Kenalog injection

[skinclinic]

Hi . This is the first time that I have ever posted . I have been a member for a year and I read the posts every day . I started on Sulfasalazine a year ago and it seemed to work for about seven months but by January this year my symptoms of awful pains in my wrists , back of hands shoulders and swollen index fingers and thumbs returned and gradually increased. In March my IlSulfasalazine was increased to 3000 mg a day by the hospital pharmacist who liased with my Rheumatologist. I haven’t any real improvements so then I was prescribed 20 msg of prednisalone daily on a sliding scale over 4 weeks and down to 5mg a day. However this has not had any effect either . I then was given an appointment to see another Rheumatologist a week ago and at this visit I was given 80 mg intramuscular injection of Kenalog. The Dr said it would start to work within a couple of days and he would see me again in August with the view to starting me on Methotrexate. But now it’s been a week and still no relief to my pains and stiffness. I rang the helpline yesterday and I just a call back from the Rhematology to say that the Dr I saw last Friday said that the injection would still be effective in stopping the joint damage and the pain must just be mechanical. I am now getting very demoralised by the awful pains I have every morning which render me incapable of using my hands useless for even the simplest of tasks .. I am hopeful that the Kenalog steroid may still kick in within the next week or so ? Had any one else had a delayed response to this steroid injection. The nurse was sympathetic did say ring again next week if i still had not relief . Sorry for such a lengthy message

[allanah]

Hi. ive always been lucky and got great relief from steroids as far as it calms down inflammation very quickly.they are probably right as I get osteo arthritis that diesnt respond to steroids sadly.

It is possible to have RA and osteo and other conditions together so really they need to look into it more thoroughly to give you help for the RA side and any other potential causes of pain .maybe xrays/ scans? Take photos of your joints etc so you can show them or forward them to the docs xxx

Feel for you. All forms of arthritis and types of musculo skeletal hurt xx 😪

[skinclinic in reply to allanah]

Thanks Allanah . I really appreciate your reply . Yes it has been mentioned by 2 Rheumatologists that I have seen - because they have noticed that the first joints on all my fingertips are all swollen ( but not PA) . So I guess it’s something I am going to have to put up with forever. Actually it does ease off at about 3 pm every day but it is back with a vengeance every morning as soon as I wake up making it impossible to do even the smallest of tasks

[allanah in reply to skinclinic]

Yes the joints near the hand are often ra the ones On the finger osteo 🥺 sending love, let me know what they say, ,however arthritis care and NRAS good help for both types xxx

[Biofreak in reply to skinclinic]

Hi skin clinic. Kenalog injection didn't work for me either. I kept waiting and waiting for it to work but it didn't and I don't know why to this day. At the time I was between biologic treatments. As a result of the kenalog injection not working my GP gave me a course of prednisolone which did work thankfully and I was then put on Abatacept injections which have so far kept my RA under control. I also have osteoarthritis which in my case affects my shoulders and back. If you don't improve ring rheumatology again because you can't carry on struggling with it and living in hope. I hope you get some effective medication soon.

[Mmrr]

I just wanted to say hello and welcome.

If things don't settle do contact your rheumatology department again, don't suffer in silence.

Steroid injections, never helped me, they are not always effective. (Oral steroids (prednisone) does, the difference is night and day.)

I hope things settle for you.

[skinclinic in reply to Mmrr]

Hi thanks so much for your reply . The reason I was given the intra muscular Kenalog was because the prednisalone didn’t touch the pain after taking it for 3 weeks- last year when my RA was diagnosed I did get amazing and fast relief from the pred . Disappointing but through this group I realise I am not on my own and it’s a relief to be contacted by others who understand and they can give me support and advice

[charisma]

Hi skinclinic

Although it is widely thought that in most cases of RA, top finger joints are not attacked, there are exceptions. The way yours are worst in the mornings but improve by late afternoon does suggest inflammatory arthritis.

I have had about four steroid injections (into muscle or into joints) and had either no or very short term relief.

Prednisolone (UK) of 20mg to start in tablet form, is still quite low; five years ago I had 40mg Prednisone (in the US) daily and the difference in pain levels was noticeable overnight. In a couple of days I felt wonderful.

An ultrasound scan would distinguish immediately between OA and RA or other RD.

I hope your Rheumatology specialist soon sorts out something more effective for you. Suffering endlessly is terribly discouraging.

[skinclinic in reply to charisma]

Hi . Thanks so much for your reply- the one thing that I gave learnt from reading the questions and comments in this group is that this disease can manifest itself in so many variable forms and how treatment can have so variable outcomes. I am very fortunate to have access to my hospital Rheumatology Helpline and they always respond quickly and proactively. I do have an over the phone appointment early June and it has been mentioned by both consultants that it is now time to change my meds - but they have been holding back due to COVID . However I shall now push to have this actioned ASAP . I am very grateful for all replies I have received- it’s so reassuring that you are all out there to help - I only have to ask

[charisma in reply to skinclinic]

It is a great community, such a comfort to know they are there! Good luck with meds decisions ahead. x