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Has anyone had cortisone injections

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Posted 5/29/2009 2:10 PM (GMT 0)
I was doing so well until the last week when the joints in my fingers are acting up again. Very stiff in the morning and only get a little better through the day. Back in January before I was diagnosed with Lupus I had received some cortisone injections in my hands for the carpal tunnel symptoms which helped tremendously. I was just on anti-inflammatories at the time. Now I am on plaquenil, folic acid, anti-inflammatories and prednisone. I really want to call my orthopaedist again but wonder if he will give me the injections to alleviate the swelling due to all the drugs I'm on. Has anyone had injections on top of everything else. I need relief and can feel nodules starting to build up at the knuckle sight. My rheumatologist told me that joint problems with lupus are not permanent but I am afraid she is wrong and will have deterioration every day if I don't do something else. Please enlighten me!!

Suffering again,
Lynnette

DX - lupus, carpal tunnel snydrome
RX - prednisone, plaquenil, folic acid, anti-inflammatories
Posted 5/29/2009 2:17 PM (GMT 0)
Lynnette,

I haven't had cortisone shots in a joint for many years, and at the time I hadn't been diagnosed. I had tendonitis in my right thumb, and yes, the shots were a lifesaver! Wouldn't it be wonderful if we could just get shots in all of our joints on a regular basis.

When I hear that you have nodules building up at the knuckles, I think RA. I'm curious about whether or not your rheumy has ever mentioned that.

I understand your concern about deterioration. My right hand already has that "arthritis look" because the four fingers on my right hand bend to the right. Fortunately, I'm not seeing any rapid changes.

Do let us know what your rheumy says about cortisone shots.

Pat
Posted 5/29/2009 2:40 PM (GMT 0)
Lynnette,

Cortisone shots treat the inflammation, the symptom, not the cause.  For lupus you want to focus on getting lupus under control.  I have had cortisone shots for tendonitis and bursitis but you don't want to have them often. 

Lupus hit ALL of my joints really bad but once lupus was under control I have not had a problem since.  I do have some arthritis at 66 and that comes and goes but aleve takes care of that when my joints hurt.  Otherwise, I don't take anything for joint pain.

If you ignore lupus and your case is attacking your joints you will have problems.  So, don't ignore treating lupus and if necessary treat joint pain with the least draconian drug that works.  If you are not confident of your rheumys opinion get a second one.

Bill

Posted 6/2/2009 1:20 PM (GMT 0)
Hey guys,
Sorry it has taken me soooo long to get back and thank you all. Had a very busy weekend. I'm going to see my rheumy next Thursday so I'll ask her. I know that the cortisone doesn't fix the problem but it sure would be nice to have some relief and not wake up to fingers that take a couple of hours to loosen up just for a little while. These autoimmune disorders sure keep you on your toes from day to day. I've noticed I can have several really good days in a row then all of a sudden the stiffness sets back in again for no apparent reason. I pay close attention to daily activity and not overdoing it when I do feel well just so I don't have a relapse. I'll keep you posted. Bill, you give me hope knowing that you were in a position with your joints that was bad, but now you are only taking an over the counter med. And Patty, I have talked to my rheumy about the RA because it is prevalent on both sides of my family tree but because my Rheumatoid factor comes back negative they say I don't have it. My PCP however says that it doesn't mean that the RA factor may not become positive in the future so I get alittle confused as to who I should believe. AAAAARRRRGGGGHHHHH!!!! I wish that when we were born we were given a medical manual for our own individual bodies so we knew what to expect and maybe how to prevent things. Wouldn't that have been nice. Have a great day everyone!!

Hugs and Angels,
Lynnette
Posted 6/2/2009 2:35 PM (GMT 0)
Lynnette,

Fifteen years ago my first rheumy diagnosed me with RA. He gave me a shot of prednisone and that made me so edgy and irritable that I'm surprise that I didn't get involved in road rage or something worse. So I never went back. Smart, huh.

My third rheumy, who's a biggie in the field, was overheard telling her nurse that I had RA, but she never would admit it to me. Because my labs for RA have come back negative, my rheumy shrugs her shoulders when I bring up the topic of RA. However, I do have the symptoms of RA, which I can't explain. Pain and stiffness when arising in the morning or after being immobile for a period of time. As the day goes on, my pain subsides. And my hubby often comments about how hot my hands are. And my fingers are becoming deformed. The most telling sign is that after having tried numerous meds for my lupus, a few months ago my rheumy prescribed Leflunomide, which is a drug that was developed for RA. And it has helped immensely.

So go figure. It doesn't matter whether I have it or not, or whether or not I have a diagnosis. What's important is that I'm being treated properly for whatever condition I have. But it does give me pause to wonder. Maybe Bill can explain it.

Let us know what your rheumy says when you see her.

Till then, I hope you do ok.

Pat
Posted 6/6/2009 3:19 PM (GMT 0)
Hey Patty,
That is exactly how I feel on a daily basis. Stiffness always in the fingers and sometimes the feet, but it dissipates somewhat throughout the day and it is always back the next morning. I just can't shake the feeling that I have RA and not lupus. She only diagnosed me on 3 criteria - joint poin, a positive ANA and a false positive syphylis test which I have had since I was in my 20's. All the DNA results come back negative, I don't have sun sensitivity, no rashes, no mouth or nose ulcers or any other lupus criteria. But I do know for sure there is something autoimmune going on so I have to trust that she is treating the symptoms right now and it seems to be working for the most part. Thank you so much for your support and I will keep you posted. Oh she did prescribe me the volataren gel that really seems to help with my hands alot. The important thing I guess is to just keep working on what works best for each individual. These autoimmune diseases are baffling and they seem to have a different agenda everyday. Have a good weekend.

Hugs and Angels,
Lynnette
Posted 6/6/2009 3:32 PM (GMT 0)

Hi Lynnete, I'm sorry things are so rough for you. mornings and late nights are the worst for me. I have had the shot in my back about a year ago now. I had a pain there for years and finally I mentioned it to my dr. she gave me a shot and I have never had the pain there again.

However the fingers are another story. I remember quite some time ago my left hand thumb and pinky knuckles aches. for the paste few months my the outside part of my right and left thumbs hurt all the time. touching them is very painful. When I do touch them it feels almost like bone spurs in the joints confused . The joint hurts the worst but the tenderness goes up a few inches on both thumbs. I havn't found anything that really helps yet. I frankly am concerned because I have osteo and they have me on fosomax and calcium to build up my bones. but with these bumps in my thumbs I'm afraid it will just make them worse.

Let us know what you come up with

hugs

carol

Posted 6/7/2009 12:16 AM (GMT 0)
Have not had to have cortisone shots in the joints, but I did have surgery on my right had in Feb for trigger fingers, trigger thumbs and carpal tunnel. Supposed to have the left done but the trigger thumb failed so Im not doing it right now. Just got done this week though with solumedrol 1000 mg IV a few days ago. Its starting to work. Anyone else have to have this too. This is a miracle drug and not really bad side effects that cant be handled besides what prednisone does.
pearl
Posted 6/10/2009 8:14 PM (GMT 0)
i have had an injection only once ... walked/hobbled into rheumies office with tears running down my face ... stiff everything ... i think he felt really bad for me so instead of upping the meds he gave me a shot - oh boy what relief BUT it comes with a price and i think there is a limit as to how many you can have (like i said i think) please feel free to correct me here ... so i keep the shot as a sort of last resort thing!
i try take the minimum meds as i build up tolerances quickly and also have adverse reactions to a lot of meds.
i thought that the *blessing* of the lupus arthiritis is that it is not degenerative as is in RA ...
always taking blessings where i can!
good luck!
Ang
Posted 6/24/2009 3:53 PM (GMT 0)
Hi all,

Had my first shot ever of cortisone to my right thumb just the other day...never expected that amount of pain to follow after the freezing wore off. And the swelling.


Is it normal to hear (actually hear) a "Popping" noise as the needle enters different things in the thumb? I thought I was going to pass out just from the sound alone.

Now, two days later, still am sore from the shot, the swelling has gone down, but still find I cannot move my thumb at all that much.

What more am I to expect?
Posted 6/25/2009 4:37 AM (GMT 0)
I'm set to get them in my spine, but I thought usually they don't like to do them while you're on pred, but I guess it depends on how much they want to give you and how much pred you are on. I was strongly cautioned against steroid injections because they can cause necrosis of the both (I forget the formal name). I had some stiff deformed fingers and a ring of thick skin going aroundmy wrist and some stiff skin patches on my arm. I was worried for my fingers. My rheumie had me double my plaquenil and I was surprised at how quickly it made it go away and even though I have gone back down to my regular dose, it hasn't returned yet, cross my fingers. I thought this was an interesting option to steroids. I hve such endo problems I have had addisonian crisis, so they have to be careful with me.

Brwn_eyes, you got me scared about my back injections. THey plan to dope me up good. I had a cortisone injection into my sacroileac for sacroileitis done by my old brilliant pc doc from up north. He used to do his wife all the time. He walked up with that huge needle and I didn't feel a thing. I was good for over two years after that one injection. I miss that doc!

I think they do try to go into the protective cartilage around the joint and in the back they plan to get right in to my nerve roots. Souds like its gonna hurt!
Posted 6/25/2009 10:36 AM (GMT 0)
I have had many cortisone injections in my spine and ribcage because of breathing and sleep issues. It does work wonderfully but you can only do so many times. It should be a last resort option because of the down the road side effects of the cortisone injections.

Short-term side effects are uncommon but include shrinkage (atrophy) and lightening of the color (depigmentation) of the skin at the injection site, introduction of bacterial infection into the body, local bleeding from broken blood vessels in the skin or muscle, soreness at the injection site, and aggravation of inflammation in the area injected because of reactions to the corticosteroid medication (postinjection flare). Tendons can be weakened by corticosteroid injections in or near tendons. Tendon ruptures as a result have been reported.

In people who have diabetes, cortisone injections can elevate the blood sugar. In patients with underlying infections, cortisone injections can suppress somewhat the body's ability to fight the infection and possibly worsen the infection or may mask the infection by suppressing the symptoms and signs of inflammation. Generally, cortisone injections are used with caution in people with diabetes and avoided in people with active infections. Cortisone injections are used cautiously in people with blood-clotting disorders.

Long-term side effects of corticosteroid injections depend on the dose and frequency of the injections. With higher doses and frequent administration, potential side effects include thinning of the skin, easy bruising, weight gain, puffiness of the face, elevation of blood pressure, cataract formation, thinning of the bones (osteoporosis), and a rare but serious damage to the bones of the large joints (avascular necrosis).

Bryan
Posted 6/25/2009 3:41 PM (GMT 0)
I didnt mean to scare anyone, I was pretty scared myself when it popped, and actually wanted to faint.   Today is Day 3 now...and Im glad to report that I am finally getting some relief from the shot.

I have heard...that cortisone WITHOUT the freezing mixed in with it, helps alot faster, and doesnt hurt for as long as what it does when they add the freezing mixture in with the cortisone.

Dont know if I want a second shot to find out...hoping this one helped.

Good luck to everyone! wink

Posted 6/26/2009 3:24 AM (GMT 0)
Thanks for this post and to you Bryan. I am scared and feel like they just are kind of getthing me through figuring why bother to do more. They had mentioned surgery, which if done right and minimally, would be okay. The infection potential from the injections scares me. I got sick from my myelogram and have had meningitis before and it is not fun. AN described to me by someone with it and by a physician discouraging me from injections sounds horrible. I think they want me to try this. My sis who is a nurse says they should just put me on pain meds not worrying about addiction and leave me on them so I can have a real life and exercise and all. She said I should have the right to that. I think they want to do this first. I wish I never got off the fentanyl patch. It was just so much easier.

I like steroids, but get sick when they wear off, and can't take them enough for my liking. So if pain meds get me through without the steroids, I sure wish that was an option. Hopefully it will be in the future. Thanks for the info. I don't look forward to the comedown. Oh well, they'll see what happens when I crash! Hopefully it won't happen.

Brwn_eyes I was scared before too. It doesn't take much. That popping sound thing really got me though, I understand totally your response, just reading about it made me want to ralph! I hope they work for both of us. Cortisone is one of my favorite steroids, so that's a good thing. I don'tseem to get as wired on it as pred. Let meknow if it works for you.
Posted 6/26/2009 4:02 AM (GMT 0)
Marji,

I have had cortisone injections in my back & hips (L4, L5, Sacroiliac & hips) and they DO aim for the nerve roots when they do them in the spine . . . dont be nervous - they dope you up really well (you won't feel or remember a thing) . . . didn't help me much in L4 or 5, but it did help in the Sacroiliac & hips . . . was approx. 6 months before the pain came back in my hips . . . it was kinda nice to have one area that didn't constantly hurt for a while!

Good luck!
Posted 6/27/2009 10:18 AM (GMT 0)
You were luck Anne they didn't do anything but give me the shot in the spine and I've got to tell you that really hurt that day and the next but after that it was worth the pain for the relief I got. I also had 10 shots a month for 2 years for scare tissue with no freezing ever.
Posted 6/29/2009 1:52 AM (GMT 0)
Thanks Anne. I hurt my neck at a youth camp thing and so any steroids at all sound good. Got too much sun too, but had fun and so did the kids. I had to pull a boat out of the water and really hurt my neck, but then its been hurting on and off for a while. They wanted to inject my neck, but someone told me not to let them because in the neck it really hurts and its not worth it. I guess the lower back will be a place to start.

Bry, I can'timagine that many shots. I'm glad they helped.
Posted 7/9/2009 2:09 AM (GMT 0)
Well It has been about 2 weeks now...and I have to say that the shot of cortisone helped significantly.  I am able to grasp things again, hold things, do up my jeans, open doors, and WRITE again.  I hated  the initial pain of cortisone, and the freezing...and the popping noise, but I would for sure get it done again if NEEDED.

Marji, thanks for sympathizing with me.   Next time I'll wear ear plugs.

Good luck to everyone! turn smilewinkgrin turn

Posted 7/9/2009 8:29 PM (GMT 0)
Hallelujah!!!!! Finally, some relief. I'm the one who originally posted the question on the cortisone shots. When I went back to my rheumatologist June 12th I asked her about getting some in the hands and she really didn't want me to. She wanted to put me back on the methotrexate but i told her I really didn't want to add another drug back into the mix to affect the whole body, when I thought I could get relief just for my hands. So I left there and waited another couple of weeks before I finally called my orthopaedist to see what he had to say. He explained that while I'm dealing with the systemic issues of the autoimmune problems does not mean that you let other symptoms go untreated to get relief and to prevent further joint damage. I have had issues with the carpal tunnel as well and he felt that the swelling in the knuckles was directly related to the tendons being so inflamed from the carpal tunnel. He injected both hands, with a non-freezing cortisone and it has been like a dream come true. I still feel some residual stiffness at times but my hands are not swollen and I can wear my wedding ring again which has always been so important to me. I realize that my rheumy wants the best for me as to how she thinks my treatment plan should go, but I realize that I have to be my own advocate and do what is right for me to have the quality of life that I need. Are there risks, sure there are, but we all know this with any of the drugs or treatment path that we take. The cortisone injections in the hands has now allowed me to back off the prednisone to just 5 mg a day where before I was taking anywhere from 10 to 12 mg to get by. I've also been able to cut back on the anti-inflammatories as well, so to me, this is a much better form of treatment then taking all the drugs that infect your entire body and I will continue to work with both doctors to make sure that I continue to heal and hopefully get this disease under control. Thanks for all of your advice, I pass this website on to many people because it has been a lifeline for me since my diagnosis. God bless you all.

Feeling good again,
Lynnette

DX - lupus and carpal tunnel syndrome
RX - plaquenil, folic acid, naproxen, prednisone, fish oil and vitamins
Posted 7/9/2009 8:42 PM (GMT 0)
Hey Lynnette! That is awsome :) I am so happy for you. If it works as well as you say it does, I might ask my rhuemy about it. Want my hands to stop looking like I weigh 400 pds! Thanks for sharing :)
Posted 5/2/2012 5:24 AM (GMT 0)
Weird question:
I am being evaluated for SLE and see a rheumy in June. I also have a herniated disk in my neck and received a epidural cortisone shot on the right side of the back of my neck. I know that some of the steroid does go systemic, because you have to watch you blood sugar if you are diabetic and I know that steroids help Lupus by reducing inflammation. Here is the question: The "malar" rash on my face is now only on the left side and over the bridge of my nose. Do you think that the steroid affected the rash on my right side ( I just had the shot yesterday)? Or do you think it is a weird coincidence ( I have never just had the rash on one side of face before)?
Posted 5/2/2012 6:00 PM (GMT 0)
Intriguing question!  Sure don't have an answer, but it would be good to mention when you see your rheumatologist in June.  Also you might want to take a photograph of the rash.  Seems often enough when your appt. finally rolls around rashes disappear.  Welcome to the forum, and good luck!  
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