In the last exciting and fun-filled blog we were talking about corticosteroids, and their use on a daily basis in my NYC podiatry practice.  The use of injectable and oral corticosteroids has revolutionized medicine, and practically gave birth to the field of rheumatology.  The treatment of inflammation, heel pain, and arthritis of the foot and ankle in many cases involves corticosteroids on some level.  And as with any other drug, where there is an effect, there is often a side effect.

It’s important to differentiate between oral and injectable corticosteroids.  Oral cortisone, often in the form of drugs like Prednisone, is used on a short term or long term basis for the treatment of inflammation and autoimmune disorders.  On a short term basis these drugs work exceptionally well at reducing inflammation in the foot and ankle and other parts of the body.  When used on a long term basis, the drugs are also effective, however that is when the side effects are most commonly seen.  Those side effects can include weight gain, body changes, adrenal gland insufficiency and even steroid-induced diabetes or osteoporosis.  It is for this reason that these drugs are only used in oral form for longer periods of time in cases of great need, such as in autoimmune disorders like rheumatoid arthritis, or lupus.  The benefits of reducing the effects of the disease must outweigh the risk of possible side effects of the cortisone.

Injectable cortisone, however, is different. When used for conditions such as heel pain, hallux limitus, or arthritis of the foot and ankle, the benefits are almost immediate, and side effects are minimal.  In fact, the most common side effect is a steroid rebound, in which the pain increases for 24-48 hours after the injection due to irritation from the drug itself, after which time the pain usually subsides.  And while in most cases the anti-inflammatory effects are temporary, lasting anywhere from hours to months, the injection is a great way to jump start relief.  The pain starts to subside within a few hours after the injection and patients can feel better while taking steps to prevent the condition from returning, such as stretching, using ice, wearing comfortable shoes and orthotics.  This is a great way to use the body’s own material to reduce pain and inflammation very effectively with minimal side effects.

So A-Rod, if things go well with the hearing and you start playing again, don’t worry about the aches and pains, sprains and strains, and minor injuries.  I got your steroids right here, baby, and they won’t get you in front of a hearing.

See you in the office.

Ernest Isaacson