Corticosteroid Injections For Axial Spondyloarthritis Treatment

Axial spondyloarthritis (AxSpA) is a chronic, progressive condition. Treatments are available to help manage the condition but there is no cure. Because there is no cure, the goals of treatment are to maximize quality of life, prevent or slow progressive structural damage, and control symptoms and inflammation and preserve mobility.1

Various medications can be used to help treat AxSpA spectrum conditions, including corticosteroid injections. While these are not first-line treatments and should not be used long-term, corticosteroid injections may provide some joint pain relief, although there is no direct evidence of its effectiveness.2

How do corticosteroid injections work?

Corticosteroids are both anti-inflammatory and are immunosuppressive, so they both reduce inflammation and work with your immune system to affect the immune response.3 They are chemically similar to the hormone cortisol, which has anti-inflammatory properties and is naturally made in the body in the adrenal glands.3

They can be given in a variety of ways, but as an injection, they can be given intramuscularly (into a muscle), intravenously (into a vein; this is not common for AxSpA), or intra-articular (into a joint).3 When injected into a joint, this relieves the inflammation and the overall inflammatory process, and its effects can last for several months.3 If used long-term, however, this can cause a loss of cartilage.

Formulations of corticosteroid injections

There are various kinds of corticosteroids, and you and your doctor can discuss the benefits of each one, along with your medical history, to find the right one for you.

What are the possible side effects of corticosteroid injections?

As with any medication, there may be side effects of corticosteroid injections. Sometimes these side effects are temporary and go away on their own; for some people, the effects may be severe enough to stop treatment with the medication. Talk with your doctor if you experience anything out of the ordinary after treatment with corticosteroid injections.

Side effects can include:5

  • Cartilage damage
  • Joint infection
  • Nerve damage
  • Death of nearby bone
  • Facial flushing
  • Temporary elevation of blood sugar
  • Thinning of nearby bone, skin, and/or soft tissue
  • Tendon weakening or rupture

*Not a complete list of side effects.

Things to know about corticosteroid injections

Tell your doctor about any medications you are on before starting corticosteroid injections. The medications may interact with adverse effects. If you take blood thinners, you might need to stop taking them several days before your shot.5 If you’ve had a fever or been sick for two weeks before a corticosteroid injection, let your doctor know.5

Corticosteroid injections for AxSpA are not a long-term solution and should not be used as such.

Additional therapy/additional treatment options

Corticosteroid injections are not the only treatment that can be used to help treat AxSpA spectrum conditions – and they should not be used alone or long-term. If you find that corticosteroid injections don’t work for you, other treatments are available, including non-drug treatments like physical therapy and various lifestyle changes. Talk with your doctor about the range of treatments available for your symptoms to fully address the symptoms you are experiencing.

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Written by: Jaime Rochelle Herndon | Last reviewed: November 2020