I’m curious if anyone has had steroid injections for enthesitis and how well they have worked.
I’m having trouble, specifically, with the attachment points on the outside of my foot. It started about four days ago, and is making me pretty miserable. Oh, and one of my jobs is walking dogs.
Usually I try to be patient and wait things out for a while, knowing that these things usually settle down. This level of discomfort will be hard to wait out. Oh, and how long does it typically take for enthesitis to clear on its own? This is not a typical problem for me.
This sounds stupid but I never really knew what enthesitis was, so I finally looked it up. It sounds like it can be associated with PsA and is often in the foot, but can be around any other joint where tendons and ligaments attach to the bone. Wikipedia didn't describe the symptoms, so I'm wondering what the pain is like. Is it associated with tendonitis? I've never had steroid injections, so I don't have an answer for you. But, are you on a biologic? Hopefully, this problem will resolve itself--it must be really difficult to walk with pain in that area!
Oh Stoney. Yikes. I have enthesitis usually close to my elbows. I've not had steroids and would wonder what precisely they would inject. I had steroid shots in my hip bursa to calm down inflammation there but wonder what in my elbows or your feet they would treat.
And Grandma J, the pain can be terrible. My elbows ached like crazy and I felt like I had tennis elbow for months. There was weird swelling that went along with it and it took a long time for the swelling and aching to subside.
I am on a biologic. Typically I get joint pain and/or swelling, and tendon pain, even along the whole length of the tendon.
This is on the outside side of my foot, at the insertion point, and the tendons are tender going up from there. I’m getting it as a very bad ache, as opposed to sharp pains, sometimes throbbing.
Janeatiu- that’s what I’m starting to wonder too. . . . What exactly would be injected? I’m trying to decide how long to manage at home with ice and topical diclofenac, and when to be seen for it.
Grandma J said:
This sounds stupid but I never really knew what enthesitis was, so I finally looked it up. It sounds like it can be associated with PsA and is often in the foot, but can be around any other joint where tendons and ligaments attach to the bone. Wikipedia didn’t describe the symptoms, so I’m wondering what the pain is like. Is it associated with tendonitis? I’ve never had steroid injections, so I don’t have an answer for you. But, are you on a biologic? Hopefully, this problem will resolve itself–it must be really difficult to walk with pain in that area!
That's more similar to what my pain felt like, Stoney, achy, sore--really sore to the touch or pressure on it. Janeatiu, I had it in my elbows, too. I guess I had it in so many places I should just list the places I didn't have it and I'd be more accurate! I can't get over how greatly that has diminished and almost completely disappeared since I've been on Enbrel. The only problem I have with stiffness and soreness is in the morning when I first get up or when I sit too long, but I limber up within 15 minutes. I've also recently had some stiffness in my groin area, so getting up from sitting is painful there at first, but I'm wondering if that's from using the eliptical or some of the strengthening equipment at the gym.
At the time I had so much of that type of pain I did have a burst of prednisone and I felt great for a few days. But, prednisone is only a temporary fix. Stoney, maybe your biologic isn't working quite as well as it should.
I have a lot of enthesitis pain in my feet and heels. Several things have been helpful. Keeping inflammation down as best possible ( I’m on Enbrel, injected methotrexate and Celebrex )
Voltaren Gel applied to Achilles’ tendon on heel or on area of foot that is bothersome. Kenalog injection (I get in buttocks- helps systemically- you can only do this a few times per year).
Keep off your feet and sit/lay with feet raised to get rid of swelling. I wear crocs clogs when my feet are hurting. Fitted shoes cause me lots of grief, especially those with backs.
I do physical therapy in a warm water pool. Just walking back and forth in the warm water feels good.
I hope something works for you
Yes, Voltaren gel, Stoney. I rub it on the tops of my feet. It's numbing. I'm not sure if it would get to your pain inside the joint, but you could ask your doctor if he thought so he could prescribe some. The top of my arches can hurt pretty badly and the Voltaren gel seems to hit the spot! I rub it in all the way down to my toes almost every evening.
Stoney, I have been asking around about the shots for your feet. And they will aim for the joint spaces. But I've heard it can be pretty darned painful.
I know you're on biologics. Any chance that they're waning a bit and you could use a boost? (asking for a friend...)
I’ve been wondering about the biologic for a number of months now. The enthesitis pain has thankfully died back to a more manageable level.
My rheumy and I have discussed my concerns about Enbrel not working great. I’m already on leflunomide, so I already have a DMARD added in. She mentioned possibly adding in MTX as well, which slightly horrifies me. I already told her that it would have to be injectable due to the GI side effects I had when I took if for six months two plus years ago. She doesn’t want to switch biologics unless she is 100% certain that it is no good anymore. I’ve been having more flares in the last six months, as well as more visible damage.
janeatiu said:
Stoney, I have been asking around about the shots for your feet. And they will aim for the joint spaces. But I’ve heard it can be pretty darned painful.
I know you’re on biologics. Any chance that they’re waning a bit and you could use a boost? (asking for a friend…)
I've had three injections into the joint of my right hip (combination Kenalog and betamethasone). The last one worked better than the first two, I think because I had a tech who really knew what she was doing and had me turn my right foot toward the left to really open up the joint. I've had real relief that evening and lasting relief for quite a while. I can have them every three or so months--I'll continue doing that until replacement sometime the second half of last year (please, let me last that long).
I had one into my left shoulder--no relief. I *think* it was betamethasone.
The one into my left hand HURT for several days, was sore for much longer (I still have one very tender spot two years later) AND I had trouble using the hand for several days afterward. I would think long and hard before I had another one of those.
I had one into the bursa of my right hip, which worked miracles. This one was dex.
I have a lot of trouble with my left Achilles, both plantar fascia and "arthritic changes" in my toes and the bones of the bottom of my feet. What helps more than anything is regular massage with plain old Eucerin lotion we get at Costco. If it's really bad or I'm swelling, soaking in hot Epsom salt water works wonders.
I've not been told that I am specifically having enthesisits there, but I'm having a whole heck of a lot of trouble with my knees. I did have one drained recently and have a stroid injection. It worked wonderfully, but it's not something you want to do too often. Maybe this is more a problem when injection directly into the joint that into a non-joint area in the foot. My feet are all sorts of messed up too, and it seems like the tendons flare off and on. it depends on how much time I'm on them, the shoes I'm wearing, my biologic, and getting time to put my feet up. Sometimes, it's better in a day or two, sometimes it can last a month.
I'd want to know why you're having more problems than usual? Also, have you tried orthotics and differetn shoes? Those can help. I also have a foot bath that I use with Epsom salts. That helps A TON.
i hope you get some relief soon. Foot pain stinks.
I've had cortisone shots in both shoulders and hip and every time it works great! It can take a day or two to fully feel the impact but I get almost instant relief! It could be the bit of freezing they also give.
