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Cortisone shot for inflammation - experiences to share? (Read 222 times)


Best Present Ever

    Research does not support soft tissue cortisone injections for reducing local inflammation.

    This is a bummer to hear. I have a shoulder thing that's driving me nuts. No actual injury, but significant pain with ADLs (I often elicit shooting pain first thing in the morning when I pull the sheets up while I'm to sleepy to remember to protect my shoulder). On one hand, I now can't put away dishes so the kids have to empty the dishwasher. On the other, I have to remember to reach for the stash of good chocolate with my left, not right, arm. PT hasn't helped, NSAIDs didn't do a thing. I was geared up to push for a cortisone injection ... What's the alternative?

      Research does not support soft tissue cortisone injections for reducing local inflammation.

       

      What's your source of information on this? Use of cortisone is controversial, but most med sites I've looked at claim that reducing inflammation in soft tissue is one of the primary benefits of a cortisone injection.

       

      e.g.,  http://emedicine.medscape.com/article/325370-overview#a3v

      Trent


      Good Bad & The Monkey

        An injection into the joint space is effective for shoulder joint inflammation

         

        This is a bummer to hear. I have a shoulder thing that's driving me nuts. No actual injury, but significant pain with ADLs (I often elicit shooting pain first thing in the morning when I pull the sheets up while I'm to sleepy to remember to protect my shoulder). On one hand, I now can't put away dishes so the kids have to empty the dishwasher. On the other, I have to remember to reach for the stash of good chocolate with my left, not right, arm. PT hasn't helped, NSAIDs didn't do a thing. I was geared up to push for a cortisone injection ... What's the alternative?

        Trent


        Good Bad & The Monkey

          A steroid injection given as an alternative to pills is generally effective at reducing body-wide inflammation, including in an injured muscle. Injecting it directly into the injured muscle is not, and may cause further damage.

           

          What's your source of information on this? Use of cortisone is controversial, but most med sites I've looked at claim that reducing inflammation in soft tissue is one of the primary benefits of a cortisone injection.

           

          e.g.,  http://emedicine.medscape.com/article/325370-overview#a3v

          Buzzie


          Bacon Party!

            My first-hand experience concurs. Took a few days to do its work, but was a huge relief.

             

            (Now, messing with my running parts would elicit a lot more caution...)

             

             

            An injection into the joint space is effective for shoulder joint inflammation

             

            Liz

            pace sera, sera


            Best Present Ever

              An injection into the joint space is effective for shoulder joint inflammation

               

               

              the problem doesn't originate in the joint space, unfortunately, but seems to be in the deltoid.  Thus the interest in cortisone's lack of effectiveness in soft tissue

                Update: Cortisone shot didn't give much help but hip/glute strengthening exercises have. No side effects either (*crossing fingers*). The acute pain while driving the car appeared to resolve with the purchase of a new car.

                 

                Bottom line is that I need to continue strengthening exercises regularly. Plus (call me crazy but the shoe companies love me) running in different types of shoes (stability, Hoka's, neutral) each time helps I think.

                Suffering Benefiting from mature onset exercise addiction and low aerobic endorphin release threshold. Hoping there is no cure.

                Rod Staples


                  Here's my take on it 6 months ago I had back surgery L-4 to S-1 .  I have had several injections prior to surgery some worked and up until surgery the day before I had a pain injection.  After surgery the Doc said my bones were soft.  Not good so now I wear a bone stimulator for 2 hrs a day for 6 months.  All because of injections so if you don't absolutely need it I would try other methods   I started running after 3 months and the back is doing fine.

                  Rod Staples


                    Here's my take on it 6 months ago I had back surgery L-4 to S-1 .  I have had several injections prior to surgery some worked and up until surgery the day before I had a pain injection.  After surgery the Doc said my bones were soft.  Not good so now I wear a bone stimulator for 2 hrs a day for 6 months.  All because of injections so if you don't absolutely need it I would try other methods   I started running after 3 months and the back is doing fine.

                      I not only have hamstring tendinopathy, but ischial bursitis, as well, which is horribly painful.  The underlying issues are weak hamstrings, weak everything to keep the pelvis in place (as a back note, I fell about 20 years ago, the right side took the brunt of the fall, and every once in awhile things get a little off kilter).

                       

                      Anyway, after almost a month of PT, the hamstrings were getting better, however the significant butt pain only increased to where I could barely sit.  After 4 months of no running, no significant walking, no anything, I am slowly increasing my core strengthening, but the butt pain persists.  I am now scheduled for a cortisone injection into the bursa itself and am praying this does the trick.  I've taken enough anti-inflammatories to stock a pharmacy and am tired of ice, ice, icing and not doing anything physical.  Once the bursa completely calms down, I will be back at PT for the hammies and more core/glute, etc., strengthening.

                      Leslie
                      Living and Running Behind the Redwood Curtain
                      -------------

                      Trail Runner Nation

                      Sally McCrae-Choose Strong

                      Bare Performance

                       


                      SMART Approach

                        Seems like a similar scenario I went through some years ago with same issue in same area. The cortisone helped me A LOT! However the this may always be a sensitive area. Buy some Wonder Gel seat cushions. I still use them 10 years later even though my issue is resolved for the most part. Good luck!

                         

                        I not only have hamstring tendinopathy, but ischial bursitis, as well, which is horribly painful.  The underlying issues are weak hamstrings, weak everything to keep the pelvis in place (as a back note, I fell about 20 years ago, the right side took the brunt of the fall, and every once in awhile things get a little off kilter).

                         

                        Anyway, after almost a month of PT, the hamstrings were getting better, however the significant butt pain only increased to where I could barely sit.  After 4 months of no running, no significant walking, no anything, I am slowly increasing my core strengthening, but the butt pain persists.  I am now scheduled for a cortisone injection into the bursa itself and am praying this does the trick.  I've taken enough anti-inflammatories to stock a pharmacy and am tired of ice, ice, icing and not doing anything physical.  Once the bursa completely calms down, I will be back at PT for the hammies and more core/glute, etc., strengthening.

                        Run Coach. Recovery Coach. Founder of SMART Approach Training, Coaching & Recovery

                        Structured Marathon Adaptive Recovery Training

                        Safe Muscle Activation Recovery Technique

                        www.smartapproachtraining.com

                          Thanks, tchuck.  I'll look into the Wondergel pad. Sitting is the worst. Right now I use an inflatable donut intermittently, but it's uncomfortable and causes other back issues. It's good to know someone else had this problem and had relief with the injection.

                           

                          Did you continue running, etc.?  I stopped running, as well as doing any out of the ordinary walking, in an attempt to get some pain relief.  I did my first 30 min walk yesterday.  Things are aggravated, but I'm in that "oh well" mode. 

                          Leslie
                          Living and Running Behind the Redwood Curtain
                          -------------

                          Trail Runner Nation

                          Sally McCrae-Choose Strong

                          Bare Performance

                           


                          SMART Approach

                            Mine goes back to overtraining in spring of 2007. My sports doc allowed me to run through most of it. I did the 4 weeks of anti-inflammatories with some relief but when I went off them there was no relief. He allowed me to run through this. I also did formal therapy, ice massage, iontophoresis etc.  When I got the cortisone, he told me to take of 2 weeks off running to be cautious. I actually took of 4 weeks just because.......in hindsight, I probably should have just took off 8 weeks.......I was on a routine of extra glute work, light stretching etc. I would always ice after runs and try to get loose before runs.

                             

                            I had a relapse a year later.....it wasn't as bad but was sore again and received bilateral cortisone injections by my family doc. Again, I received relief but told myself this it for cortisone. I took off another 4 weeks.....This was now 2008. Over the next 5 years, I tolerated it. I had things under control but there was always some soreness after runs and races but I would seem to bounce back for the most part. There continued to be a bit of discomfort in sitting but not like what I went through or you are going through now.....I know EXACTLY what you are feeling. It is probably a combo of bursitis and tendonitis.....at least that is what I had.

                             

                            I was able to run and race over next 5 years but one gets tired of the chronic soreness......I work with sports docs and orthos in my work. I had one of my docs do diagnostic ultrasound on my upper hammys. She said my left side was a classic case of tendonapathy/tendonosis but not serious. My right side was messed up. Severe tendonosis with micro tearing throughout. ZERO inflammation was seen. The chronic soreness was related to diseased tendons. In late 2013 I had this doc do PRP injections on the tendons along with poking the needle into the tendons multiple times while injecting the platelets. Most of the PRP she put on the right side.  I took off another month. Resumed running and would probably say I had an additional 30-50% relief at the 6 months mark after the injections. BUT, there was still some soreness there but figured it is what it is and could live with it. Doc said I should get maximum benefit by 6 months.

                             

                            Around this time I was also doing additional research on supplements/tendons/better health etc. I started taking 5,000 iu of Vit D3 with Vit K2 (Mk-7) and still take it. Whether it was coincidence or the Vit D I don't know but within the following 6 months I feel my hammys were 95% healed. Now 3 years later they feel the same and am able to race and run without major issues. They do get sore at times from races or overuse, but they bounce right back. Sitting is no longer an issue but I still use cushions when I know I will be sitting a long time. I continue to do prehab exercises and warm them up before every run. I have an infrared heating pad I sit on too regularly which I swear by. I also do a decent amount glute and hip and core work too regularly. this is important......need to train the glutes to work to take stress off the hammys. I have stayed away from icing. I also cranked up my hammy stretching and hip flexor stretching........After the Vitamin D results, I was finally able to start aggressively stretching without pain. It would also be painful to stretch, do lunges etc. Now, I have no pain with stretching.....I hope this helps......my recommendation is to get this resolved this time and try to avoid a chronic situation where those tendons get diseased. Take the time you need and heal!!!

                            Run Coach. Recovery Coach. Founder of SMART Approach Training, Coaching & Recovery

                            Structured Marathon Adaptive Recovery Training

                            Safe Muscle Activation Recovery Technique

                            www.smartapproachtraining.com

                              Thank you for the information.  It's really helpful.  It's been hard to find someone else who has gone through this.  I have been diagnosed with hamstring tendinopathy, worse on the right than the left, but because I've been compensating sitting-wise by sitting more on the left, the left hamstring is more compromised now than it was when this all started in late Dec/early Jan.  My goal is to see how much the shot helps the bursitis, then get back into PT for the tendinopathy, which was helping but inflamed the bursitis.  I've been able to do some hamstring, glute, etc., strengthening/stretching on a limited basis (no repetitive motions) and, whether it's psychological or not, I think I'm getting some minor hamstring relief.  I understand from my readings that this could be a chronic issue and that I'll have to be very diligent with my core/glute/hammy strength training from here on out.

                               

                              The Vit D info is interesting and I will keep that in mind.  And I ordered one of the Wondergel pads.  It should be here tomorrow!

                               

                              Thank you for sharing your experience with this.  I really appreciated it.

                              Leslie
                              Living and Running Behind the Redwood Curtain
                              -------------

                              Trail Runner Nation

                              Sally McCrae-Choose Strong

                              Bare Performance

                               

                              trackbunny


                                Cortisone shots are a temporary fix, they're an anti-inflamitory pain killer that does nothing to actually heal your injury. RICE and taking care of your injury are really the best things.

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