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Injectable Corticosteroids in Sport

Olafsen, Nathan P., MD*; Herring, Stanley A., MD; Orchard, John W., MD, PhD, FACSM, FACSEP, FFSEM(UK)

Clinical Journal of Sport Medicine: September 2018 - Volume 28 - Issue 5 - p 451–456
doi: 10.1097/JSM.0000000000000603
General Review

Objective: To review the literature guiding all aspects of the use of injectable corticosteroids for painful musculoskeletal conditions, with a focus on the treatment of athletes.

Data Sources: An extensive search of the literature was completed including search terms of corticosteroid, steroid, athlete, and injection, among others. Additional articles were used after being identified from previously reviewed articles.

Main Results: Injections of corticosteroids for a variety of painful conditions of the extremities and the axial spine have been described. Numerous minor and major complications have been reported, including those with a high degree of morbidity. There is a dearth of published research on the use of corticosteroid injections in athletes, with most of the research on this topic focused on older, nonathlete populations. Generally, these injections are well tolerated and can provide short-term pain improvement with little or no long-term benefits.

Conclusions: Corticosteroid injections should be used cautiously in athletes and only after a full consideration of the pharmacology, pathogenesis of disease, potential benefits, complications, factors specific to the athlete, and rules of athletic governing bodies. Corticosteroid injections are just one component of a comprehensive rehabilitation plan available to the physician providing care to athletes.

*Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University School of Medicine;

Departments of Rehabilitation Medicine, Orthopaedics, and Sports Medicine, and Neurological Surgery, University of Washington; and

School of Public Health, University of Sydney, Australia.

Corresponding Author: Nathan P. Olafsen, MD, Washington University, Department of Orthopaedic Surgery, 425 S. Euclid Ave., Campus Box 8233, St. Louis, MO 63110 (nolafsen@wustl.edu).

The authors report no conflicts of interest.

Received October 08, 2017

Accepted April 06, 2018

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