A small and very rare risk is that the injected joint becomes infected (1 in 15,000). Patients who experience a very painful, red, or swollen joint after injection should seek medical attention immediately. Thankfully, the most common cause of these symptoms is not a concerning infection but a reaction to the injected steroid (called steroid flare ) that occurs in 2-5% of patients. A steroid flare usually begins 6-12 hours after the injection and can last for 2-3 days. Regardless of the cause, it is important for patients with symptoms of infection to see a doctor because infections require immediate treatment.
Steroid injection has been around since the early 1950s, and it remains a primary treatment for general practitioners all the way to orthopedic surgeons. Why? First of all, it offers the hope of quick relief. Second, it’s a Big Fat Cash Cow. Let’s do the math. Say you have sciatica, and you go to see Dr. Prick Butt and he says, “Not much I can do for you other than give you a steroid injection. Of course, it may take up to three of these to achieve the best results.” Three injections @ $150 per injection = $450. Now, taking into account that the average orthopedist probably sees at least 20 patients a day and works 180 days a year, that comes to 3,600 patients. If 20 percent of those patients get three steroid injections, that’s an annual income of $324,000 ($450 X 750 patients). That’s for 10 minutes of work per patient. And you wonder why things haven’t changed in more than 50 years.