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Pain scores (VAS, WOMAC) showed numerical but not statistically significant improvements in most trials

Supplementation ensures adequate levels to prevent complications like nerve damage or anemia

This typically involves: Intrinsic factor antibodies (highly specific for pernicious anaemia, though sensitivity is only 50%) [12] [28] Gastric parietal cell antibodies (more sensitive but less specific) Coeliac serology if malabsorption is suspected Consideration of upper gastrointestinal endoscopy in selected cases, particularly with autoimmune gastritis/pernicious anaemia NICE guidance emphasises that treatment should not be delayed whilst awaiting antibody results if clinical features strongly suggest deficiency, as irreversible neurological damage can occur

The limit is not to the number of injections into the body but rather to the amount of cortisone put in your body