A modern physician would never prescribe Cocaine to treat a toothache, so why are you still using cortisone to treat knee pain?

By April 26, 2021 No Comments

Modern medicine is always advancing, and if you do not know about the newest non-surgical treatment option for Osteoarthritis you may be doing your patients and yourself a grave disservice…

As the US population continues to age, chronic age-related diseases such as Osteoarthritis (OA) are only becoming more common. Osteoarthritis of the Knee is now the third fastest growing condition in the US (75%), behind only diabetes (135%) and dementia (84%).1 By 2030 it is estimated that nearly 70 million Americans will have doctor-diagnosed Osteoarthritis of the Knee.2 Yet while the number of patients with this disease are continuing to increase, standard of care treatment options for OA are not keeping pace to meet this demand. In fact, Intra-articular corticosteroid (IACS) injections remain a primary treatment option for this disease despite conflicting evidence on their potential benefit. There is a lack of prospective and large retrospective studies evaluating potential joint findings, including increased risk for accelerated OA progression or adverse joint events, after treatment with IACS injection. A recent publication by the Radiographic Society of North America titled “Intra-articular Corticosteroid Injections in the Hip and Knee: Perhaps Not as Safe as We Thought?” really says it all…3

Additionally, according to Mayo Clinic4, the potential side effects of cortisone shots can include:

  • Cartilage damage
  • Death of nearby bone
  • Joint infection
  • Nerve damage
  • Temporary facial flushing
  • Temporary flare of pain and inflammation in the joint
  • Temporary increase in blood sugar
  • Tendon weakening or rupture
  • Thinning of nearby bone (osteoporosis)
  • Thinning of skin and soft tissue around the injection site
  • Whitening or lightening of the skin around the injection site

Further, Mayo Clinic sites the risk of repeated cortisone injections over concern that repeated cortisone shots might damage the cartilage within a joint and do not recommend cortisone injections more often than every six weeks and usually not more than three or four times a year.

So, if you are currently treating Osteoarthritis patients in your practice with a more frequent dosage of intra-articular cortisone injections you may be placing your patients at elevated risk, as well as increasing your malpractice exposure. One such example of the potential legal liability associated with cortisone injections can be found in Missouri where a jury awarded $2.88 million against a pain clinic for malpractice related to the injection of steroid in a single patient.5 Is a procedure that reimburses less than $100 from Medicare really worth $2.88 million dollars of risk?

It’s not just the medical and legal risk factors associated with cortisone injections to be mindful of, there’s also the fact that it may not work as intended and can even make the patients condition worse. Recently published research has revealed that corticosteroids cause cytotoxic effects of the chondrocytes and mesenchymal stem cells6the very structures our body relies upon to regulate and repair cartilage in the joint!

But there’s good news… modern medicine no longer uses cocaine to treat toothaches, and you do not have to use cortisone to ineffectively treat your Osteoarthritis patients any longer either!

There is an alternative outpatient procedure called The Advanced Arthritis Relief Protocol; a combination of intra-articular injections of hyaluronic acid to increase joint space, reduce friction, and stop the mechanical destruction of cartilage within the knee, combined with a PDAC approved unloading knee brace to relieve pain and improve function, as well as a unique home rehabilitation protocol to reduce ligament laxity and return stability to the joint. In a randomized clinical trial of 384 patients, all but one experienced some relief, and 92.7% experienced a 50% or greater reduction of pain and improvement in ADL function in a single course of treatment!7 In addition to its enhanced effectiveness and reduced risks, The Advanced Arthritis Relief Protocolis covered by most major insurance plans including Medicare and yields an average case fee of over $9,000 at Medicare’s average allowable fee schedule.

To learn more about how adding this protocol to your practice can increase clinical outcomes, reduce risk, and provide substantial additional profits schedule a risk-free introductory webinar here or call (855) 854-6332 today!

About the Author: Lance Liberti is a nationally recognized healthcare consultant and new patient marketing professional with more than a decade of practical experience in the field. His experience spans multiple areas of practice including non-surgical spinal decompression, medically supervised weight loss, aesthetic medicine, and non-operative extremity pain management. The president and CEO of Integrative Practice Solutions, Inc. Mr. Liberti specializes in assisting health and wellness professionals integrate boutique medical services into their practices to offer non-surgical solutions to those suffering from various degenerative musculoskeletal conditions. To learn more about Mr. Liberti’s extensive experience and see examples of his work products view his LinkedIn profile here:


  2. Arthritis & Rheumatism 2006;54(1):226-229 [Data Source: 2003 NHIS]
  3. Andrew J. Kompel, Frank W. Roemer, Akira M. Murakami, Luis E. Diaz, Michel D. Crema, Ali Guermazi. “Intra-articular Corticosteroid Injections in the Hip and Knee: Perhaps Not as Safe as We Thought?” Radiographic Society of North America, Vol. 293, No. 3: October 15th, 2019
  6. Wyles, C.C., Houdek, M.T., Wyles, S.P. et al. Differential Cytotoxicity of Corticosteroids on Human Mesenchymal Stem Cells. Clin Orthop Relat Res 473, 1155–1164 (2015).
  7. Nicholas Ghanem, M.Sc. ““Intra-Articular Hyaluronic Acid in Tandem with Physical Therapy Program for the Treatment of Symptomatic Knee Osteoarthritis”

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