Steroids and Healing

Standard care for the types of soft tissue trauma which respond very well to Manual Therapy is the use of corticosteroids. In addition to the contamination issues recently uncovered in manufacturing facilities in the United States, their long term efficacy has been drawn into question. In a recent study by  Bill Vicenzino of the University of Queensland, Physical Therapy proved to have a better long term outcome than steroid injections. The study was published in the 2/6/2013 JAMA. I do not have access to the study, but here is a link to an article in the San Francisco Chronicle describing the report:


Steroids can be extremely effective at managing inflammation during the acute phase of healing from physical trauma. However, they in no way address the underlying structural issues the set up the emergence of the inflammatory response. Without addressing any intrinsic imbalance that initiated an inflammatory response, as the steroids wear of the inflammation will more likely than not re-kindle. Therapy organized around reorganizing the intrinsic imbalance (Manual Therapy / Physical Therapy), will usually remove the trigger for inflammation, thereby both accelerating the healing process and provide a long term solution.