Injection and tablet steroids

[Yorkshire-Rose]

Hi all

Have posted in the past, but not done so for a while, though I read posts regularly. Been hiding, head in the sand.

I have RA in hands and feet and was reluctant to take the prescribed Methotrexate, because I was scared, but due to a new flare up a few weeks ago, I have started taking the meds again, stupidly thought it was a mistake and that the RA would go away.

The new flare-up seemed to favour my feet and ankles, the right one being the worse affected, nothing at all in hands and wrists as previous.

On my last visit with a Rheumatologist, saw a new one this time, after the consultation I was sent to have another steroid injection..my 3rd in several months, of 120mg Depomedrone.

When reading posts I've noticed some newly diagnosed get the low-dose steroid tablets along with their DMARD/S to tide them over the inflammation and pain effects from the RA flare up, just wondering why some get the injections and others get the tablet form, surly the injections would be better especially when considering side effects. Does it all come down to the individual Rheumatologist or just patient preference.

Cheers

[VeronicaF]

A big welcome Kif50

snap been there, done that, it was a wake up call when I was on all fours to get up stairs like (I agree now I have RA) and then that scared me more than the tablets,so started to take them just over 2 weeks ago.

I have steroid tablets but haven't taken them yet, trying not to, although at times I am close to taking them

I don't know the answer to your question, but I wouldn't mind a injection in both my knees at the moment, as they are causing me big problems.

[Yorkshire-Rose in reply to VeronicaF]

Hi VeronicaF

Actually it was you that spurred me on to ask the question about the steroids, because I thought poor woman having all that pain, surly having a intramuscular steroid injection to help with all the pain would be the better option than taking low dose steroids ,daily. But I don't know ,maybe the tablets are better for the more severely affected, which is why I asked.

I feel for you and I hope your meds help you soon and your pain levels improve.

[StormySeas]

I don't know. I've had both courses of steroids and a steroid injection (at different times). My guess is that steroid injections are used with a specific, single-joint issue, rather than multiple or more widespread pain.

I had an injection in a specific joint (knee) that was very swollen for 3 months and was preventing me from walking. It was very effective, thank goodness.

I imagine a single targeted shot might be less damaging than a whole course of steroids....

Interesting to see what everyone else thinks

[medway-lady]

Steriod jab in the bottom wears off gradually so you don't need to taper down the pills. But in both jab and pills sometimes they work and sometimes they don't !

[helixhelix]

I think it depends where you are with the disease and your treatment. The IM jabs in your bum are great if you have widespread inflammation or need something to fill the gap before meds work. Injections into specific joints are smaller doses & more targeted. But tablets are I think better to bring down out of control inflammation, as you can start on higher dose, and if you're likely to need a low dose for a longer time.

Also doctor's choices..

[oldtimer]

Having had both... I now use the tablets. I'm on a low maintenance dose and have been advised to take a week of double of the dose immediately I get a flare up, then back to the lower one. This is flexible for me, I'm in control and I don't need to take up the time of the Health Professionals as I did when I needed an injection. And I can do it immediately, no wait for an appointment.

But it doesn't always work, then I have to contact the Health professionals anyway, but I do have a supply at home and can then vary the dose according to their advice (as I'm doing currently having had an unpleasant and painful flare 10 days ago which hasn't completely settled with a week's extra.

[Joy_1]

Hi

I was given a big jab in my butt when I first presented at clinic. Once that wore off I was put on 10mg Pred.

For me it was about getting my RD dampened down while they awaited on all the results. Once they knew what was going on and where the 'targeted treatment began'.

[Hidden]

I think it may be something to do with age. My GP practice nurse told me usually patients with RA were getting steroids and monitored for it but the specialist nurses said that was because I was too young for that not to harm me.

[dbestdeb]

I think it’s individual rheumatologist’s choices. My first had no problem giving me steroid injections every 2.5 months. My new rheumatologist was horrified and won’t give any kind except in an emergency. She said the risk of bone loss and other effects is just too great long term.

[Yorkshire-Rose]

Wow great response and really helpful!

I had 8,i think affected joints at the time of diagnosis, and the steroid injection was great in bringing down the inflammation markers shown in my blood on second follow up, but I still had synovitis, which was still causing pain and swelling. So had to have another injection.

I was just worried that 120 mg injection as a lot and as I have had 3 in last months I'm concerned of affects it could have on my bones.. but I do worry far too much anyway.

But saying that, I've not had any problems at all with the steroid injections, RE side effects, may be a bit hyper and thinking I can do loads of stuff, when I can't.

[MissMinto]

I've had experience of both steroid tablets and injections. The first thing I'd say is we are all very different individuals, nobody reacts the same for each drug. Personally, my experience is this: I cannot tolerate oral steroids - they affect me so badly, in that I pass through what my daughter calls 'roid rage' (absolute uncontrollable anger) through to totally desperate, suicidal ideation followed by a ridiculously prolonged period of tapering. Alternatively, a quick steroid jab in the bum makes me feel on top of the world (or more accurately, HOW I USED TO FEEL BEFORE RA STRUCK, which gradually wore off naturally over the next 2-3 months). Injections directly into a joint were something I always avoided, but if I'm/you're in the middle of a flare I wouldn't hesitate to go for the jab in the bum. I think 3-4 per year can be had without any serious consequences and I wouldn't be without them.

What I would say re: the methotrexate is that in the beginning (20 years ago) I was very afraid of taking methotrexate (side effects etc) and held off and went down the homeopathic/exclusion diet route for two years. In that time I gained nothing but permanent joint damage, but I had to explore all avenues before I surrendered to the 'evil' methotrexate. Of course in retrospect I regret that now, but I had to go through it to learn that. Hindsight is a wonderful thing!