I was dx with GCA about three years ago and have reduced Pred to 7.5 mg. Now it has been suggested by my rheumy that I have 'facet joint injections' around the lower back - this is for lower back pain.. Sounds nasty.
An MRI scan showed up wear and tear in the vertebrae as well as some arthritis.
Are these likely to affect my pred reduction? Has anyone on pred had these injections?
Hi Trenny
I haven't got any personal experience of facet joint injections, although they were suggested by a Pain Management Clinic during my year of non-diagnosis. At the time I wasn't convinced - probably being a bit of a wimp! But I would feel a little apprehensive whilst on steroids unless I could have reassurance that they weren't likely to cause infection owing to a lowered immunity from the steroids, and I would probably go down the natural route first, ie donning a support girdle (I have slipped vertebrae in my lower spine - Spondylolisthesis). Or even perhaps investigate Bowen therapy.
Hopefully, someone with personal experience of facet joint injections will be able to respond with some reassurance.
I have had low back injections. Mine were not intraarticular (into the joint) but they were to deal with sacroiliacitis (inflamed sacroiliac joints). Facet joint injections can be either into the joint or onto the nerve which doesn't involve going into the joint. I was on 20mg of medrol at the time and the anaesthetist who I saw at the pain clinic was suggesting these if we couldn't get the pain under control any other way so I don't think there is a problem with doing them with pred - I'd trust Astrid with my life!
I had been told by one orthopod that the low back pain I had was due to wear and tear and probably arthritis in the spine (not that he'd looked at an x-ray) and I'd just have to live with it. In fact, it turned out it was entirely due to muscle problems - they were spasmed and pulling the joints tightly together which was what was leading to the pain. Getting the muscle problem sorted out got rid of that pain and I have steadily reduced the pred since. I still have to be very careful - there are certain things that will persuade the muscles they'd like to spasm again. Great excuse not to do the cleaning...
Do go and discuss this with whoever does them. They are usually done in hospital under sterile conditions, not just in the GP practice. They are administered with a local anaesthetic so don't hurt at the time. There MAY be pain afterwards and you MAY feel worse for a day or so after the local anaesthetic has worn off and before the steroid works - not necessarily but I don't believe in telling fibs and saying it won't hurt when it MIGHT.
There are some very good explanations on line - here's one
I had lower back steroid injections about 9 months ago. I was dx with PMR 3 years ago and am on 4mg Pred at present, a bit more then. I had sciatica which was so bad I could hardly walk. My spine has degenerated (I am 71) and I gather the nerves were getting pinched but I do not remember if they were called facet joint injections. Anyway they helped enormpusly with the pain, my walking is back to normal and there were no side effects .
So they certainly worked for me and I was delighted. Good luck to you.
There is a lot of disc trouble, according to the rheumy's report but, strangely, I don't have much pain unless I garden (ie pull up a few weeds) or hoover, when I sit down until it eases. I really don't think it warrants the injections at the moment. Did it affect your pred reduction schedule, I wonder?
Good to know that the injections helped you. I am 84.
I had facet joint injections about 5 months before the PMR started. I had a series of 3- the first was injecting steroids which worked for 3 weeks( I was told that for a third of patients it can cure the pain and for another third it doesn't work at all) and the consultant regarded this as proof that he had got the right place, the second was a rhizotomy which kills all the nerve endings, but he didn't use long enough needles so I had to have that done again and , 4 years later, I have not had the same pain again. All 3 times, I was sedated and really liked that until the third time when the bigger injections meant they had to top up the sedative 3 times! They were done in an operating theatre with an anaesthetist in attendance, thank goodness! There was not much pain after the first 24 hours from the procedure. I did not have arthritis or any other diagnosable condition other than the pain. The hip on that side has been more problematic since the PMR I must say and I have often wondered whether there is a connection between that treatment and the ensuing PMR.
Rhizotomy, will have to check into this, Thanks B x
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