Steroid injections can offer short-term relief—but repeated use can cause long-term structural harm. The NIH warns that overuse can weaken soft tissues and damage joint structures.

What’s happening

Steroids reduce inflammation but also reduce collagen integrity. Over time, this increases the risk of tendon rupture, joint collapse, and chronic instability. In 2024, Sally noticed a drastic change:

“Months later my foot looked like part of it had collapsed… which it had.”
— Sally Figueroa

The injection had weakened tissue rather than healed it.

What you can do

• Ask providers how many injections are safe per year.
• Request imaging before repeat injections.
• Explore alternatives: physical therapy, braces, pacing strategies.
• Track pain patterns to identify triggers.

What to avoid

• Treating steroid injections as maintenance therapy.
• Assuming no long-term consequences.

How to move forward

Second opinions are protective, not confrontational. Your future mobility depends on today’s decisions.

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Verification Note

Checked and verified active December, 2025
All sources are government, peer-reviewed, or nonprofit medical authorities directly supporting claims made in this article.

Risks of repeated corticosteroid injections

NIH / National Center for Biotechnology Information — Corticosteroid Adverse Effects
Comprehensive clinical review documenting that repeated or high-dose corticosteroid exposure can weaken connective tissue, impair collagen synthesis, and increase risk of tendon rupture and joint damage.
https://www.ncbi.nlm.nih.gov/books/NBK531462/

NIH / National Library of Medicine — Local and Systemic Side Effects of Corticosteroid Injections
Peer-reviewed analysis explaining how intra-articular and soft-tissue steroid injections can cause tissue atrophy, cartilage degeneration, and structural weakening when repeated.
https://pubmed.ncbi.nlm.nih.gov/25152531/

Tendon rupture, joint instability, and structural collapse

American Academy of Orthopaedic Surgeons (AAOS) — Cortisone Shot Risks
Notes that repeated corticosteroid injections may weaken tendons, increase rupture risk, and damage joint cartilage over time.
https://orthoinfo.aaos.org/en/treatment/cortisone-shot-steroid-injection/

NIH / PubMed — Corticosteroid Injections and Tendon Integrity
Reviews evidence linking steroid exposure to decreased collagen production and increased susceptibility to tendon rupture.
https://pubmed.ncbi.nlm.nih.gov/14685920/

Imaging and limits on injection frequency

American College of Rheumatology — Glucocorticoid Use Guidance
Recommends limiting frequency of steroid injections and using imaging and alternative therapies when pain persists.
https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Treatments/Glucocorticoids

British Society for Rheumatology (widely cited in U.S. practice) — Joint Injection Safety Guidelines
Advises caution with repeat injections due to cumulative tissue damage and recommends reassessment before continuation.
https://academic.oup.com/rheumatology/article/57/iv/iv1/5070336

Non-steroid alternatives and protective strategies

NIH / National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Outlines non-steroid management options including physical therapy, bracing, pacing, and activity modification for chronic musculoskeletal conditions.
https://www.niams.nih.gov/health-topics

Agency for Healthcare Research and Quality (AHRQ) — Non-Pharmacologic Pain Management
Supports physical therapy, pacing, and structured movement as first-line strategies to reduce reliance on repeated injections.
https://www.ahrq.gov/painmanagement/nonpharmacologic-treatment.html

Patient safety, second opinions, and long-term mobility

Patient Safety Network (PSNet), AHRQ — Shared Decision-Making in Pain Management
Emphasizes second opinions and informed consent when interventions carry long-term structural risk.
https://psnet.ahrq.gov/primer/shared-decision-making