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  1. #1
    JosefRakichFitness.com JOSEF RAKICH's Avatar
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    Muscle atrophy caused by cortisone injection?

    From what i have heard cortisone injections are a powerful anti-inflammatory medication. Also used as pain relieving medication in a the particular area of inflammation.

    Is it true that it degrades muscle tissue in the area making it weaker, breaking down tissue, helping swelling that way?

    For example: If i get a injection of cortisone would that certian muscle atrophy?
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  2. #2
    Registered User entropy1's Avatar
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    basically yes. have a read here what cortisone does http://en.wikipedia.org/wiki/Glucocorticoids

    it's also worth noting that the cortisone will enter the blood stream and affect the entire body, not just the injection site. unless it's injected into a joint capsule or some other "sealed" area
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  3. #3
    cockney turning scouse melon's Avatar
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    Originally Posted by entropy1 View Post
    basically yes. have a read here what cortisone does http://en.wikipedia.org/wiki/Glucocorticoids

    it's also worth noting that the cortisone will enter the blood stream and affect the entire body, not just the injection site. unless it's injected into a joint capsule or some other "sealed" area
    No, this is incorrect.

    Local corticosteroid injections will not cause local atrophy unless it's an enormous dose and given repeatedly. They do enter systemic circulation, but the dose is so tiny that it makes no difference. They are injected locally to avoid systemic side effects as you can give a smaller dose.
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  4. #4
    Registered User entropy1's Avatar
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    Originally Posted by melon View Post
    No, this is incorrect.

    Local corticosteroid injections will not cause local atrophy unless it's an enormous dose and given repeatedly. They do enter systemic circulation, but the dose is so tiny that it makes no difference. They are injected locally to avoid systemic side effects as you can give a smaller dose.
    it depends on the dose rate and the type etc, you'll aways get some systemic affect just sometimes it's so low you dont notice and clinical affect (according to my lecture). and that "repeatedly" business also depends on the amount and type, a big hit of methylprednisolone acetate will certainly stay around for ages and cause some cushiod type affects.


    vets use a lot more corticosteriods than the human world btw

    end of the day, if you need cortisone, it's best to have it (atleast intially)
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  5. #5
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    Originally Posted by entropy1 View Post
    it depends on the dose rate and the type etc, you'll aways get some systemic affect just sometimes it's so low you dont notice and clinical affect (according to my lecture). and that "repeatedly" business also depends on the amount and type, a big hit of methylprednisolone acetate will certainly stay around for ages and cause some cushiod type affects.


    vets use a lot more corticosteriods than the human world btw

    end of the day, if you need cortisone, it's best to have it (atleast intially)
    I refuse to believe that a local injection of steroid, no matter how strong, will cause Cushingoid side effects. In real life, that just doesn't happen. I'm not sure about animals, but certainly in people you would struggle to notice any systemic effects from steroids. Apart from children, but they are different physiologically and can get adrenal suppression from long term steroid inhalers.

    Can you get Cushing's syndrome/disease in animals then? That's interesting. Although I doubt you would bother performing neurosurgery to remove the adenoma in Cushing's disease in a cow for example.
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  6. #6
    Registered User entropy1's Avatar
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    Originally Posted by melon View Post
    I refuse to believe that a local injection of steroid, no matter how strong, will cause Cushingoid side effects. In real life, that just doesn't happen. I'm not sure about animals, but certainly in people you would struggle to notice any systemic effects from steroids. Apart from children, but they are different physiologically and can get adrenal suppression from long term steroid inhalers.

    Can you get Cushing's syndrome/disease in animals then? That's interesting. Although I doubt you would bother performing neurosurgery to remove the adenoma in Cushing's disease in a cow for example.
    well i've certainly seen it, but we use a lot more steriods becuase we rely less on antihistamines, chemo drugs etc

    yes, animals do get cushings, mainly dogs (its the most common metabolic disease in dogs) and horses. and no, we dont bother to do neurosurgery in animals becuase we have trilostane (and also mitotane). we do remove adrenal tumors though (bilateral sometimes too which is fun)
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  7. #7
    cockney turning scouse melon's Avatar
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    Originally Posted by entropy1 View Post
    well i've certainly seen it, but we use a lot more steriods becuase we rely less on antihistamines, chemo drugs etc

    yes, animals do get cushings, mainly dogs (its the most common metabolic disease in dogs) and horses. and no, we dont bother to do neurosurgery in animals becuase we have trilostane (and also mitotane). we do remove adrenal tumors though (bilateral sometimes too which is fun)
    Fair enough. I've never seen it in humans though, so I guess we'll leave it at that.

    I just looked up Trilostane. I can't imagine using a drug like that on people, seeing as you are effectively deliberately causing Addison's disease to treat Cushings. I guess dogs can handle it better than we can.
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  9. #9
    JosefRakichFitness.com JOSEF RAKICH's Avatar
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    Originally Posted by entropy1 View Post
    basically yes. have a read here what cortisone does http://en.wikipedia.org/wiki/Glucocorticoids

    it's also worth noting that the cortisone will enter the blood stream and affect the entire body, not just the injection site. unless it's injected into a joint capsule or some other "sealed" area
    Diddnt expect you to make a post entrophy, thanks for the info.

    So basically it will effect the entire body unless its injected into a "sealed" area then it will only atrophy the injection area?
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  10. #10
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    Originally Posted by JOSEF RAKICH View Post
    Diddnt expect you to make a post entrophy, thanks for the info.

    So basically it will effect the entire body unless its injected into a "sealed" area then it will only atrophy the injection area?

    I have a friend who goes to piano school. She plays the piano hours each day.

    she ended up getting tendonitis in her forearms from the overuse.

    Her father a doctor injected her forearms with cortisone injections. Her muscles in her forearms wasted away.

    She has not played the piano in months. Maybe its just her.
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  11. #11
    Registered User entropy1's Avatar
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    Originally Posted by JOSEF RAKICH View Post
    So basically it will effect the entire body unless its injected into a "sealed" area then it will only atrophy the injection area?
    it will get into the rest of the body if it's injected into muscle/sub cut etc etc. However, as others noted, it probably wont have any affect on the rest of the body unless it's an extremely high dose etc etc.

    but either way you probably need it

    Originally Posted by melon View Post
    I just looked up Trilostane. I can't imagine using a drug like that on people, seeing as you are effectively deliberately causing Addison's disease to treat Cushings. I guess dogs can handle it better than we can.
    nah, you control the dose and only shut down the neoplastic tissue, the normal tissue works normally. it's actually highly effective and you need to montior blood cortisone levels to establish a dose for a bit though. and because it works on the enzyme it's completely reversable
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  12. #12
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    Originally Posted by HALON View Post
    I have a friend who goes to piano school. She plays the piano hours each day.

    she ended up getting tendonitis in her forearms from the overuse.

    Her father a doctor injected her forearms with cortisone injections. Her muscles in her forearms wasted away.

    She has not played the piano in months. Maybe its just her.
    Another wonderfully anecdotal story from our resident doctor-hater HALON.
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  13. #13
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    Originally Posted by melon View Post
    Another wonderfully anecdotal story from our resident doctor-hater HALON.
    No just one of the the many 470 000 examples of doctor stupidity, and
    another stupid answer from our local fruit the melon.

    My sig sums it all read it.

    Yeah her forearms decided to atrophy by themselves. I think it was magic actually.


    I know inject yourself with some cortisone injections in your forearms. Then come back and say anecdotal. First I have to ask her how many injections she had and the dosage.

    Up for the challenge my fruit. I think it would be a good first hand (I should say forearm) learning experience for you. You do medicine right?. What better way to learn about the treatment you give patients by receiving it yourself.

    You use the word anecdotal alot, espcially if you cant provide a definite answer or reason. If its not the cortisone injections then what else caused her attrophy?.
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    Originally Posted by HALON View Post
    I have a friend who goes to piano school. She plays the piano hours each day.

    she ended up getting tendonitis in her forearms from the overuse.

    Her father a doctor injected her forearms with cortisone injections. Her muscles in her forearms wasted away.

    She has not played the piano in months. Maybe its just her.
    You serious?

    Or you being sarcastic?

    Originally Posted by entropy1 View Post
    it will get into the rest of the body if it's injected into muscle/sub cut etc etc. However, as others noted, it probably wont have any affect on the rest of the body unless it's an extremely high dose etc etc.
    I see.

    Cheers thanks for the info.
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    [QUOTE=JOSEF RAKICH;388363051]You serious?

    Or you being sarcastic?



    QUOTE]


    No I am serious. This actually occured.


    But I think its just an isolated incident. Maybe some people react differently to it.
    "In AUSTRALIA
    Each year there are 470 000 adverse events, 18 000 deaths, and 50 000 permanent disabilities arising from medical error and negligence each year. This is four times higher compared to the USA." (Second oppinion, GERMOV quote, page 293)

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    Originally Posted by HALON View Post
    No just one of the the many 470 000 examples of doctor stupidity, and
    another stupid answer from our local fruit the melon.

    My sig sums it all read it.

    Yeah her forearms decided to atrophy by themselves. I think it was magic actually.


    I know inject yourself with some cortisone injections in your forearms. Then come back and say anecdotal. First I have to ask her how many injections she had and the dosage.

    Up for the challenge my fruit. I think it would be a good first hand (I should say forearm) learning experience for you. You do medicine right?. What better way to learn about the treatment you give patients by receiving it yourself.

    You use the word anecdotal alot, espcially if you cant provide a definite answer or reason. If its not the cortisone injections then what else caused her attrophy?.
    How on earth am I supposed to tell you what happened to her arms from a few sentences of information. All I am saying is that pharmacologically, but in terms of how corticosteroids work and how they are absorbed and distributed around the body, a local injection should not cause muscle atrophy in the sense that a difference is noticed either visually or in terms of strength. There's certainly no way the muscle would become "wasted" with a single injection.

    I'd rather not inject them into my own arms, as intramuscular injections are very painful. Plus, why should I, I didn't invent the drug so I have no reason to stand up for it in that way.

    So you think doctors are stupid, that's your opinion. I guess you know better than we do from a few online articles you have read, no doubt written by another teenager who thinks they know everything.

    We've had this argument before in a different thread so I know we're not going to agree. Do you really not know anybody that has seen benefit from treatment by a doctor?
    The first rule of cheat club is you do not talk about cheat club. The second rule of cheat club is you DO NOT talk about cheat club. Third rule of cheat cub, someone yells stop!, goes limp, taps out, the cheat is over. Fourth rule, one cheat at a time, fellas. Fifth rule, cheats will go on as long as they have to. And the sixth and final rule, if this is your first night at cheat club, you have to cheat.

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  17. #17
    Registered User HALON's Avatar
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    Originally Posted by melon View Post
    How on earth am I supposed to tell you what happened to her arms from a few sentences of information. All I am saying is that pharmacologically, but in terms of how corticosteroids work and how they are absorbed and distributed around the body, a local injection should not cause muscle atrophy in the sense that a difference is noticed either visually or in terms of strength. There's certainly no way the muscle would become "wasted" with a single injection.

    I'd rather not inject them into my own arms, as intramuscular injections are very painful. Plus, why should I, I didn't invent the drug so I have no reason to stand up for it in that way.

    So you think doctors are stupid, that's your opinion. I guess you know better than we do from a few online articles you have read, no doubt written by another teenager who thinks they know everything.

    We've had this argument before in a different thread so I know we're not going to agree. Do you really not know anybody that has seen benefit from treatment by a doctor?

    I think she may have had more then a single injection. I have to ask her.


    Personlly no. I have never seen benefit from treatment by a doctor for myself.

    Although I do use doctors for medical certificates and for writing up 5 free osteopathic treatments.
    "In AUSTRALIA
    Each year there are 470 000 adverse events, 18 000 deaths, and 50 000 permanent disabilities arising from medical error and negligence each year. This is four times higher compared to the USA." (Second oppinion, GERMOV quote, page 293)

    353 fatal car crashes were recorded on Australian roads in 2008 (RTA, 2008). You are 50 TIMES more likely to die from medical negligence from a DOCTOR compared to being fatally injured in a car crash and they say driving is dangerous.
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    This is a funny thread isn't it!? Let me try and set the record straight. A properly administered corticosteroid injection placed next to but not directly into an inflamed tissue will almost never result in a detrimental systemic effect or in local muscle atrophy. When administered orally, the same drug will almost certainly have a systemic effect and if administered repeatedly will almost certainly have a catabolic effect.
    Josef asked 'If i get a injection of cortisone would that certain muscle atrophy?'. The answer is No - not if it is performed correctly. It should also be pointed out that the target tissue for most cortisone injections is not muscle itself. It is usually tendon or ligamentous tissue. I cannot think of a valid reason to inject a muscle with cortisone.
    I hope this clears up any confusion!?
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    Walking like an Egyptian. Finnegan Bell's Avatar
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    I had a cortisone shot in my left shoulder. I never heard about muscle atrophy until I noticed in the mirror my left delts got smaller than the right . Fixed it in 2 weeks with heavy lateral raises ,nothing major.
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    Originally Posted by thesparkly1 View Post
    This is a funny thread isn't it!? Let me try and set the record straight. A properly administered corticosteroid injection placed next to but not directly into an inflamed tissue will almost never result in a detrimental systemic effect or in local muscle atrophy. When administered orally, the same drug will almost certainly have a systemic effect and if administered repeatedly will almost certainly have a catabolic effect.
    Josef asked 'If i get a injection of cortisone would that certain muscle atrophy?'. The answer is No - not if it is performed correctly. It should also be pointed out that the target tissue for most cortisone injections is not muscle itself. It is usually tendon or ligamentous tissue. I cannot think of a valid reason to inject a muscle with cortisone.
    I hope this clears up any confusion!?
    Pretty much this.

    I highly doubt there would be any significant atrophy unless the dosage was wrong or it was adminstered incorrectly. Repeated doses, it may occur.
    No post is professional medical, nutrition or training info!

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    Unhappy Question for you.

    Originally Posted by melon View Post
    No, this is incorrect.

    Local corticosteroid injections will not cause local atrophy unless it's an enormous dose and given repeatedly. They do enter systemic circulation, but the dose is so tiny that it makes no difference. They are injected locally to avoid systemic side effects as you can give a smaller dose.
    I accidentally came across this thread looking for reasons why a i have a huge new indention in my butt. About a month ago I got a cortisone shot. 1 single shot for back pain. Since then I have noticed a little bit of discoloration of the skin and a continuous "muscle ache feeling" in the site. Now I have a hole in the muscle exactly where I got the injection. I don't think it's coincidence, so please explain if you can. I completely believe I couldn't live without the help of my Dr's and modern medicine, but I am very disappointed in how quickly Dr's are giving out injections that can cause things like this. I'm also concerned about how much more of this muscle with go and if it will be able to be reversed. I mean, muscles don't regenerate....do they?
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  22. #22
    Registered User nakima's Avatar
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    Originally Posted by melon View Post
    No, this is incorrect.

    Local corticosteroid injections will not cause local atrophy unless it's an enormous dose and given repeatedly. They do enter systemic circulation, but the dose is so tiny that it makes no difference. They are injected locally to avoid systemic side effects as you can give a smaller dose.
    I just had a couple cortisone injections due to long term pain in hips and perifiormis muscle and the glutes atrophied, within 3 days it was almost gone! I freaked out... went back to my dr. said he's never seen anyhting like this. Doing everything I can to get built back up. I'm small and a hard gainer so it took a long time to get my glutes in good shape and put some size on them. now there gone and I'm scared, so maybe i'm just one of those odd cases but it does happen. I would not advise injections in large muscle groups, just in case. Had I been advised of this possible side affect I would not have done it I can only hope it I can get it back and that its only temperary ( keeping my fingers crossed) and hitting the gym. no advise from my dr. at this time. I read somewhere on line that it could be temperary and others have said theirs is permanent. I guess I should have checked all possible side affects before recieving the shots. shoulda, coulda, woulda, its bad. Hope this gives others food for thought. oh this just happened 2 week ago not much change yet.
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  23. #23
    Registered User nakima's Avatar
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    Originally Posted by hollimichele View Post
    I accidentally came across this thread looking for reasons why a i have a huge new indention in my butt. About a month ago I got a cortisone shot. 1 single shot for back pain. Since then I have noticed a little bit of discoloration of the skin and a continuous "muscle ache feeling" in the site. Now I have a hole in the muscle exactly where I got the injection. I don't think it's coincidence, so please explain if you can. I completely believe I couldn't live without the help of my Dr's and modern medicine, but I am very disappointed in how quickly Dr's are giving out injections that can cause things like this. I'm also concerned about how much more of this muscle with go and if it will be able to be reversed. I mean, muscles don't regenerate....do they?
    you have my sympathy because I to am going through this myself right now. I also have the little dents on each of my hips at the injection site but it also took the whole muscle out out along with it and it happened within 3 days my glutes are mush and at first all I could do was cry and now I just have to try not to cant think to much about it. I just have to do what ever I can to try and get them back and pray that I can. My dr. has no clue as to why this happened I was at wits end with the pain and thats why I got the shot, now I wish I had left it alone but I had tried everything else an nothing helped, oh well I guess these things have to happen to someone in order to warn others but hang in there and just work a little harder to get it back. it took several years to build this butt and two mins to take it out I'm very upset gggrrrr but life goes on.
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    Originally Posted by hollimichele View Post
    I accidentally came across this thread looking for reasons why a i have a huge new indention in my butt. About a month ago I got a cortisone shot. 1 single shot for back pain. Since then I have noticed a little bit of discoloration of the skin and a continuous "muscle ache feeling" in the site. Now I have a hole in the muscle exactly where I got the injection. I don't think it's coincidence, so please explain if you can. I completely believe I couldn't live without the help of my Dr's and modern medicine, but I am very disappointed in how quickly Dr's are giving out injections that can cause things like this. I'm also concerned about how much more of this muscle with go and if it will be able to be reversed. I mean, muscles don't regenerate....do they?
    Sorry, I just noticed how old this message is but I am curious to find out the outcome anybody else ever experienced this? I'm hopeing it"s temperary... thanks for any input or suggestions.
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