The use of corticosteroid injections for the treatment of osteoarthritis has been controversial for a long time. And there is a good reason for that.
While these injections may help relieve pain for a short while, they can actually worsen your arthritis. They damage bone and cartilage, cause rapid joint destruction, lead to stress fractures and may accelerate the need for joint replacement surgeries.
They also decrease immune system response and can affect blood sugar levels in people with diabetes.
Whether you know it or not, it is for these very reasons that corticosteroid treatments are limited to three or four times per year.
But there is an interesting alternative to corticosteroid injections. It’s something called hyaluronic acid. It works as a lubricant and shock absorber for your joints. So it reduces friction and reduces wear and tear on the joints. This, in turn, reduces pain and makes joint movement easier.
And it may be a better treatment for crippling arthritis pain than corticosteroid injections.
In two different studies presented at the 2022 annual meeting of the Radiological Society of North America, patients were injected with either corticosteroids or hyaluronic acid. Both treatments helped with pain relief.
But, as suspected, those receiving corticosteroids had significantly more osteoarthritis progression. The hyaluronic acid group, on the other hand, showed a decrease in the progression of osteoarthritis.
This suggests that hyaluronic acid injections may be a safer treatment option for those who experience severe pain associated with arthritis.
But keep in mind that neither corticosteroid nor hyaluronic acid injections are a first line of treatment for arthritis. They should only be used when first-line options aren’t working.
The First Line of Treatment is just as Bad as the Second
The minute you started feeling the pain, stiffness and swelling from arthritis, you’re doctor probably recommended taking an NSAID pain reliever.
Well, I hate to be the bearer of bad news, but NSAIDs can be just as bad as corticosteroids. These medications are known to accelerate the breakdown of joint cartilage and prevent the formation of new cartilage.
As a matter of fact, a 2019 meta-analysis published in Osteoarthritis and Cartilage found that using NSAIDS accelerates the structural progression of arthritis. The authors of the analysis clearly note that this accelerated progression to more severe arthritis symptoms could potentially result in an earlier necessity for joint replacement surgery.
In other words, like corticosteroids, NSAIDS can literally speed up the progression of arthritis, the very disease for which they are most often used and prescribed!
Just as importantly, NSAIDs can trigger heart attack, stroke – even cardiac arrest – within just weeks of use.
A Better Alternative to NSAIDs
Arthritis is an inflammatory disease. So when it comes to shutting down pain, managing the inflammatory response is at the top of the list for treatment options. And there are several nutrients that can do just that, and perhaps help you avoid harmful pharmacological treatments and surgery.
A favorite of mine is green lipped mussel extract. It’s high in something called “furan” fatty acids. These fatty acids scavenge damaging free radicals. Just 150 mg. daily can improve knee joint pain, stiffness and mobility.
I also like an enzyme found in pineapple, called bromelain. It helps keep certain inflammatory substances (bradykinin and fibrinogen) from building up around your joints and triggering inflammation. Taking 200 mg daily can reduce pain, stiffness and swelling.
Another good choice is chicken cartilage extract. It contains type II collagen. This is the type of collagen that’s needed for the synthesis and repair of connective tissue and helps improve pain, stiffness and physical function in arthritic knees. Taking 400 mg daily may provide anti-inflammatory activity and improve joint flexibility.
The most exciting, however, is curcumin. In particular, curcumin shuts down inflammation by blocking enzymes that produce pain. In the majority of cases, people who take curcumin are able to stop taking dangerous anti-inflammatory drugs within just weeks. In fact, it’s proven to be just as effective as ibuprofen when it comes to decreasing pain and improving function.
Look for a formula that contains 95% curcuminoids and at least 5 mg. of bioperine (a black pepper extract) to help boost absorption. Take 500-1,000 mg. twice a day to shut down inflammation.
You can also find over-the-counter hyaluronic acid supplements, which can help cushion joints, protect your cartilage and ease joint movement.
And don’t forget to stay active! I know it’s hard to get moving when you’re in pain, but exercise actually helps reduce pain and ease inflammation.
Kompel AJ, Roemer FW, Murakami AM, Diaz LE, Crema MD, Guermazi A. Intra-articular Corticosteroid Injections in the Hip and Knee: Perhaps Not as Safe as We Thought? Radiology. 2019 Dec;293(3):656-663.
Steroid Injections Worsen Knee Arthritis. Radiological Society of North America. Press Release. Nov 2022.
Migliore A, Procopio S. Effectiveness and utility of hyaluronic acid in osteoarthritis. Clin Cases Miner Bone Metab. 2015 Jan-Apr;12(1):31-3.
Simic M, Harmer A, van der Esch M, Bennell K, Ferriera P, March L, Fransen M, Day R. Do Non-Steroidal Anti-Inflammatory Drugs Cause Osteoarthritis Progression, A Systematic Review and Meta Analysis. Osteoarthritis and Cartilage. 2019; 27:S92eS516.
Abshirini M, Coad J, Wolber FM, von Hurst P, Miller MR, Tian HS, Kruger MC. Green-lipped (greenshell™) mussel (Perna canaliculus) extract supplementation in treatment of osteoarthritis: a systematic review. Inflammopharmacology. 2021 Aug;29(4):925-938.
Crowley DC, Lau FC, Sharma P, Evans M, Guthrie N, Bagchi M, Bagchi D, Dey DK, Raychaudhuri SP. Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial. Int J Med Sci. 2009 Oct 9;6(6):312-21.
Lugo JP, Saiyed ZM, Lane NE. Efficacy and tolerability of an undenatured type II collagen supplement in modulating knee osteoarthritis symptoms: a multicenter randomized, double-blind, placebo-controlled study. Nutr J. 2016 Jan 29;15:14.
Appelboom T, Maes N, Albert A. A new curcuma extract (flexofytol®) in osteoarthritis: results from a belgian real-life experience. Open Rheumatol J. 2014 Oct 17;8:77-81.
Kuptniratsaikul V, Dajpratham P, Taechaarpornkul W, Buntragulpoontawee M, Lukkanapichonchut P, Chootip C, Saengsuwan J, Tantayakom K, Laongpech S. Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study. Clin Interv Aging. 2014 Mar 20;9:451-8. Oe M, Tashiro T, Yoshida H, Nishiyama H, Masuda Y, Maruyama K, Koikeda T, Maruya R, Fukui N. Oral hyaluronan relieves knee pain: a review. Nutr J. 2016 Jan 27;15:11.