Steroid Shots Do Little for Knee Pain of Arthritis

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Doctors often prescribe steroid injections for the pain of knee arthritis, but a rigorous trial has found they work no better than a placebo.

Researchers randomly assigned 140 men and women over 45 with painful knee osteoarthritis to injections of either a corticosteroid or a saline placebo. The subjects were injected every three months for two years, with neither the patients nor the people who gave the shots knowing who got the placebo. The study is in JAMA.

At each visit, the participants filled out pain questionnaires and took tests of physical ability. At the end, there was no overall difference between the two groups in pain, stiffness or how well someone could stand from a seated position or walk. Bone and joint scans also showed no significant differences, except for a clinically insignificant cartilage loss in the steroid group.

The lead author, Dr. Timothy E. McAlindon, the chief of rheumatology at Tufts Medical Center in Boston, said that steroid injections for short-term pain relief might be useful, but not over the long term.

“There’s a lot of excitement about treating inflammation to influence this disease,” he said, “but this study is a test of that notion, and it’s negative. So we really have to question whether it’s correct.”