Cortisone and ankle osteoarthritis

A March 2025 study (1) writes: “Intra-articular corticosteroid injections are commonly used to treat osteoarthritis, both in the foot and ankle and elsewhere in the body, but clinical practice is highly variable,” and “Over recent years, there has been a growing awareness of potential detrimental effects of intra-articular corticosteroid injections including chondrotoxic effects and accelerated osteoarthritis progression, subchondral insufficiency fractures, osteonecrosis and increased risk of prosthetic joint infection, although the evidence is not robust.” However, repeated “intra-articular corticosteroid injections may provide some improvements in pain, function and quality of life up to 24 months after administration, they did not outperform placebo or other injectables at 12 and 24 months.” Future research is needed to address fundamental questions around the use of intra-articular steroids in the foot and ankle. Key uncertainties include: whether these treatments are clinically- and cost-effective, which products should be injected, whether imaging guidance improves outcomes, whether injected corticosteroids delay time to surgical treatment or whether they increase the likelihood of adverse events, such as post-injection infection.

Jones K, Bruce J, Lewis TL, Nolan CN, Munteanu SE, Menz HB, Backhouse MR. Intra-articular corticosteroid injections for the treatment of people with foot and ankle osteoarthritis: a systematic review. Rheumatology Advances in Practice. 2025 Mar 11:rkaf030.

Surgery versus nonsurgical treatment for cervical radiculopathy

An April 2025 study (2) compared surgery versus nonsurgical treatment for cervical radiculopathy. Two randomized clinical trials divided 180 patients with disabling radicular arm pain and cervical disc herniation or spondylosis to receive either surgical or nonsurgical treatment. Surgery involved anterior cervical discectomy and fusion. Nonsurgical treatment involved three sessions with physical medicine/rehabilitation physicians and three sessions with physiotherapists for functional and cognitive behavioral support. The primary outcome in both trials was the Neck Disability Index (NDI) score (range, 0 to 100; higher scores indicate greater disability; minimal important difference is 15) at 12 months, which was self-reported by the patients.

  • The researchers found a statistically significant difference for Neck Disability Index (NDI) score at 12 months in favor of surgical versus nonsurgical treatment in the disc herniation trial, but no difference in patients in spondylosis trial.

Taso M, Sommernes JH, Sundseth J, Pripp AH, Bjorland S, Engebretsen KB, Kolstad F, Zwart JA, Brox JI. Surgical versus nonsurgical treatment for cervical radiculopathy. NEJM evidence. 2025 Mar 25;4(4):EVIDoa2400404.

A December 2024 study (3) looking at the problems of older women from the Women’s Health Initiative Long Life Study found antidepressant prescriptions were  cross-sectionally related to worse self-reported physical function, and with worse performance-based physical function after more than 20 years of follow-up. Complex relationships was also found for hypnotic/sedatives given to these women and the subsequent rapid deterioration in these women.

Beydoun HA, Beydoun MA, Kwon E, Alemu BT, Zonderman AB, Brunner R. Relationship of psychotropic medication use with physical function among postmenopausal women. GeroScience. 2024 Dec;46(6):5797-817.