Stay away from steroid injections for joint pain

And a surprising, different kind of “injection” that can work wonders

I’ve never been in favor of steroid injections for relief of any type of pain—neck, back, or joints.

Under the best of circumstances, steroids only provide a quick fix and don’t do anything to remedy the long-term problem that’s causing the pain. At worst, I’ve seen hundreds of cases of contaminated steroid preparations that have caused fatal fungal brain infections in unsuspecting people.

As I discuss in my report The Insider’s Ultimate Guide to Pill-Free Pain Cures, there are many natural alternatives to steroids for managing pain. And for joint pain specifically, new research shows that manual and physical therapies and another little-known natural treatment—prolotherapy—are just as effective as steroid injections. But without any of the risks.

Let’s take a look at these natural therapies and the compelling new research that shows how they can end your joint pain—forever.

Non-invasive, natural therapy works better than steroids for shoulder pain

In a new study, researchers looked at 104 people with shoulder impingement syndrome—a common type of persistent pain that can be caused by tendonitis, bursitis, or other inflammation in the shoulder joint.1

These study participants were randomly divided into two groups. One group received physical therapy twice a week for three weeks. The other group received three steroid injections, as requested, over a one-year period.

Both groups showed improvement in shoulder pain after one month, and their improvement continued over the course of the year. However, during the following year, 60 percent of the steroid group  went back to the doctor for more treatments, compared to only 37 percent of the physical therapy group.

Even more tellingly, 19 percent of the steroid group  ended up getting physical therapy anyway in addition to more steroid injections.

And the steroid group also racked up more healthcare bills than the physical therapy group.

When the study was published in August, both medical and mainstream media reported that it showed that physical therapy and steroid injections were “equally effective.”  But I sometimes wonder whether the editors and authors who write the headlines actually pay attention to the real results.

Don’t you think a treatment works better when, after just three weeks of therapy, it produces  benefits that last for one year for all patients—and appears to permanently “cure” the problem in nearly two-thirds of those patients without any risky side effects?

All without the dangerous risks of steroid injections. And the steroid group was more likely to end up getting physical therapy anyway.  So why even take the dangerous, expensive, temporary detour of steroids at all?

If you needed any more reason not to ever go near a steroid shot, here it is.

But not all needles need be bad. In fact, there is another kind of “injection” using a completely different principle that is remarkably effective for pain.

A simple sugar shot soothes 10 years of knee pain

Ten years ago, I was preparing a medical textbook on natural therapies for pain with my colleague, Mike Weintraub, MD, professor of neurology at New York Medical College. He suggested we include a chapter on prolotherapy. But back then it was not easy to find practitioners of this little-known pain treatment.

We searched high and low until finally locating Donna Alderman, DO, of Hemwall Family Medical Centers in California.  As one of the few prolotherapy practitioners in the state, Dr. Alderman commuted between Hemwall’s San Francisco and Los Angeles area clinics. On Fridays, she was at her clinic in Glendale,  where my brother and his family live.

In 2007, I went out to visit my brother during “spring break,”  and I ended up getting prolotherapy from Dr. Alderman for my right knee. The knee had been bothering me ever since I had injured it in 1997 and then took to a long airplane trip, and a long drive, to visit Dr. Larry Dossey near Santa Fe, New Mexico.

My brief, painless prolotherapy treatments worked like a charm. Afterwards, I was able to drive and sit in airplanes without any pain—which I hadn’t been able to do for 10 years.

Prolotherapy is based on the premise that chronic joint pain at least partially results from inadequate repair of connective tissues around the joints. Prolotherapy practitioners  inject minute amounts of substances such as cornstarch, sugar, or a cod liver oil mixture into those connective tissues.

The body reacts by promoting tissue repair and growth—like tiny, cellular “micro-sutures” that tighten up the tissues without surgery. Taking vitamin C before and after prolotherapy treatments also helps lay down the collagen that cross-links the new connective tissues to make them strong.

Hippocrates used the same principle when he employed red-hot needle cautery to treat dislocated shoulders on the battlefields of ancient Greece. And from 1835 to 1935, a number of “hardening” agents were injected during hernia repair to promote formation of new and strong fibrous connective tissues that could close the tear forming the hernia.

In the mid-1950s, prolotherapy emerged as a treatment for joint pain. But it remained virtually unknown by doctors or patients until very recently.

You have to wonder why such a simple, effective, safe, and inexpensive treatment for something as common as joint pain remained hidden for so long? Of course, it probably has something to do with the fact that prolotherapy  doesn’t require expensive (yet often ineffective) surgery—and repeat surgery—by the burgeoning orthopedic industry.

The good news is, prolotherapy has recently been attracting more interest from researchers. And they are reporting fantastic results.

For instance, a new study looked at 38 adults who had at least three months of osteoarthritis-related knee pain. During the first, fifth, and ninth weeks of the study, the participants were given prolotherapy injections containing dextrose (a sugar) in the connective tissues surrounding their knees. More injections were given to those who needed them at 13 and 17 weeks.2

The researchers concluded that these prolotherapy treatments resulted in significant levels of safe, sustained improvement in mild to severe knee pain, function, and stiffness. And there were no adverse effects.

In addition, at the end of the study, 91 percent of the people who had the prolotherapy treatments said they would recommend them to others with painful knee osteoarthritis.

In my own experience, I received only two prolotherapy treatments, close together, since I was on a travel schedule. But I found that was enough to be remarkably effective.

If you’d like to try prolotherapy yourself, it’s much easier today to find a practitioner than it was a decade ago. In fact, there’s an entire website,, listing practitioners throughout the United States.

Considering the proven effectiveness and safety of prolotherapy and physical therapy for joint pain, there is truly no need for you to ever have steroid injections. And, certainly, never consider surgery until you have tried these much safer and more cost-effective alternatives first.


1Rhon DI, et al. One-year outcome of subacromial corticosteroid injection compared with manual physical therapy for the management of the unilateral shoulder impingement syndrome: a pragmatic randomized trial. Ann Intern Med. 2014 Aug 5;161(3):161-9. doi: 10.7326/M13-2199.

2Rabago D, et al. Dextrose Prolotherapy for Knee Osteoarthritis: A Randomized Controlled Trial. Ann Fam Med May/June 2013 vol. 11 no. 3 229-237.