Olafsen Nathan P, Herring Stanley A, Orchard John W
Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University School of Medicine.
Departments of Rehabilitation Medicine, Orthopaedics, and Sports Medicine, and Neurological Surgery, University of Washington.
Clin J Sport Med. 2018 Sep;28(5):451-456. doi: 10.1097/JSM.0000000000000603.
To review the literature guiding all aspects of the use of injectable corticosteroids for painful musculoskeletal conditions, with a focus on the treatment of athletes.
An extensive search of the literature was completed including search terms of corticosteroid, steroid, athlete, and injection, among others. Additional articles were used after being identified from previously reviewed articles.
Injections of corticosteroids for a variety of painful conditions of the extremities and the axial spine have been described. Numerous minor and major complications have been reported, including those with a high degree of morbidity. There is a dearth of published research on the use of corticosteroid injections in athletes, with most of the research on this topic focused on older, nonathlete populations. Generally, these injections are well tolerated and can provide short-term pain improvement with little or no long-term benefits.
Corticosteroid injections should be used cautiously in athletes and only after a full consideration of the pharmacology, pathogenesis of disease, potential benefits, complications, factors specific to the athlete, and rules of athletic governing bodies. Corticosteroid injections are just one component of a comprehensive rehabilitation plan available to the physician providing care to athletes.
回顾指导注射用皮质类固醇治疗肌肉骨骼疼痛性疾病各方面的文献，重点关注运动员的治疗。
完成了对文献的广泛检索，包括皮质类固醇、类固醇、运动员和注射等检索词。从先前综述的文章中识别出其他文章后加以使用。
已描述了注射皮质类固醇治疗各种四肢和脊柱疼痛性疾病的情况。报告了许多轻微和严重的并发症，包括那些发病率很高的并发症。关于在运动员中使用皮质类固醇注射的已发表研究很少，该主题的大多数研究集中在老年非运动员人群。一般来说，这些注射耐受性良好，可提供短期疼痛改善，但几乎没有或没有长期益处。
在运动员中使用皮质类固醇注射应谨慎，且仅在充分考虑药理学、疾病发病机制、潜在益处、并发症、运动员特有的因素以及体育管理机构的规则后使用。皮质类固醇注射只是为运动员提供护理的医生可采用的综合康复计划的一个组成部分。
