Alternatives to Steroid Injections
As most of us know from recent extensive news coverage, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are coordinating a multi-state investigation of fungal meningitis among patients who received an epidural steroid injection. Several of these patients also suffered strokes believed to have resulted from their infection. As of mid-October, 24 deaths had been reported.
Any time you have any kind of injection, you are at risk of complications. Steroid injections create additional complications as well as the risk of infections. The real question is “Are there alternatives to these injections?”
Several months ago, I twisted my knee getting out of my seat on an airplane. It was immediately sore, and I started using my PEMF therapy as soon as I got home. I even walked every day – 3 miles, as I usually do, using a SomaPulse under a knee brace. Still, I had discomfort when I placed any pressure on my knee, so I went in for an MRI, which revealed a mild ACL strain and a slightly torn lateral meniscus.
I saw a well known orthopedic surgeon, who told me not to do anything strenuous. He offered me a steroid injection for my knee. I declined, saying I would continue with my PEMF therapy instead. As expected, he scowled at my choice.
Nevertheless, I left without the injection, and continued to use my PEMF for the next month, with my knee now feeling essentially normal. Obviously, my body has not yet repaired my ACL or meniscus, but I did not get or need the injection to relieve the pain.
Why did I refuse the steroid injection? Because as a doctor, I knew better. I have given steroid injections throughout my career, just as most other doctors do. But it always bothered me that the risks probably outweighed the benefits a large part of the time. At that time, these were the only options I had available. This is one of the reasons I began searching for other alternatives for pain management, and in the end, found PEMFs.
I know these injections do not cure anything. In fact, they do create risks, not the least of which is the risk of infection. Steroid injections into tissues always (let’s repeat that—ALWAYS) thin out the tissues into which they are injected. That is why doctors will typically tell you that you can only get 1 or 2 steroid injections in the same area.
If you do a steroid injection into a ligament, it increases the risk of rupture. If you inject them into the skin, you almost always will get a little pock mark. These are potent anti-inflammatory and tissue destroying injections. Yes, they decrease inflammation and improve comfort, but only temporarily.
So, knowing this, why do doctors continue to use them? Because they don’t know other alternatives – and since they bought the steroids and have them in their fridges, they at least need to get their money back, because they expire if not used in time.
There are alternatives to steroids – alternatives that are safe, noninvasive, and non-toxic. In addition, they actually help with the healing of the underlying tissue when possible. When it is not possible, even the steroids don’t help. PEMFs almost always help at some level with the underlying problem. More importantly, you don’t need to see a doctor for this therapy, after you have your diagnosis and have been recommended a treatment plan. You can do PEMF treatments at home, on your own, at your convenience, and with virtually no risk. And, other people in the household can benefit as well.
Sometimes, steroids are a good idea. There are major infections and conditions that steroids provide important help with. In these cases, steroids should be strongly considered. Conditions like these include bad poison ivy rashes, major infections called sepsis, severe asthma, severe flares of rheumatoid arthritis and other autoimmune conditions which can be disabling or life-threatening. Rarely are orthopedic steroid injections medically necessary, whether epidural or into joints or ligaments.
Steroid injections can be placed into the skin or muscle directly, into ligaments or tendons, into joints, including spinal joints, or into the space overlying large nerves, including the spinal cord. This is considered the epidural space, where these meningitis-causing injections were given. Epidural injections are frequently given for chronic back pain. They may or may not work, and are very uncomfortable. Obviously, they carry the risk of infection into the nervous system, plus other potential complications including bleeding and paralysis.
So, in my medical experience, I will now always try to do the noninvasive, non-toxic, safe approach to treating pain before I ever resort to injections. Additionally, my goals are to have you be able to do your own treatments at your own convenience, with the additional expectation that we will actually have the hope of helping to heal the underlying tissue and cause of the pain. This is one of the reasons the Dr. Oz show supported the use of PEMFs—to help heal the underlying cause of the pain instead of simply treating the symptom.
Clearly, tissues need time to heal. Anything that gives you immediate relief for a chronic problem is either a drug, procedure or surgery. These approaches frequently don’t work for long, or have complications. The complications may be permanent and irreversible, and are usually unpredictable. Again, this is why I always try to do a more conservative approach first, typically using PEMFs.
PEMFs have been found to decrease inflammation too, and very well at that. Maybe they don’t do this as dramatically or quickly, and that’s the seduction of steroid injections. You will usually know within a week whether the steroid injection is actually working. Even then the benefits do not last for long if the underlying cause is not managed as well. In addition, PEMFs have the potential to reduce swelling, improve circulation and stimulate tissue healing. They also have the additional benefit of being able to actually reduce pain directly, called anti-nociception. In fact, in animals and humans they have been found to be equivalent to about 10 mg of morphine, without using the morphine.
As discussed on the Dr. Oz show, most doctors do not know about these alternatives for pain management. Even if they did, doctors typically keep doing what they are doing unless forced to change. Sometimes a change happens because doctors make mistakes or end up with complications and have to learn different approaches. Sometimes the finances of the procedures drive doctors to use particular approaches. Sometimes change happens only because everyone else begins doing something different, and the doctors don’t want to stand out. In the end, doctors are typically creatures of habit. And as we all know, habits are hard to change.
As you can see, the rationale for why certain treatment approaches are offered may have nothing to do with the patient’s best interests or the most effective approach to the problem. PEMFs are a very rational, safe approach to chronic pain management, potentially offering a significant solution to the problem, reducing the pain a large percentage of the time with no complications and potentially healing the underlying cause of the pain, for relatively little cost and great convenience.
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