cortisone injection

Hi group,
I had a cortisone injection into a trigger point or my spot where it hurts and I keep getting reinjured (nervous system is oversensitized) and I'm deconditioned. How long does it take to work completely and how long will it last. My problem is chronic pain and inflammation. If I take Flexeril it works in about a week and is good for 3 weeks and that is it (but I can't it anymore due to an arrythmia), If I take Ibupropin it goes away if I take it 3 times a day plus one tylenol after a week or two it really helps. But that hurts my stomach. The other NSAIDs don't work for me. Anyway, I have myofascial pain syndrome (MRI, neg and bone scan and HIP xrys negative). So I'm hoping this will knock the pain signaling down. Anyone have an experience or info they want to share?
thanks,
mkh9

[geminigirl1963]

I've gotten cortisone injections in my knees, my hips and my shoulder.  The injection is usually mixed with a numbing agent, so if the injections you're talking about are like the ones I've had in the joints, you probably will feel some immediate relief becuase of that numbing agent.  The full effect of the cortisone usually takes a couple of days to effect - you may feel some improvement before that, but give it several days to really "kick in" before you say whether it has helped or not.

As for how long the inejctions last - again, I'm only going by the ones I've had in my joints - they told me I could have them approximately every 3 months - you can't have them too often, becuase they, themselves, can cause joint damage from the steroid.  So, TECHNICALLY, they could last that 3 months.  However, i've nEVEr had one last that long - the most relief I've gotten out of any of them as been about 2 weeks.

However, I must input here that my joints are VERY BAD - I've already had one shoulder replaced and have been told I will need to have both knees and both hips replaced in the next few years.  So, becuase of them being so bad, it's possible that's why I didn't get longer relief from the injections.

I don't know if this information I've given you is completely pertanent to your situation, but did want to let you know my experience with cortisone injections.

[geminigirl1963]

I've gotten cortisone injections in my knees, my hips and my shoulder.  The injection is usually mixed with a numbing agent, so if the injections you're talking about are like the ones I've had in the joints, you probably will feel some immediate relief becuase of that numbing agent.  The full effect of the cortisone usually takes a couple of days to effect - you may feel some improvement before that, but give it several days to really "kick in" before you say whether it has helped or not.

As for how long the inejctions last - again, I'm only going by the ones I've had in my joints - they told me I could have them approximately every 3 months - you can't have them too often, becuase they, themselves, can cause joint damage from the steroid.  So, TECHNICALLY, they could last that 3 months.  However, i've nEVEr had one last that long - the most relief I've gotten out of any of them as been about 2 weeks.

However, I must input here that my joints are VERY BAD - I've already had one shoulder replaced and have been told I will need to have both knees and both hips replaced in the next few years.  So, becuase of them being so bad, it's possible that's why I didn't get longer relief from the injections.

I don't know if this information I've given you is completely pertanent to your situation, but did want to let you know my experience with cortisone injections.

[mkh9]

Hi and thanks for all your info. Yes, I got a lot of relief from the lidocaine so I slept well for the first time in a long time last night. Since my injections were into the muscle they may not last that long. But, one time it took my chronic pain away so I hope for the best. I know for back pain, you really get the longest relief when it is an epidural type injection. But, I was wondering if it could take like two days to start working because I still feel it but not quite as bad today. My main problem is my nervous system is very oversensitized and any inflammation causes more oversensitization. So, I'm trying to knock it down a bit and see if that helps. I heard cortisone can damage the tissue. I'm not sure why though. Can it still damage the tissue if you wait the 3 months? The last two injections (one in the wrist for tendonitis) took effect as soon as the lidocaine wore off so I was wondering if there could be a delay.  I'm really sorry about your joints that is a lot to deal with. We are about the same age (i'm 49) so I think that is very young to have so many joint problems. I hope you have success with your replacements when you get them done. I know the knees are painful but they have better procedures now. They can't inject stem cells for more cushioning? That is a new procedure if that is the problem but if isn't collagen and it is structural that is different.
thanks,
mkh9

[geminigirl1963]

I'm glad you got some good relief immediately after the injections and were able to get some much needed rest.  Hopefully the steroid will take effect soon and you'll continue to have relief from these injections.  Since I've never had them in the muscle, I honestly can't tell you how long they might last.  Did your doctor give you any idea?

Again, I've only ever had the cortisone injections directly into a joint, so I'm not 100% sure on tissue damage when it's injected into a muscle, however, I'm presuming it would have the same possibility.  I know one possible side effect of oral steroids such as prednisone is muscle problems, so again, I'm only presuming this could be the same with an injected steroid.  Steroids definitely can and do cause thinning and wearing down of bone and that's one main reason I have so much troubel with my joints.  I've had to be on prednisone MANY times in my life and sometimes at very high doses for extended periods of time.  I have severe asthma, DDD, fibromyalgia, severe arthritis in all of my joints (from finger tips to tips of toes and everywhere in between) and lupus.

I've had the Euflexxa injection in one of my knees - my doctor and weren't real sure it would do any good simply becuase of the extent of the damage, but thought we'd give it a try anyway.  I didn't get any relief from it - again, more than likely because my knees are just way too far gone.  I've not heard of teh stem cell injections - will ask my doc about it, but as you said, if it's not simply a cushioning problem with the joint, I doubt it would do much good - I'm bone on bone in my joints and of course, that has caused deterioration of the bone itself.

I really hope you get some good relief from these injections!

[mkh9]

HI and thanks for the info. I was told that perhaps 2 weeks on up if it works. I did have a steroid injection into the same area in 2007. It worked for 2 days (all pain gone even the leg pain). Then the pain came back but after a month it went away for a year and a half.  I sure wish that would happen again. It may have been because i was doing a lot of physical therapy and it inflammed the area and the doc said to quit that too and I got a steroid shot so I don't know if it was the combination or what. But now I'm out of shape (atrophied) and I don't want to see another PT because two of them injured me and one really badly or I wouldn't be in this shape. So, I sat too much due to pain and now I'm having trouble getting to do things again. I am now walking about 50 minutes to an hour (half hills and half flat), I drive and can do the dishes and a few things but I can't bend to dress myself , or put shoes on etc. I can't cross my left leg over to react my left foot either. The doctor doesn't want me to work on that yet but it seems like I should be moving it until it loosens up. He thinks that the walking will loosen me up. I have only had two shots total and may get one more in a few months. I don't think that will cause too much harm, hopefully. My problem is that somehow my nerves got oversensitized and so slight movements give me what feels like a back strain. I get these about twice a month so the inflammatory process kicks in a lot. I tried muscle relaxers and they worked but made me sleep walk and I hurt myself then it didn't work any more (basically 3 weeks). I am not sure how to get back to normal again. I'm sorry about all of your problems. I hope you can get help. My best friend  has Lupus (both discoid and now systemic). She went off all meds. She had tried high dose  accutaine and that worked but it can eventually give you a brain polyp,and she was on plaqunil but went blind due to the toxicity and her doctor not monitoring enough. So she is just staying out of the sun and she does have arthritis but she also stopped cortisone for her face and except for facial problems is doing well considering. She didn't take steroid injections as it is toxic to the kidneys so I don't know. it is possible apparently get off the drugs but I'm sure she is paying for it pain wise. But she still take care of  4 cats and lives alone and her house is spotless and she has someone get her a ride to the market. I need some more of that courage.  Well, take care and let me know how you do as well.
mkh9

[mkh9]

Hi geminigirl1963,
Well I had the cortisone shot Tuesday and after the long acting lidocaine wore off I am back to my usual pain today. So, I don't know if it isn't going to work or if it will take some time. Can it really work after a certain amount of time? I had the injection Tuesday and pain today on Friday. Oh well, I didn't expect miracles but was hoping that I would get a little relief for a couple weeks. I still have in the back of my mind that last time it took 20 days or so to work or maybe it was because I stopped physical therapy per doctors orders. So, I don't know what to think. I still am doing my usual rountine which isn't much except for the walk in the morning. Hope you are doing ok today. Regarding stem cell or cell injection into your knee. If you have no cells left they can't use those cells to make more but if you do they it is a possibility. My neighbor can't get his done as he has no cells left. My mother in law also has the same problem with her knee, bone on bone. What do they do put fake cartiledge in there?  Are you taking anything for the fibro? Eventually, I may try a norepinephrine reuptake inhibitor if it doesn't go away with exercise. Oh well,
have a good day.
mkh9

[geminigirl1963]

I'm sorry you're back in pain again.  I've always been told, when I've gotten my injections, that it takes a couple of days for the steroid to start working, so based on that, I would have thought you would have noticed it by now.  I'm not really sure about it starting to work after an extended period of time, but I suppose it's possible - the longer it's in your system, the more it's helping to reduce inflammation, so therefore, pain is reduced - kinda makes sense.  Hopefully that will be the case like with your last injection.

Thank you for the added information about the cell injection for my knees.  I'll definitely ask my ortho about it.  As far as what they do for the bone on bone - there's pretty much not anything they CAN do other than a joint replacement - it's got titanium/plastic for the joint part and I'm not exactly sure what the "cartilege" is made of, but definitely something man-made.  I'm trying to postpone having them done as long as I possibly can because they don't last indefinitely and the younger you have them done, the more likely it is you'll have to have it redone in your lifetime.  I'm also trying to lose weight so that whenever I do have th esurgeries, it'll definitely make it an easier recovery.
I've tried several of the "normal" anti-depressant type meds they usually try for fibro, but have always had pretty bad reactions to them, so am unable to take them.  I was on Lyrica for a few years until it stopped working at the dose I was on and when we increased the dose, I started experiencing horrible side effects that far outweighed any benefits.  Right now I have pain meds, muscle relaxers and a sleep aid (sleep is always a big problem for me).  I also use heating pads, warm showers, gentle stretching and as many relaxtion techniques as I can think of.  Some days those things help and others there's nothing that's going to help so I just try and tough it through.
Today, unfortunately, is "one of those days" - I had a busy day yesterday, a HORRIBLE night trying to sleep last night - and I'm paying for it today in pain.  We've also just had a change in weather and that always bothers me, so am sure that's adding to it.  Oh well - at least I didn't have anything that I HAD to do today, so am just trying to rest and take it easy.
Do you also find that weather changes affect your pain levels?
Hope you have a good day and a great weekend!
Robyn

[mkh9]

Hi sorry that you are havng a bad day. Yeah, I know that the knee replacements are not long lived. So, it is best to wait as long as you can but not so long that you get too old to heal. (I know you are not old as we are similar in age). I have the same problems in that if I do too much I will pay for it later. Weather, if it is cold my muscles tighten and I think that doesn't help since I supposedly have myofasicial pain syndrome. I tried Neurontin for a while but it did nothing. I don't think it is nerve pain on my end. Antiiflammatories and muscle relaxers work the best and heat. But, I took Flexeril and it made me so dopy I sleep walked and hurt myself. Then it only really worked well for 3 weeks. I was thinking if I can't take it anymore to try something like Sevella or Pristiq. But then I won't be able to take my migraine meds and would have to switch. It causes nausea too and I can't deal with that. So, I'm trying to walk it off even though it hurts. Since I'm atrophied from too much sitting I have to get back into good shape and hope for the best. I initially took Tramadol, and vicadin and a muscle relaxer called Skelaxin. I started getting breathing problems and with both insomnia so I couldn't take those more than a month. It is too bad they don't have a good pain med . Some say valium helps a lot if you plan on staying on it or using it a few days  a month. I can't take it because I take another benzodiazepine for my migraine variant (Klonopin) for the last 20 years. I doubt I'll ever got off of it. Well, rest and I hope you feel better tomorrow.
mkh9

[mkh9]

It is not in clinical trials yet, but there is some great research out about a drug for chronic pain. It knocks out the signaling at the nerves or turnes the oversensitizaiton switch off. It will be great whenever it gets through clinical trials. I believe it is called N60.
mkh9

[geminigirl1963]

I twould be great if they were able to come up with a new med for chronic pain - especially if it didn't have some of teh severe side effects that some of the narcotics and other meds currently being used for it have.

[mkh9]

Yes, for sure! This drug if the side effects are ok and it works as well in humans as it does in rats has few side effects and it shuts down the pain and doesn't have to cross the blood brain barrier. It is going into clinical trails. But, you never know how that will turn out. But, this group from CalTech and genetech plus Columbia University are extremely smart and have put out some really good drugs. The paper is hard to read but it is by Ying Ju Sung, Ph.D. and entitled And a little Mollusk Shall Lead Us. It is called that because the work they did was on a sea slug called an aplesia. It has a very large nervous system and is easy to see how the nerve in it work. Then they went to the rat and it worked well there. So now they have approval to start a trail and in proces of getting funded. My husband knows one of the inventors because way back when, he worked on aplesia at Caltech for a while too. Apparently, with chronic pain there is a switch that gets turned on and needs to be turned off. Very interesting. It makes me think I have to get on meds in order to get out of chronic pain. But the thing is that I don't if the meds currently on the market shut down this pathway. I wish it was out now. There is another drug in Europe that is non addictive , very low side effects analgesic for chronic pain, they have been using it for 20-30 years but it has to go through clinical trials here even though it is safe for millionis in Europe! That one is already in stage two clincial trials and I'm tempted to get on a trial since it already has been tested for so long in Europe. Oh well, we can get hope from the future.
mkh9