Was I wise

[ChinaWuntoo]

Currently on 3.5mg.

Rheumatoid arthritis has shown itself in both hands and is very painful. GP said 'I could give you a steroid injection but I don't expect you want that'. I said not - the word 'steroid' frightened me as I am afraid it will be play havoc with the Pred.

Was I right to reject his offer?

Thanks

[PMRpro Ambassador]

I would have accepted it happily. It is a short-lasting injection. in this case into the region of the troublesome joints which takes the acute inflammation out. It doesn't stay in the body for long, the effect lasts a lot longer,

nhs.uk/medicines/hydrocorti...

If the steroid given is depot medrone it is into your bum muscles and it releases over a period of a month and then is gone but it is tapering automatically all the time. Rheumies often use them to avoid increasing the oral dose for a flare.

verywellhealth.com/cortison....

Not a lot of the cortisone shot gets into your bloodstream, obviously some does, The half life of the injection is 8 1/2 days, but it would only affect the adrenal cortisol for about 4 days.

[SheffieldJane]

I think your doctor frightened you. I would have accepted it for the direct action on the pain.

[DorsetLady PMRGCAuk volunteer]

I had a couple for knee/shoulder osteoarthritis whilst on oral Pred - no issues -

nhs.uk/conditions/steroid-i...

[ChinaWuntoo]

Thanks all. Most of my fingers have quite severe pain, some are bent, so I wonder how much steroid will go in!

GP said he would refer me for a brace (but did not mention carpal tunnel, for example). I think I'll wait for the referral and hope I get someone who will take the broad view and with whom I can chat about steroid injection.

[PMRpro Ambassador in reply to ChinaWuntoo]

If it is RA - what does your rheumy say?

[ChinaWuntoo in reply to PMRpro]

I don't have a rheumy! And since I got rid of the last useless one (18 months ago?) the GP has said nothing about replacing him.

The referral is to a clinic in a GP practice - I think! No idea who or what this means and I am doubtful that a brace is what is needed if he is thinking of fingers as they are so painful and a brace would immobilise them and cause more pain. I've had to chase it once and don't have a lot of faith that he will make a suitable referral.

As if PMR is not enough! I may have said before that I wonder whether the Pred masked the RA pain because it has developed very quickly after I got down to 3.5mg.

[PMRpro Ambassador in reply to ChinaWuntoo]

If you have RA - you need a referral to a rheumy as you really need a DMARD to reduce the risk of that hand pain progressing and causing irreprable damage to your joints over time.

[GOOD_GRIEF]

If you have RA, you need a rheumatologist. The first line of treatment is often prednisone + methotrexate, which reduces inflammation and therefore relieves much of the pain. The MTX reduces the progression of joint damage. Nothing reverses the damage.

Steroid injections can reduce flares and damage from flares, but are not a good call for frequent treatment. Depending on the severity of the RA, you may or my not be put on a biologic. There's some hesitation on moving straight into biologics because while they work well over the mid-term, their effectiveness doesn't seem to last over the long haul. Since RA can effect the entire body, the tendency seems to be to hold off on biologics until problems with joints beyond the hands becomes evident.

RA is lifelong and it's progressive . It doesn't go away. Often, heart problems occur and the damage is permanent. And, as with any powerful treatments, there are side effects to be considered.

Find a good rheumy, or enter a university hospital program.

[PMRpro Ambassador in reply to GOOD_GRIEF]

We don't have uni hospital programmes in the UK. NHS or private - one or t'other

[Pass7 in reply to GOOD_GRIEF]

I have PMR as well as RA. Primarily my right hip & leg. I startedAria infusion Biologic yesterday. I’m hoping it kicks in for some relief. Since increased prednisone to 15 daily, the pain isn’t causing nausea.

[ChinaWuntoo]

Thanks to all for helpful comments. I see I need to talk firmly to my GP.

[PMRpro Ambassador in reply to ChinaWuntoo]

The sooner you are treated with a DMARD, the less damage is done and the referral is supposed to be prioritised. You do need to speak very firmly to the GP ...

[Pixix]

I have steroid injections in my hands, & they help a lot, but only for a short time! I don’t see any reason not to have one…I’d jump at the chance…currently waiting for steroid injection for bursitis…& looking forward to it! But, as others say, if you’ve been diagnosed with rheumatoid arthritis (presumably your doctor thought you have RA & it was your blood tests confirmed it?) then you need other drugs! I’d be interested to know what your CRP level was in your blood test, if you know, please, as I’m currently suspected of having RA, my CRP is elevated, but not sufficient for a consultant to agree with doctor! There is a good forum, & versus arthritis is an excellent source of help & info!

[ChinaWuntoo]

My CRP level is 2 - so not high. It was less than 1 nine months ago.

I am now wondering whether my GP actually said I had RA: certainly he said arthritis. But he sent me (if I understood him!) to a clinic to receive a brace which I don't understand at all as immobility makes more pain and less movement.

Having looked at

michiganmedicine.org/health...

I think mine is RA

[BigEric]

I had a steroid injection as prescribed by my rheumatologist and it really did help and I felt so much better. I’m about to have another one. Hope this helps.