I am coming up to year 3 of PMR journey and, at the moment, am on 9.5 mg of Pred. In that time, I have undergone 2 Carpal Tunnel Syndrome (CTS) operations and, as from Monday next 20 January am possibly going to have a steroid injection in my right knee.
Recently, I had an MRI scan on my knee which has shown 'near complete loss of articular cartilage' and 'a tear in the medial meniscus' along with arthritis in the knee. Unfortunately, this has affected my mobility in the last few months, such that I can't walk far and need a forearm crutch to do so.
Both the CTS and the knee problem have come about since starting Pred, so I believe them to be a side-effect of steroids. When I had the CTS operations (local), it never occured to me that perhaps I should increase the Pred but since reading posts on the forum, I wonder if I should do so before having the steroid injection or does one only need to do that before have a full anasthetic type op?
Would be grateful to have your thoughts please. Many thanks.
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tempusfugi
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if you are talking about a steroid injection straight into the knee then no problem.. I had a couple in my knee and shoulder whilst on low doses of Pred. The Pred just goes to the local area to help the pain there -and you should be advised to rest that joint for 24 hours afterward.
It ‘s a minor procedure that only takes a minute or two and hopefully will help. 😊
Thanks so much, DL. You have given me confidence, just by sending me your reply. It IS an injection straight into the knee as I understand it. Hopefully, it will work. I know they don't always do so. My brother had one the other year and had no response at all so eventually had knee replacement.
Hope you're continuing to enjoy your time in New Zealand😎
I suppose, then, these injections are a kind of stop-gap before going the whole hog. If they work for a while, fine, but as you say eventually replacements may be necessary.
For some certainly - depends how quickly the OA deteriorates. It’s a familial issue for me, and definitely had it in knee pre GCA. .. Think shoulder was made worse by GP diagnosing frozen shoulder instead of GCA so had 3 steroid shots before correct diagnosis - although MRI scan whilst having GCA did show AO issues.
On higher doses it was “contained”but as I got down to single figures and then off Pred, it became more of an issue… ended up having 3 replacements-knee 2018, hip [aggravated by opposite knee- no previous issues] 2019 and finally shoulder in 2020.
Fingers crossed and with a following wind hopefully won’t need any more surgery.
Gosh! It's amazing what you and others on this forum have gone through. Makes my complaints seem minor in comparison. As we so often say, it's people like you, PROpro and other regulars on this site that continue to inspire others. Such an enormous help and resource.
Well I was disgustingly healthy until I hit 63 (only visited hospital for 2 pregnancies & a hysterectomy) but packed a lot in between then and 73.. Hoping I can get a few more “free” years - and intending to make the most of them😊
Very similar tale to DL, a few injections over the years which generally made some difference but when you get to bone on bone then replacement is the only option. Had my replacement nearly twenty five years ago, it was, and still is brilliant.
Thanks, Bcol. Wow! your replacement has lasted well. Very good to hear. I will, of course, be speaking to the Consultant in more detail about the result of my MRI scan, but I have a feeling I might eventually have to go down the road of a replacement. In fact, I think I might already be at the point of bone on bone since the scan showed a near complete loss of cartilage, which as I understand it is a shock absorber. Time will tell, I suppose.🤔
I think it might be worth enquiring about PRP (plasma rich plasma) injections - if there is enough cartilage left to have an effect. Where does moderate end and severe start???
Oh! sorry to hear that the shoulder injection didn't work, piglette. So have you still got pain then or did something else happen with your shoulder (ie like Dorset Lady)?
I think I had sprained my shoulder somehow and it actually slowly got better. It was a private doctor and he insisted that I had an injection in my shoulder.
Interesting because this is a private consultant who is advising the injection, which he will action. On this occasion Benenden, my insurers, are forking out!
In my case it was a private consultant too although he also worked for the NHS. He charged about two hundred pounds for the injection which I don't think I needed.
Thanks, powerwalk. I don't know why but I have a feeling the injection won't work for me. I guess I just have to hope it will but, since it did nothing for my brother, I think my brain is telling me it won't do anything for me. Doesn't necessarily apply, of course. Must be my state of mnd😔
Honestly, your brother could have another one and it could work better. They are that kind of thing! Fingers crossed for you. Im off this morning for epidural for my back, like a patchwork quilt!! Let us know how it goes.
Thanks, powerwalk. I hope the epidural went ok today. I had one of those 47 years ago when I gave birth to my son.🥰 You sound as though you've had a few of those if your back is like a patchwork quilt! Will keep you posted...
The CTS is not due to the pred - it is due to inflammation compressing the median nerve in a tunnel in the forearm - pred can relieve that so while it may have been OK at higher doses of pred, it may not be now you are at a lower dose. The inflammation may be due to the PMR which would account for them occurring in tandem.
The knee is another matter, There are doctors who believe that pred contributes to the breakdown of the cartilage - but pred also relieves some of the pain of OA so again, it was less noticeable at higher doses.
Do hope the injection helps - my daughter has meniscus problems and has had a few PRP injections on the NHS (Platet-Rich Plasma) which she says has made the knee feel totally different and better. They are used for mild to moderate OA, maybe yours is too far advanced but could be worth asking about.
Thanks, PMRpro, of course it makes sense that it's PMR inflammation that probably caused the CTS. I have a tendency nowadays to blame Pred for anything and everything! So thanks for putting me right there.
As regards the knee, I first noticed a problem back in 2019 and was told that I had a torn cartilage at the time, so that was 3 years before I was diagnosed with 'a sort of PMR'. So I guess that's been coming on for some time.
It's good that your daughter gets relief from her PRP injections. As I understand it, I would need to come off steroids 2/3 weeks before a PRP injection and remain off Pred for a few weeks afterwards. I obviously can't do that so presumably the Consultant won't offer it to me.
I think I’ve had about 20 steroid injections now, & the effect varies. I only had one that failed & it was a guided injection in an operating theatre into my hip, lasted 48 hours! All others have lasted well, up to 4 months. I have to say you are right, the attitude that your brothers injection didn’t work so yours won’t is not good!! Go into it with positivity, & hope…& it should work well!
I'll take your advice, Pixix, and think positively (I am a glass half empty person, I know, or so my friends tell me)! I didn't realise one could have so many steroid injections - all new to me, I guess.
Hi, I have torn irreparable tendons in my right shoulder. I have had 2 steroid injections in the last 9 months which have helped with the pain considerably. I had minor side effects after the injections. Good luck 🌸
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