Anyone here have any experience or info. regarding getting steroid injections in joints or in the spine. I always have a constant lower back pain and my pain doctor said that he thought getting steriod injections near the joint would be beneficial. I am hesitant but if anyone has information to share please do so. If it allows me to sit longer for my job that would be a plus but I do not want to do something that has no benefit.
The problem for me and I think it happens to be a problem for most people is to understand why an nsaid helps me when my inflammation is supposed to be controlled by cosyntex? I use hydrocodone in conjunction with nsaid and it adds to my relief from pain. This leads me to two questions. Is my biologic injection working and if so why does a nsaid help me?
Hi Woodworm. I have had quite a few steroid injections over the years, mostly the ones in the backside that help joints in general. I believe they are used much more frequently in the UK than in other parts of the world, though.
Apart from those, Iāve had steroid injections in my knees when stiffness, swelling and pain were very pronounced. They did help. Of the āposteriorā ones, I can only remember one time that I failed to get a great result. Iād say go for it!
Iāve always found that steroid injections help stiffness so the relief allows a more normal range of movement. And as long as you donāt overdo it, that has to be good news in terms of correcting posture and giving tense tendons and muscles a bit of a work out while you can.
I think NSAIDs are really just add-ons most of the time, which is not to say they donāt have their uses. Plus if we have damage to joints the biologics arenāt so likely to prevent that particular pain I guess ā¦ perhaps steroids and NSAIDs do help more with localised inflammation ā¦ hmmm.
Just replying to say that weāre investigating steroid injections for my husband so Iāll be interested to follow this discussion. Are you in the US, Woodworm? We messaged our rheumy about them and sheās referred us to the orthopedist my husband was seeing before the PsA diagnosis; I was surprised that that would be the specialty that would do it; has that been other peopleās experience?
My momās had steroid injections into her lower back that did her a world of good. I believe the steroid stays localized, so itās probably safer than taking oral steroids. She also had trouble over the years with shoulder pain and steroid injections helped that, too. I agreeāgo for it. Iāve never heard anything negative about this method of pain relief.
I had them in my hip bursa. My rheumy administered. They really helped me. The pain and swelling had rendered my hips less and less flexible and made me much less mobile.They lasted a pretty good whileālong enough for me to move into physical therapy.
Oh I hope our othopedist says heāll do them! My husbandās hips are almost locking up at this point. Itās taking such a long time and multiple attempts for him to stand up in the mornings. It would be fantastic to have more mobility and be able to do physical therapy
FWIW if I were having hips and especially spine done, I would only consider an interventional radiologist who was using either fluoroscope or MRI guidance to make sure they get EXACTLY the right spot. There are too many open areas that may or may not be where the problem is.
These days I would tend (as much I hate to say it having had some experience with ortho) to avoid the ortho as injections are part of the step therapy requirements prior to surgery. As a result they sometimes are prone to checking off a box more than into the procedure. Anesthesiologists fellowship trained in pain management are a good choice for backsā¦
I second tntlamb on this oneāIāve had better luck getting them in my lower back from a pain management specialist who uses the flouroscope guidance. Iāve also been told it depends on the problem with a joint. If one already has arthritis, they are less likely to help. Also, if tendons are involved, there is risk of killing the tendon. My husband had 2 steroid injections in his elbow that actually made his problem worse, resulting in surgery to remove a huge piece of dead tendon (our tried & true Orthopedist of 8+years --and numerous miracles for my knees----says he sees this frequently because Drs donāt always know WHERE to inject the steroid.) Iāve personally had 9 knee surgeries and currently am getting by with a cartilage implant in my right knee until we replace it in 5 yrs or soā¦Iāve had a few complications, but my surgeon refuses to inject it with steroids for fear of increased damage to the soft tissues and remaining articular cartilage. I say all of that just to reinforce the important of knowing whatās really going on with a joint before doing anything. So yesāif it was my lower back, I wouldnāt want just any Dr injecting me.
This is just my 2 cents though, as Iāve been burned my them too. I had 2 steroid injections in my ankle years ago, and it just prolonged the inevitable bone spur surgery that would have been much easier if I hadnāt covered the problem with injections and waited so long. The pain always came back after 2-3 months, and by then the bone spur was massive and damaged most of the cartilage in that ankle. Sometimes hindsight is a real pain in the butt.
Great insights @lisarockgirl4. The cornerstone of this is to know WHY the injection is being done and to take the path thatās appropriate for the cause. Iāve heard about damage that can come from steroid injections but also of the relief that they can offer in certain situations. Thanks for the reminder that steroids are not a one-size-fits-all solutionā¦
Hi tntlamb - do you happen to have any research/outcomes information about hip injections? My husbandās ortho just offered to do an ultrasound-guided hip injection for him (his right hip is almost locked up with inflammation); I was excited about the possibility of hip injections to get him some relief but certainly donāt want to risk an adverse outcome! Any resources you might have to help us make this decision are very appreciated!
Keep in mind in all three of these studies Synovitis (inflammation of the synovial membrane) was a significant predictor of response. With PsA synovitis is a bit different and doesnāt respond the same way. In PsA, as a result of repeated biomechanical stress, it appears that microdamage at the enthesis triggers an inflammatory response in the synovium, leading to synovitis. It may or may not respond to injections, as the damage at the enthese still exists and will continue to irritate the synovium. So really there is only one way to knowā¦ Its very rare to have issues in the hip.
I have had them in my shoulder 3 years ago and can still swim freestyle ( couldnāt before the three needles which were adminisered over a three month period). Last year I had 8 steroid injections into the facet joints in my lower back given under general anaesthetic. I was getting severe hip pain and pain down the leg as well as lower back. I definitely gained a benefit from it but was warned by the pain specialist who recommended and administered that it would only last for a year or so. It has definitely helped with my pain and I have been able to continue working a physical job as a deckhand on a tug boat. Iām now over a year post back injections and my back is still better than it had been for years.
Thanks all for the replies. My pain dr. was recommending it and I said I was open to it. Spines and needles makes me pause. It would occur in the surgery part of the pain clinic. He was telling me after he poked the spot and I was moving away from him saying yep thatās it. He said he would administer it on the tip of the joint on the outer side. I cancelled the procedure because I wanted to get more info. Maybe I will reschedule but I am not sure.
