On Jan. 24 1978, the New Zealand governor-general referred to a Commission of Inquiry an investigation to determine the desirability of providing for reimbursement of chiropractic benefits under the New Zealand Social Security Act and the New Zealand Accident Compensation Act. The commision's findings would impact chiropractic worldwide for decades to come.
Danger! The Wrong Way to Manage Joint Pain
As a doctor of chiropractic, you know how to address joint pain without the use of drugs, but unfortunately, corticosteroid injections remain a popular choice among medical providers for patients suffering from osteoarthritis. The problem, according to new research: such injections may actually escalate the progression of OA and increase the likelihood that the patient will require joint replacement surgery at some point.
Published in Radiology, "Intra-articular Corticosteroid Injections in the Hip and Knee: Perhaps Not as Safe as We Thought?" by A.J. Kompel, et al., found a significant rate of complications among osteoarthritis patients who received intra-articular corticosteroid injections to the hips or knees. Complications appeared two to 15 months following the injections.
Findings came courtesy of analysis of two sources: the existing literature database on corticosteroid injections for OA and data on 459 patients at Boston Medical Center who received 1-3 injections for hip or knee OA in 2018.
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The clinical takeaway, according to the study: "In patients with no OA or only mild OA on a radiograph who are referred for IACS injection to treat joint pain, the indication for IACS injection should be closely scrutinized. Case series and retrospective reviews have shown that some patients who develop rapid progressive joint space loss or destructive OA tend to have no OA or only mild OA at initial presentation."
In their introduction, the researchers emphasize that "practitioners should be alert for emerging evidence that clarifies or helps determine the balance between benefits and potential harm. Patient preference should have a substantial influence on the type of treatment selected." If their very own study isn't "emerging evidence that helps clarify" the potential harm side of the equation, we don't know what does. Make sure your OA patients understand these findings and are well-educated on nondrug alternatives for their joint pain.