Steroid Injection

[Macas]

I have had right shoulder pain for weeks. The pain starts in my shoulder and then across my upper back. I have had it over the years but this time it’s been really bad. With all the problems trying to see a doctor I have just been taking co-codamol. In the end with the pain and not sleeping I managed to get an appointment. Doctor wanted an X-ray and ultrasound and in the meantime carry on with Co-codamol. Telephoned hospital for appointment but it’s a 6 week wait for an Ultrasound. I tried the Private hospital and got an appointment the following day I just couldn’t stand the pain for another 6 weeks.

The Ultrasound shows !Wear and Tear, Tendinitis, Inflamation ,and Arthritis. They have suggested a Steroid Injection. Any thoughts on this please. I take 5mgs pred and I also take Apixaban for Afib.

Than you Mary

[Marijo1951]

More than 20 years ago, a long time before I developed GCA and PMR, I had a frozen shoulder which was agonising, especially as it was on my dominant side, the right. Any kind of movement was intolerable. I remember once that a woman asked me directions and I frightened her by yelping when I pointed out the way. I never had an x-ray or ultrasound, however my GP said he would try a steroid injection, though he couldn't guarantee that he would hit the right spot first time. The first injection slightly missed and left me still in pain, but the second one really hit the spot and I felt the pain and stiffness melting away. There was a tiny core of tenderness left for a while, but I was able to move and reach and didn't keep waking up in pain.

[Macas in reply to Marijo1951]

Thank you Marijo 1951 yes mine is my dominant hand and any movement has been extremely painful and made me very miserable . I’m waiting to hear from my Doctors Surgery as they have the report from the hospital.

[PMRpro Ambassador]

All I can say is that here I suspect the pain clinic would be very reticent about a steroid injection because of the Apixaban and bleeding risk. The cardiology team get terribly upset if I miss even one dose of the Pradaxa I take for atrial fibrillation. These factors have to be balanced. I think you have to discuss it with both teams if you can.

[Macas in reply to PMRpro]

Thank you I am still trying to decide. It appears if I stop my Apixaban for two days it should be ok ?? I have paroxysmal Afib which hasn’t caused any problems for some time. It’s difficult because I have had six weeks of pain and I am becoming a real misery .

[Broseley in reply to Macas]

I'm on apixaban and I was offered a steroid injection in my hip, with no mention of pausing the apixaban. (I didn't take it due to it being during lockdown). When I had my GCA temporal biopsy, they said to stop the apixaban for the week before, which I did. There were no problems.

However I had a medication review with the pharmacist at the surgery yesterday. He said if you miss just one of the twice daily doses of apixaban it increases the likelihood of stroke. He's changing me to a new drug called edoxaban which you only take once a day. If you forget, you just take it as soon as you remember.

[PMRpro Ambassador in reply to Broseley]

Exactly - and a/f is one of the primary causes of stroke!

[Uglow]

I have asked for steriod jab for my debilitating back. They said I have to have mri first. I will but absolutely hate them I wish I could go in the sit up one.

[Macas in reply to Uglow]

I really understand how you feel about the MRI I know I couldn’t do it. I half expected to be sent for one and had looked up those you can sit in. There is one in London. thankfully the ultrasound and X-ray were fine. I hope you can get sorted soon.

[Broseley in reply to Uglow]

I didn't mind the MRI except it was difficult to keep still. Also they offered me a choice of music. I asked for 70s and got 'Crazy Horses' by the Osmonds, followed by The Rolling Stones, The Rubettes, TRex etc. Not very relaxing!

[Iamfedup in reply to Uglow]

I have sedation as I can’t do small spaces it’s brilliant

[tempusfugi in reply to Iamfedup]

Can someone tell me about MRIs please? I mean I've had a couple so you'll be wondering why I'm asking but the reason is that I have become more claustrophobic as I've got older (didn't used to be), so I wasn't looking forward to being put in a machine and closed in. In fact, it wasn't like that at all because it was open ended, which made me feel better. OK, it wasn't that pleasurable because it was an MRI on my head, at the time, so you can imagine.

Since then, I've spoken to friends who've had MRIs and they tell me they were completely closed in to the machine. So are there different types of MRI machines used nowadays or was I just fortunate to have a newer model? Just interested to get your views.

[PMRpro Ambassador in reply to tempusfugi]

If you want a general answer from several you will need to repost this as a new thread - only Iamfedup, DorsetLady and I are likely to see it here.

[tempusfugi in reply to PMRpro]

Oh yes, of course, PMRpro. I wasn't really thinking sensibly about this! Think I will put it up as a new thread and see what happens.

[Sharitone in reply to Uglow]

It was an MRI scanner that first triggered my slight claustrophobia, and I couldn't do it. However, I developed a technique of shutting my eyes as soon as I started to move in, keep them tightly shut all the time, and sing every song I know by heart. (in my head)

However, the last time I had one3, the scanner was miraculously improved - there were so many mirrors, and light that it did not feel so much like going into a tunnel and the masterstroke was that there was a current of air blowing through it so you so not feel like you are being suffocated. I still kept my eyes shut, though, but I would not worry about having one again. I hope you have a similar experience.

[Viveka]

Would suggest you first find a good physio who is recommended by people. It's likely that your shoulder problems are being exacerbated by how you are moving your arm. I have a torn supraspinatus that is reluctant to heal (no doubt cause of pred). My physio is tackling all sorts of wonkiness where I have shut down muscles to avoid pain but made things worse long term. There may also be an alternative type shoulder specialist in your area - chiro/osteo - again only go to people who are recommended. They may be able to help also - many use a range of mediums like infrared light and acupuncture.

I had a steroid injection prior to physio (I am only on pred) but consultant said he would only do one. Basically injections can give you a space to do the movement work.

[Macas in reply to Viveka]

Thank you Viveka I have tried in the past Physio, acupuncture chiropractic but the pains remain. I decided to have the ultrasound and X-ray and I am still waiting for my GP to discuss the results with me and then I can make a decision whether to have the steroid injection.

[Hankb]

I had a shoulder pain about a year ago similar to what you describe. After an examination and an Xray the specialist said it was due to wear and tear and suggested a steroid injection. Initially I was a little apprehensive as I thought I'm on cortisone already (prednisone) and don't want any more pumped into my body. However I went back a few days later and had the jab, within days the pain disappeared and 12 months later I am still pain free. I was on 10 mg a day at the time. I'm know we are all different but just want you to know my experience. Best wishes.

[Macas in reply to Hankb]

Thank you Hankb sounds great to be pain free. This last few weeks have been so miserable so you offer me hope

[Darkchocolate1]

I have had several steroid injections into my painful dominant shoulder with mixed results. My orthopedic doctor gave me several with no notable pain relief. My rheumatologist injects in a different spot on the shoulder and usually I have great pain relief for nearly 3 months. The last one not as much relief. My pain also goes across my upper back and I wonder if it is PMR pain. My shoulder is destroyed by arthritis, full of bone spurs and inflammation. It interferes with sleep and all movement. I was scheduled for replacement surgery but had to cancel due to spinal pain. I hope someday to have the replacement. So, I think placement of the injection is essential and likely how bad your shoulder is as well. I hope it works for you. When it works it is brilliant. Best wishes.

[Macas in reply to Darkchocolate1]

Yes I may well decide to the hospital as I’m told they will use the Ultrasound to get injection into correct place?It will cost £625.00 but if it works and If it can be done while I am taking Apixaban. I have tried to speak to my GP but still awaiting a call back from him.

[Judywalks]

I had about 3 steroid injections and they really helped for a time. I ended up having a shoulder replacement a year ago because they didn’t want to give me more steroids.I was also on Prednisilone then.

Do hope you can get some relief from the pain. It’s so hard when we are on other medications as well.

[Macas in reply to Judywalks]

Thank you good to hear the injections have worked for you. Still waiting to hear from my GP to discuss my other medication.

[pegpowell]

I had one steroid shot in my right shoulder when I was first diagnosed with PMR about 8 years ago and it took all the pain away. Unfortunately, much use and possibly because of a much lower dose of pred (1/2 mg), this year it is beginning to ache when used too much. I have also had shots in my knees and one hip; eventually one knee and one hip have been replaced. Two shots a year delayed hip and knee replacements for about two years. I recently received a shot in my unreplaced knee and it has not worked as well, possibly because of the injury or the doctor who gave it. My orthopedic surgeon has given me the successful shots thru the years.