Hydrocortisone!!!

[powerwalk]

Can I ask a question about hydrocortisone! I've read a lot that's been on here about it, I have to get injections for pain which as far as i know is cortisone. I've gotten them for years and always swear never again, til the pain gets so bad. I feel like hell after it (I did post about this before). I mean weeks and weeks of literally even worse fatigue and mood horrors etc. My question is if it's meant to help adrenals, why on earth do I feel so horrific, should I not feel a bit better while it's in my system. My big fear is I am going to an endocrinologist this week and afraid he'll want me to change from pred to hydrocortisone. Thanks for any input. I know I'm very bad with meds and seem to spend my life telling the powers that be that I can't take stuff. But this, this has been more weeks of hell!

[PMRpro Ambassador]

It doesn't HELP the adrenals - it is cortisone, not cortisol (that's what the adrenals make) and is a corticosteroid like pred and also suppresses the production of cortisol. However - it is unusual for the single injection to make such a difference in terms of symptoms. If I felt that bad I'd just say no! But with pain it is a rock and a hard place isn't it.

No doctor should force any patient to take something that makes them feel worse unless it is a life and death matter.

This healthline.com/health/osteo...

"The corticosteroids in the injection are formulated as slow-release crystals to give you long-term pain relief. Pain relief usually lasts for several months. However, the presence of these crystals can irritate your joint, which is what creates the sensation of pain around the area of the shot."

I wonder if something in the make-up of the injections that you are reacting to? They are designed to last with slow release over weeks/months - so it would fit wouldn't it?

[powerwalk in reply to PMRpro]

Yes it would alright. And the rock and hard place is soooo true!! The pain in my back gets so bad i end up giving in and niw mt hip is the same, so thw rheumt guy injrcted the bursae(?) After that so had a double whammy!!! Thanks for the clarification.

[PMRpro Ambassador in reply to powerwalk]

What is the pain due to? Maybe a referal to a pain clinic might find alternative options?

[powerwalk in reply to PMRpro]

The back guy is the "pain clinic"! Its lo gstanding issue with my low back, no particular issue found. The hip is a newer thing. No arthritis found on mri.

[PMRpro Ambassador in reply to powerwalk]

My pain lady considered a nerve block for the low back pain if the injections didn't work - but they did. Is it muscular do they think?

[powerwalk in reply to PMRpro]

I think the low back one is a nerve block, its an epidural. Id say more muscle, it usuallt gives relief for a few weeks, then starts to come back, just as the systemic side effects are wearing off!! Then i manage with painkillers til it gets too bad. When i was on higher pred i had no pain.

[PMRpro Ambassador in reply to powerwalk]

How much higher pred? My lot work hard just on muscle - the current pain lady won't give me the injections because me being on anti-coags she is worried about bleeding. It means it is ongoing but the side effects are minimal.

[powerwalk in reply to PMRpro]

When i started on 20mg, all pain went, stayed that way til i was on maybe 7.5 ish. But ive never had that kind of relief even if i put it up, probably the build up of pred ivrr time. Im on 5mg. Only good thing my neck is still good which was actually worse than anything for several years. Used to get the injections into the nerve going into my head and the joints. Not nice!

[Amkoffee in reply to PMRpro]

I've been getting those injections in my lower back for 15 years and most of that time I've been on blood thinners. They just make me stop the blood thinners a week before the injections. Obviously that is a risk in itself although they do allow me to take aspirin and I'll do that during that week that I'm off my blood thinners.

[PMRpro Ambassador in reply to Amkoffee]

My rheumy will do them after stopping the current one for a couple of days - it's the anaesthetist at pain clinic who won't!

[Amkoffee in reply to powerwalk]

A nerve block is not the same thing as an epidural injection. An epidural injection is an injection of steroids. Although sometimes some doctors will mix drugs for the epidural. For example my pain Dr that I used to use mixed Lidocaine with the steroid. The lidocaine gives immediate relief and steroids are for the long-term relief. A nerve block which is also called a nerve ablation involves burning the nerve that is causing the pain. The nerve regenerates so it's not a permanent solution but it lasts longer than the injections. And before they can do a nerve ablation they need to identify the nerves that are causing the pain.

[powerwalk in reply to Amkoffee]

Thank you, so i get the epidural. Yes i wish they could leave a permanent lidocaine dose there. Magic! That lovely numb feeling. Til it wears off!