every orthopedic surgeon tells the same story: ligaments at facet joints and other joints get destroyed, become brittle. Local anesthetics like Ropivacaine plus as an option morphine do a much better job. Patients get mislead by the pain "killing" effect of cortisone. They are not told about the local side effects.
Based on molecular pharmacology it is clear which substances are a better choice.
From molecular biology it is clear what the job of steroids is. Those who neglect molecular biological facts and just base their judgement on so called clinical studies are not acting according to the state of science.
So called inflammation is not the only mechanism of pain generation. Peripheral pain receptors multiply; but these are not considered by clinicians who use cortisone locally.
Is there more research on this topic?
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