Shots, Shots, Shots: Is There Such a Thing as One Too Many?

Corticosteroid injections are everywhere in musculoskeletal medicine. Epidurals, joints, facets, bursae: when inflammation and pain are the targets, steroids have long been one of the sharpest tools in the shed. But does local treatment mean only local consequences? And when does another shot become one shot too many? In this episode of the JDD Podcast Corticosteroid Stewardship Series, host Dr. Adam Friedman sits down with Dr. Joseph Bax, an interventional physiatrist and Assistant Professor of Orthopedics and Rehabilitation and Human Performance at the Icahn School of Medicine at Mount Sinai, to inject some perspective into procedural corticosteroid use.

The two take aim at the when, where, why, and how often of corticosteroid injections: Who is the right patient? How much is too much? Perhaps most importantly, who is keeping the steroid scorecard when one patient gets an epidural from one physician, a joint injection from another, oral prednisone somewhere else, and a topical steroid from…well, you know who? From cumulative corticosteroid exposure and comorbidities to physical therapy, radiofrequency ablation, nerve blocks, PRP, and other steroid-sparing strategies, Drs. Friedman and Bax explore how to reduce reliance without replacing evidence-based medicine with wishful thinking. So before you say, “Just give ’em another shot,” give this episode a gander. Good corticosteroid stewardship isn’t about taking the needle away, it’s about the right shot, right patient, right time, and right reason.

Guest: Dr. Joseph Bax