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Steroids Cause the Same Tissue Changes as Tendon Injury

Patients who get a steroid injection in their shoulder for rotator cuff pain relief or improved// shoulder function should not return to their regular activities for a few weeks, according to a study.

“Steroid injection temporarily produces a molecular response in the tissue that is similar to that of a tendon injury, possibly making it more vulnerable to damage during this time,” said senior study investigator, Loyola University Chicago Stritch School of Medicine.

“This is especially important because steroids often give patients rapid pain relief,” said Callaci. “If a patient returns to rigorous activities right after a steroid injection, the weakened tissue may not be able to sustain itself.”

He cautioned that these findings should not preclude people from having a steroid injection or physicians from administering steroids. “The study gives us a better understanding of what is happening on the molecular level,” he said.

Loyola presented the findings here today at the 53rd annual meeting of the Orthopaedic Research Society.

“We found that steroid injections cause a tendon to behave in a way where it thinks it has been acutely injured,” noted Callaci. “Steroids rapidly provide anti-inflammatory and pain relief. That is why steroids are so popular, but physical therapy also can produce some of the same effects. It just takes longer.”

For the study, Callaci and colleagues examined the global gene expression profiles in rotator cuff tendons following injury or exposure to corticosteroid. The researchers used gene array analysis of the complete rat genome to characterize the molecular response of rat rotator cuff tendon tissue to injury, injection of corticosteroids, and the presence of both injury and corticosteroid.

Results of the study shows that 2,000 genes were changed by injury; 1,000 genes were changed by steroids. A significant number, 750, of the changed genes overlapped bet
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