steroid injections for Multiple Sclerosis
A doctor may administer steroid injections when someone with MS (multiple sclerosis) suffers from a flare-up. Intravenous injections of methylprednisolone are commonly used as a treatment course. The same medication may also be prescribed as tablets by a doctor.
Steroid injections for the backbone
A doctor can sometimes inject the epidural area surrounding the spine with corticosteroids. Inflammation of the spinal nerves causes pain in the lower back, arms, and legs. Other conditions can cause spinal nerve inflammation, such as bone spurs and herniated disks.
As long as cortisone shots are administered appropriately, they can calm inflamed joints and tissues, but they will not speed healing or prevent future problems. Corticosteroid injections are commonly used to treat the following conditions:
Epidural space: Epidural injections target nerve roots exiting the spinal cord and extending to other body parts. Often, sciatica is caused by pain near the nerve roots.
Tendons and bursae: Tendinitis is caused by inflammation of tendons, the tough, fibrous connective tissue between muscles and bones. Cortisone shots are used to treat this condition.
During muscle and tendon movement across bones and other joint structures, bursae act as cushioning pads of tissues to reduce friction. A bursa that is inflamed or infected (bursitis) can also be treated with steroids.
Joints: Arthritis-related inflammation can be treated with cortisone injections. Spine facet joints and knee joints are commonly targeted for steroid administration.
Steroid injections in COVID-19
“When comparing COVID-19 patients receiving systemic corticosteroids with those usually receiving care and a placebo, there was a lower 28-day all-cause mortality,” according to the researchers.
The World Health Organization (WHO) now recommends intravenous corticosteroids and tablets, such as dexamethasone, for severe and critical COVID-19 cases. A review of the available evidence led to an update to the WHO guidelines in September 2020.
Anabolic steroids and COVID-19
It is common for athletes and bodybuilders to abuse anabolic steroids to improve their performance or appearance. As a result of using anabolic steroids, the immune system is altered, and infections can occur more often.
A 2022 study found that using anabolic steroids increased the risk of COVID-19 severity in the past year.
The study found that current steroid use was associated with a five-fold higher risk of contracting COVID-19. A higher chance of developing COVID-19 was also related to current anabolic steroid use.
Risks and Side effects of Steroid Injections
When it comes to the side effects, a steroid injection may hold several side effects too. The route of administration may also play a role in causing specific after-effects.
Following are some after-effects and side effects that people may experience after getting steroid injections:
- The injection site may be painful and swollen for a couple of days
- Facial flushing
- The injection site is bruised
- The skin at the injection site becomes dimpling or loses its color
- Diabetes patients can be particularly affected by raised blood sugar levels
- There may be a temporary increase in blood pressure in hypertensive patients
- Infection is another more severe side effect of steroid injections.
Those who notice their joints becoming painful or hot should seek medical attention.
Epidural steroid injections
Epidural injections can cause severe headaches and other undesirable side effects; some of them are:
Infection: A relatively small percentage of all epidural injections cause infections at the injection site. Conditions can cause epidural abscesses. Infections are not always traceable to their source.
Dural Puncture: It is possible for dural (spinal sac) punctures to cause a “spinal headache.” If the headache persists, blood may be injected into an arm vein to cause clotting around the sac (blood patch).
Temporary Numbness: The bladder or bowels may experience temporary numbness, although it is rare. Epidural injections used to treat inflammation of the SI (sacroiliac joint) are associated with this risk.
Bleeding and Nerve damage: It is possible to experience some bleeding following the injection, but this is rare. Those with underlying conditions that increase bleeding are more likely to experience bleeding. Nerve damage can also occur as a result of bleeding or infection.
Consult a doctor if you experience this particular side effect.
Intravenous injections
Injections into the bloodstream may have different side effects because they are less localized. These effects can include:
- Mood swings
- The desire to eat more
- Insomnia
- Other risks
- The body can be less able to fight infections when it receives corticosteroid injections.
The vaccinations should be discontinued if a person contracts chickenpox, shingles, or measles after receiving the injections. Steroid injections may not be tolerated by people with infections who have had vaccinations or are about to have them.
Consult a doctor before starting treatment if you experience any of these problems or underlying medical conditions.
Steroid Dosage
It depends on whether to prescribe steroids for a short or long period. The doctor will prescribe high-dose steroids if your lungs and airways are inflamed due to asthma or COPD.
It may be life-threatening when someone struggles to breathe, so doctors may need to get that down as quickly as possible. Further, if you suffer from cancer-related fatigue, you may need a lower dose of steroids.
If your pituitary gland or adrenal gland is malfunctioning, you might have to take replacement steroids for the rest of your life.
Steroids and Pregnancy
Using antenatal corticosteroids to enhance fetal lung maturation may induce adverse maternal and fetal effects. Patients with premature rupture of membranes may experience an increase in infections after multiple courses of corticosteroids, as well as chorioamnionitis and endometritis.
When a single dose of corticosteroid is administered, the number of maternal white blood cells increases, as do the concentrations of amino acids and fasting glucose in the mother’s blood.
Corticosteroids during pregnancy reduce the movement and breathing of the fetus as well as the variability of the heart rate without affecting fetal Doppler waveform patterns.
Several studies have suggested that multiple courses of corticosteroids administered antenatally might negatively impact fetal growth and birth weight. Sepsis of the newborn is also associated with various causes.
Steroids and Diabetes
Steroid-induced diabetes occurs when blood sugar levels rise unexpectedly after using steroids. It can happen to both diabetics and non-diabetics.
Compared to type 1, steroid-induced diabetes is more like type 2. Insulin is not adequately absorbed by your cells when you have type 2 or steroid-induced diabetes. The pancreas does not produce insulin in people with type 1 diabetes.
The symptoms of steroid-induced diabetes usually disappear after you stop taking the steroids.
Type 2 diabetes can develop if you use steroids long-term. If this happens, it will need to be managed for the rest of one’s life.
Type 2 diabetes is associated with the long-term use of steroids. Factors that may increase your risk include:
- Diabetes type 2 runs in your family
- Obesity
- Gestational diabetes
- PCOS
- Whites over 40 years of age
- South Asians, African Caribbeans, or Middle Easterners who are 25 years or older
According to diabetes.co.uk, people with prediabetes may experience permanent problems if they continue to use steroids for more than three months. It applies equally to oral, injectable, and topical steroids.
Steroids and Chorioamnionitis
There is also no clear evidence that antenatal steroids cause histologic chorioamnionitis. However, there is relatively little information on the effects of antenatal steroids in the presence of histological chorioamnionitis, even though antenatal steroids are contraindicated for clinical chorioamnionitis.
When to Consult a Doctor?
Having an injection of steroids is not recommended if you have an infection in the inflamed area or another part of your body. Your doctor won’t administer steroids if you have an infection in that area or another part of your body. Injections are unlikely to help a joint that has been severely damaged.
If you take anticoagulant medications (often called “blood thinners”), steroid injections may cause bleeding. Doctors take great care when prescribing steroids to their patients.
Specialist doctors at Your Doctors Online will preferably prescribe you steroid injections after thoroughly examining your health and underlying issues.
FAQs About Steroid Injections Answered By Your Doctors Online Team
Steroidal injections are generally used for treating inflamed areas with a high dose of medications. The efficacy of oral or IV steroids cannot be guaranteed. It eases pain effectively, but it is not a cure.
Steroid shots relieve pain in different ways for different people. In most cases, it starts working within 24 to 48 hours. There can be a prolonged effect.
Steroid injections can have side effects such as:
1. An infection
2. Symptoms of allergy
3. Bruising
4. Tendon rupture
5. Skin color changes
6. Mood swings. etc
Most patients experience fewer serious side effects from local steroid injections than from other forms of steroid treatment. As a result of steroid injections, inflammation in a joint usually subsides, making it easier for it to function. As a result, you may not need to use oral steroids or higher doses of oral steroids, which can have more severe side effects.
Patients with diabetes or other underlying medical conditions are not recommended to receive steroid injections.
