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Spondylitis or RA- Cortisone question!!

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Posted 11/10/2005 11:42 AM (GMT -7)
Hey Ya'll smurf

I saw my Rhuematologist a while ago and I finally got some answers. She said I have some form of Spondylitis, and that RA was most likely not my problem. But, she said that there is a small chance that it is Ra. A very small chance.

So, we are going to treat this as (IBD related) spondylitis. I am currently taking Imuran 100mg and I am also on Methadone.

I know some people think "oh my! Methadone!" but it really isn't as hard of a drug as you might think. I take 20mg every 8 hours and it keeps my pain away for the most part. Without it I am a mess and I can barely function, I just hurt all over! Since I cannot take any NSAIDs-- and tylenol does nothing for pain, I am left with the hard drugs. I want to try to get off of them again soon though.

My Rhuemy gave me a few cortisone shots and it made me feel quite a bit better in those areas, so I might be able to cut down on the pain killers and try and live a normal life. How many of you have had cortisone shots?  does it work for you, and how long??

I am just wondering about the cortisone because people have told me that it is dangerous and not good to do on a regular basis. I figured if it is what will help me, that is what I am going to use. Those of you with experience on this, could you please give me some advise on what to do/ be careful of?

Any advise would be greatly appreciated!

 

Posted 11/10/2005 12:20 PM (GMT -7)
Hi there! Cortisone injections can really help deal with localized inflammation. Did you get the injections into soft tissue or into joints? I've had cotisone injections in several joints and into a neuroma in my foot. Some worked better than others. I had a cort injection into my right shoulder in May. My shoulder is still feeling good. The cort injections into the foot neuroma did not work as well. Took three within 8 weeks to get me relief.

Your rheumy sounds good and I doubt she would stray outside the guidelines for administration. I believe that the limit is 3 injections max to one area within 3 months. There can be downsides to repeated cort injections. I developed very thin skin over the site of my foot injections. This makes injury more of a risk. Also, if the injections are given too close to a tendon, it can cause tendon problems including rupture. A skilled doc should not run into difficulty with that. In some people, there is a risk of systemic absorption of the steroid. The amount can vary. Some people develop all the lovely side effects of steroids when they get alot of cort injections. That is another reason that docs limit the number a person gets.

I'm glad that you got some relief! Your rheumy sounds like she is really trying to get you feeling better.
Ides
Posted 11/11/2005 11:28 AM (GMT -7)
Ides, Thanks for the information.

So, you are saying in a 3 month timeframe, I could get 3 injections into the same joint? I had one in each ankle and one in my shoulder. My shoulder is not doing too good, but my ankles are great! So what you are saying is that I can have 2 more in that shoulder in the 3 month period?

If it would help I will ask her. In my shoulder I have more than just the inflammation. I have had a pretty bad injury to my shoulder as well. I had been thinking about surgery at one point for the shoulder. How does having this inflammation affect a surgeon ability to fix a joint?

I might still want to have it fixed!

The injections I was given were directly into the joint I believe. It was interesting watching her freeze the spot before the injections! I really couldn't feel much during the injection!
Posted 11/11/2005 1:53 PM (GMT -7)
Casey, I "think" the rule is no more than 3 injections into the same place in a 3 month period. Don't quote me on that. Food for thought on having that many so close together - I got severe thinning of the skin on both the top and bottom of my foot when I had 3 cort injections in 12 weeks in a neuroma in my foot. I had to be extremely careful because the skin became paper thin and was susceptible to ripping with the slightest pressure.

I empathize with you regarding the shoulder problems. I have a partially torn rotator cuff in the right shoulder. To complicate it, all of the tendons inserting in the shoulder are torn in places from the inflammation. PT showed me exercises to try and build the muscles so I can avoid surgery. I have been doing them diligently and it has helped. I also have impingement issues in both shoulders. Fortunately for me, the cort injection into the right shoulder worked very well.

How you continue to see improvement! --Ides
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