Steroid injection v pain killers

[margiebell4]

I would appreciate some advice or opinions on treatment I've been offered. I'm 3 years into PMR and down to 3.5mg prednisolone. I've recently been diagnosed with osteoarthritis of the hips (I'm 58)

I've been taking at least 4 paracetamol and 4 ibuprofen every day, which is enabling me to be fairly comfortable. I also now need to take a PPI to protect my stomach.

I have agreed to have a steroid injection so that I can hopefully have a break from the pain killers, but I'm not sure which is the lesser of the two evils.

[DorsetLady PMRGCAuk volunteer]

Hi margiebell4,

In much the same situation.

If the cortisol injections work, and they don’t always seem to be consistent, then I find them better. But of course you can only have them every 4 months, and it’s not recommended to rely on them indefinitely.

I think it’s a case of mix and match to what suits you - injections, painkillers, sports masseur may help, acupuncture et al!

Oh, happy days!

[margiebell4 in reply to DorsetLady]

Thank you, will you eventually need a replacement?

[DorsetLady PMRGCAuk volunteer in reply to margiebell4]

Hi

Yes - I’m on the list!

[piglette in reply to DorsetLady]

One thing Dorset Lady is that you have got to leave quite a time period between having steroid injections and having a replacement hip op, some surgeons like around six months, they are afraid the steroids may introduce bacteria so there is more chance of the new hip becoming infected. My GP would not let me have any steroid injections once I was on the waiting list.

[DorsetLady PMRGCAuk volunteer in reply to piglette]

Hi piglette,

Left knee is being operated on - haven’t had injection in that for at least 18 months - no point, nothing to inject into as its bone on bone! So painkillers & gel only!

Have had injection in left hip for bursitis or whatever it was last year before NZ trip. Plus left shoulder and last week in right knee so that I don’t have pain there when I need it to support other one after op!

And I thought GCA was a pain!

[piglette in reply to DorsetLady]

They should be happy with that! Good luck.

[dinhal in reply to margiebell4]

Don’t mean to be a downer and I sure hope the injection helps

I can’t tell you how many I have had and how little they helped.

I’ve had them in back and hips

I just kept hoping the next one would be the one

Talk to people who have had them as I have. I have as yet not found anyone who really got help

The drs are making lots of money on these procedures

Good luck in any case

[PMRpro Ambassador in reply to dinhal]

The money-making is rather less a feature in the UK - but I have had steroid injections that worked for trochanteric bursitis. Needed 2 originally but sometimes 1 works. Depends on the case and the patient.

[PMRpro Ambassador]

Is this for the OA?

[margiebell4 in reply to PMRpro]

Yes, I've been offered it in my right hip which is the most painful.

[PMRpro Ambassador in reply to margiebell4]

Are they sure it is OA and not trochanteric bursitis? Though steroid shots help that too.

[margiebell4 in reply to PMRpro]

Only slight wear and tear showed up on the X-ray which didn't equate to the pain I have so I've had an MRI which didn't show anything else so they're sticking with the OA diagnosis. The orto told me a steroid injection could be diagnostic too, which I don't really understand.

[PMRpro Ambassador in reply to margiebell4]

Trochanteric bursitis wouldn't show on an x-ray or MRI.

[margiebell4 in reply to PMRpro]

That's interesting, so it could be that. I guess the injection would need to be in a slightly different area if it was bursitis.

[PMRpro Ambassador in reply to margiebell4]

Mine are given into the area that elicits the biggest squeal when they prod it!!!!! Usually on the outside of the thigh, you know, where you can feel the knob of bone?

[Bramble2000]

in my opinion, the injections are the lesser of the two evils. They should have fewer side effects.

[PMRpro Ambassador in reply to Bramble2000]

You do also have to consider the context - you wouldn't use oral pred for trochanteric bursitis which is what is being discussed here Though they don't always work in this situation. Deep i.m. injections are a different thing altogether.