Steroid injection for OA in shoulder

[Marymon]

I experienced severe pain in shoulder at 8mg of Pred, and increasing dose had no affect. An X-ray showed bone on bone OA.

I continued with taper now on 7mg. and shoulder has virtually gone. I think it flared up with too much use on recent holiday, and existing conditions do tend to assert themselves on lower Pred.

Doctor yesterday said at sometime I would need a shoulder replacement.

When I lived in France I had hyaluronic acid injections into shoulder and it was amazing, course of three lasted 18 months. My present records show this, and I asked if I could have injections again, and have an appointment on May 17th. This morning logging into Patient Access, I see it shows it is for a steroid injection.

My longwinded question is will this corticosteroid be just increasing the Pred I already have in my system ?

I am seeing consultant next week for hip replacement in next couple of months,so don’t want to mess it up with more steroids as have been trying hard to decrease before op. as well as reducing my weight.

Reading NHS on line, they do not seem to consider hyaluronic acid is affective. Well it certainly worked for me, and as it helps to lubricate the joints.

I had injections of synthetic synovial fluid, in my knee in France again pain free for several years, both knees since replaced.

This is straying from topic, but should I be taking on more steroids? interfering with PMR Pred taper.

I can put up with the pain in shoulder at present, using creams and paracetamol.

Any advice please?

[PMRpro Ambassador]

If I were coping with the shoulder pain as you say you are and they said it was due to bone-on-bone OA I don't think I would have a steroid injection. It won't significantly affect your systemic dose although some does stray into the blood stream, it must do, and it MAY help your taper a bit though it is difficult to say. If you were having a PMR flare it probably would - not sure how it might work if you aren't.

It's a case of a treatment that the rest of the world thinks is worth it is pooh-poohed by the UK. Nothing new there then. This is a good article I think:

arthritis.org/living-with-a...

You are in the group it worked for - but how much is due to the skill of the operator? Versusarthritis still has an article on their website about them - so possibly they could tell you where it is possible to get them done

versusarthritis.org/contact...

If you google hyaluronic injections you will find links to a variety of clinics who offer them. Maybe there is an affordable one close to you?

Oh - and if you are at 7mg I'd say not to try to force a lower dose, most surgeons like their patients to be stable on a dose that will allow them to do the rehab well. Loads of people on the forum have had hip replacments on 10mg and even above.

[Marymon in reply to PMRpro]

Thanks PMRpro,

For good advice and links, will read them again later.

I have been looking into having non steroidal injections.

They are done privately by the hospital where I will be having hip op on NHS.

Will discuss it with them next week, and think I will cancel steroid injection anyway.

Will take your advice to not reduce further, I have a six monthly review on my taper in June, that Doctor is the sort ‘get off Pred ‘ take Alendronic Acid, which I have refused every time he mentions it. Will come back with dexa scan needed.

Trouble is I see one doc for PMR, another for OA, and it would be another for injection.

All GP’s in same surgery, no specialisation, and if I mention PMR to the OA he is not interested....

Thank you again, I needed your take on it.

[PMRpro Ambassador in reply to Marymon]

Is that a private hospital for the hip op?

[Marymon in reply to PMRpro]

Yes, had a knee done there 18 months ago.

[Pollyanna16]

Thank you for your interesting post. Just a comment re. The steroid injection. I had one in my knee last week & definitely felt a surge of energy for a couple of days so it certainly affected my whole body. Back to “normal” now!

[Marymon in reply to Pollyanna16]

Glad you had a couple of days relief, I am looking for more than a couple of days. That’s why I want the hyaluronic injections as a cushion between the joints. Interesting you got an energy boost.

[Pollyanna16 in reply to Marymon]

Well, it has helped my knees to quite a degree. I don’t expect it to last more than a couple of months though. I was trying to say I felt generally more energised after the injection. I am quite sure it did touch other parts of my body. I have heard about hyaluronic injections I believe they are not generally available. I will be interested to hear how you get on.

[DorsetLady PMRGCAuk volunteer]

My reply originally send to other post (for completeness) -

I had steroid injections in knee and shoulder whilst still on oral Pred for GCA....and yes it is all steroids but the injection is localised to the affected joint, and doesn’t get into the system as the tablets do.

I never found it interfered with tapering.

The injection is probably Depo-Medrone 40mg/1ml suspension for injection vials - or similar.

By all means discuss with surgeon, but I doubt he’ll have a problem with injections.

By the way, this post has two entries, so you might want to delete previous, unless it has responses.

[Marymon]

Thanks for sorting out duplicate posts. I hope you are

skipping around now, and your knee is improving.