Steroid Injection, Physical Therapy, or Both?

-  Submitted by Kimberly Phomsopha, PTA

Studies have shown that both physical therapy and steroid injections can be effective for combating pain and inflammation for certain types of joint-related issues - such as bursitis, tendonitis, frozen shoulder, and plantar fasciitis.  So why choose physical therapy first?

Physical Therapy lasts longer in the long run.

Physical therapists will perform a thorough evaluation to identify the possible causes of pain and prescribe a comprehensive treatment approach to correct dysfunctions contributing to their patients’ symptoms.  Patients receiving physical therapy not only receive treatments to relieve pain and inflammation during their appointments but they also receive prescribed exercises to do at home.  This extension of the therapists’ care allows the patient to preempt a problem before it starts.  With steroid injections, the patient often must go back to their provider when the injection wears off.  The goals of physical therapy are to support long term relief of pain and to reduce the future recurrence of injuries.  

Steroid injections may produce side effects when received over a long period of time.

Cortisone injections are a powerful anti-inflammatory that can be administered by a Medical Doctor to treat pain, and can sometimes help diagnostically to differentiate different conditions.  It is important to share any concerns with your doctor and understand why this treatment approach is being recommended so that the goals of the injection and what to expect following is clear.  Although steroid injections may temporarily relieve pain and inflammation, long-term use of steroids may produce numerous side effects such as: thinning of the skin at the injection site, weight gain, mood changes, bacterial infections, easy bruising, increases in blood pressure, degeneration of joints, and more.

Combining steroid injections and physical therapy may sometimes be the answer.

There are times when steroid injections are the best treatment to manage a specific condition when other treatments have failed, however sometimes it is more effective to be done in conjunction with a structured physical therapy program.  Studies show that incorporating exercise and manual therapy under direction of a physical therapist after a steroid injection may result in greater reduction of pain and inflammation.  As these two treatments work by different mechanisms, this combined treatment approach is often more effective than the single components.  Because earlier improvement in pain and function is seen with steroid injection combined with exercise and manual therapy, the recommendation is to combine these therapies for the best overall outcome.  It is important to first speak to your doctor to see if your condition is appropriate to receive a steroid injection.

Try physical therapy first!

If you are debating about whether to have a cortisone injection or physical therapy, why not try physical therapy first.  While there are definite risks and side effects associated with steroid injections, there are none associated with early implementation of physical therapy.  If physical therapy is unsuccessful initially, then injections can still be considered in the future if you are a candidate.


-  Submitted by K
imberly Phomsopha, PTA

About Kimberly Phomsopha, PTA

Kim is a Physical Therapist Assistant at Loudoun Physical Therapy.  She received her Associate of Science degree with an emphasis in Physical Therapy from Northern Virginia Community College in Springfield VA in 2014. She also has her certificate in Early Childhood Education. Kim joined Loudoun Physical Therapy in September of 2015. Outside of work, Kim enjoys spending time with her family as well as motocross, soccer, basketball, mountain biking, canoeing or basically anything outdoors.

 

To learn more about steroid injections and physical therapy, please click here.

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