Locally acting (depot) Steroids
Some steroid drugs are available in a formulation for injection where they release slowly, over a number of weeks, from the site where they are injected. The most commonly used drugs in this group are triamcinolone (Kenalog) and methylprednisolone (Depomedrone).
These drugs may be useful for pain when used in injections through several mechanisms.
- They have a local anti-inflammatory effect and this can help to reduce pain from arthritis and wear and tear in joints and other tissues.
- They can help to reduce swelling, and so if a nerve is compressed this can help to reduce the swelling and tightness around it.
- One of the changes in nerves that are functioning abnormally and giving rise to nerve pain is that the channels allowing sodium ions to flow through their membranes become abnormal and can fire off spontaneously or have a low threshold for activation. Locally acting steroids can affect the abnormal function of these channels and may help some nerve pains when applied directly to the nerves.
These depot steroids used on a one-off basis by injection woud not be expected to cause the side effects often associated with steroids given chronically by mouth. There are some potential side-effects of these drugs, and particularly with repeated injection they could cause thinning of bone close to where they are injected or potential harm to cartilage and other structures in joints. We would tend to be cautious about frequent or multiple repeated injections of these drugs.
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Pain Service Website, Gloucestershire Hospitals NHS Foundation Trust
Webmaster Dr J G de Courcy, Consultant in Pain Medicine and Anaesthesia
Page updated 19/02/2016