Bone Health

Use of cortisone injections in the treatment of muscle and joint inflammatory reactions is becoming increasingly popular. First popularized by Janet Travell, MD, muscle injections are a remarkably effective adjunct to pharmacologic and physical therapies and are safe and easy to perform. Joint injections, while technically more difficult to perform, also can be of great benefit in the patient's recovery. The purpose of this article is to introduce the basic principles of muscle and joint injections. Other references can provide specific details on how to inject at a given anatomic location, such as for bursitis, tenosynovitis, or intra-articular inflammation.
ContentsUse of cortisone injections in the treatment of muscle and joint inflammatory reactions is becoming increasingly popular. First popularized by Janet Travell, MD, muscle injections are a remarkably effective adjunct to pharmacologic and physical therapies and are safe and easy to perform. Joint injections, while technically more difficult to perform, also can be of great benefit in the patient's recovery. The purpose of this article is to introduce the basic principles of muscle and joint injections. Other references can provide specific details on how to inject at a given anatomic location, such as for bursitis, tenosynovitis, or intra-articular inflammation.
Jerrold N Rosenberg, MD 2001

Epidural steroid injections (ESIs) have been endorsed by the North American Spine Society and the Agency for Healthcare Research and Quality (formerly, the Agency for Health Care Policy and Research) of the Department of Health and Human Services as an integral part of nonsurgical management of radicular pain from lumbar spine disorders. Radicular pain is described as a sharp, lancinating, radiating pain, often shooting from the low back down into the lower extremity in a radicular distribution. Radicular pain is the result of a nerve root lesion or of inflammation. Clinical manifestations of nerve root inflammation include some or all of the following: radicular pain, dermatomal hypesthesia, weakness of muscle groups innervated by the involved nerve roots, diminished deep tendon reflexes, and positive straight leg–raising tests. ESIs have been recommended to deliver steroids in a more localized fashion to the area ofaffected nerve roots, thereby decreasing the systemic effect of the administered steroids. Studies have indicated that ESIs are most effective in the presence of acute nerve root inflammation.
Synonyms and related keywords: epidural corticosteroid injections, ESIs, nonsurgical management of radicular pain, nerve root inflammation
Chen et al 2007