One of my knees has been very stiff and painful for about three weeks. The back of it is very stiff and painful. I know it’s the PsA, my question is would a shot of steroids into the knee help?
Has anyone tried this? I’m sure I can get my doc to do it, but since the shots hurt so much, I don’t want to do it if it will not help.
Hi tamac.
A steroid shot in both knees was the first treatment I ever had. I started oral steroids and Mtx the same day but obviously even the steroid pills take a couple of days to take effect so I can say with some certainty that the shots are likely to work. I was walking more easily than I had in many months the very next day. It was still very hard-going but I’d been unable to walk more than a few steps beforehand.
I admit they were painful but my knees were very swollen and the rheumy bemoaned the lack of ultrasound to guide her, so I daresay it can be a lot easier. Based on my experience - highly recommended!
Hang on, just remembered … I had my knees drained at the same appointment and it was that which really hurt I think. The steroid shots probably were not much fun but were quick so no biggie really.
I think it’ll be worth a try. I’ve never had one in my knee, but I had one in my wrist and it helped. I also had a topical numbing agent applied to my skin so it didnt hurt at all. (Did hurt a bit after the numbness was gone but nothing severe.) I had relief for a few weeks but many people have relief for a few months. Also my rheum stressed that cortisone shots dont fix the problem so it’s important to keep up with your other treatment even if you start to feel better.
I’ve had 2 in my ankle joint and 3 in my knees. All hurt a lot, but taking ibuprofen 1-2 hrs before and again 3-4 later made the rebound pain MUCH better/easier to handle.
I personally don’t see them as a PsA treatment. I’d prefer a 2-week,low-dose taper of oral steroids. That’s what my Orthopedist and Rheumatologist prefer I do every 4-5 months. I have had 10 knee surgeries, and my ortho says every cortizone injection breaks down the articular cartilage a it more–just speeding you towards replacement. He sees them as a means to an end—where the end is how long you’re postponing a much needed knee surgery (regardless of the problem) or how long you’re waiting for a knee replacement.
I hope this makes sense. I don’t have a lot of info/experience on using them without a TRUE diagnosis of just what the problem is or for just “PsA soreness” flaring up…so I hope I’ve not offended anyone. All I know if they DO speed up joint damage. I had a fancy A.C.I. (autologous chondrocyte inplantation) procedure to save my right knee back in 2015—avoided a knee replacement by with this fancy, expensive high-tech new way of using my own cells, culturing them, growing 36 million more, then transplanting them back in to my huge articular cartilage defect. I now have awesome, full-thickness gorgeous hyaline cartilage in that area of my knee. 
He and his physician’s assistant have made it very clear they will NOT inject steroids into that knee though. It will damage my fancy new cartilage.
If one is desperate though, do what you have to. I’m just tossing out my own experiences here. I wouldn’t wish PsA or it’s frustrating mysteries/pain on anyone. Best of luck to you.
–Lisa
I have both osteo and psa in my left knee. I had a knee shot with steroids and some other stuff from a “pain doctor.” It hurt really bad but only for a few seconds. That night and for the next three days it felt like I was wearing a knee brace it was so tight, in a good way. The medicine did not get the entire sore area though. If I do it again, I am going to have him come from both sides. Extra poke, but big deal. It’s been about six weeks since the injection and it still feels way better.
My first medication for PsA was a steroid injection into my right knee joint, plus an intramuscular steroid injection for the widespread pain in my body, and methotrexate. My Consultant gave me the injection into my knee joint and I didn’t feel a thing - honestly. It’s his practice to inject a little anaesthetic into the joint first. Brilliant! Within a day I was walking pain free and the effects lasted ten months. It’s back now and I’m hoping to get another one when I see him tomorrow. 
Doc passed on injecting my knee, we are changing to Cosentyx in a few weeks. Yesterday though, I was going into work and the curb jumped up and tripped me. Twisted my knee just enough it is now swollen and painful. Can’t win.
That’s what mine did too. Works beautifully. I’ve had it in mine, and my sister has had it in hers too. It’s not a fix, but it can make you more comfortable while you wait for the ultimate solution.
@lisarockgirl4 I’ve never known anyone to have had that treatment! I’m impressed.
well, Maybe the cosentyx will help.
Oh no! I know that hurts! I took a fall a month and a half ago and my left knee is still sore and swells about every couple of days. But I’ve always seemed to take longer to heal than others.
Prayers your knee heals quickly and with little or no more pain.
Know what you’re saying, Angie! All of us perceive pain in our own way, and we all have our own tolerance. Having a high tolerance for pain isn’t always good, though: things can be much worse than you perceive them. That’s why we say that pain is not a good indicator of how active your disease is, or how bad your damage is.
Seenie—I feel blessed to have had the opportunity, and even if it only lasts 5-7 yrs instead of the hoped-for 10 yrs, I’ll take it. My physical therapist says to not bet on more than 6-7 after what we’ve put it through since the implantation, just to get it to BEND again.
I also am blessed to live half an hour from one of the well-known sports Orthopedic surgeons in the midwestern US. He does a ton of cutting-edge articular cartilage repair. As glad as I am it worked, it was a miserable experience and one I pray I never go through again. Again, the end result was great, but I’d reconsider doing it again if it gets to that point on the other knee. It was 11-12 months of physical therapy and pain “HELL”–but then again, I don’t have near the PsA problems most of you do here though----so I try not to complain about my knees and overall stiffness. Steroid shots in my knees do scare the crap out of me though and I’ll keep avoiding unless there’s no alternative. I’m glad they exist for those who need them though.
–Lisa
Hey Seenie.
Most definitely. I’ve been told and seem to agree that I have a high tolerance for pain. Like when I hurt my shoulder a few years ago. The orthopedic surgeon wasn’t expecting the damage to be as bad as it was, because most the time my pain level was about 5 or 6 on the 1 to 10 pain scale, with 10 being the worse pain ever. I wouldn’t take the pain meds either just otc ibuprofen.
I understand what you mean. Thank you for the reminder.