Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Post Steroid Injection - Please Help

Hi Molly,

Just a crazy thought... I think it could be possible that the needle could have struck the cartilage or nicked the bone causing the increased inflammation and pain. I'm not trying to scare you or anything like that, just offer another possible explanation. I'm thinking this since you said it is definitely a mechanical problem.

It's been so long since I had steroid injections that I can't remember if I had any late reactions.

I hope your foot feels better soon,
take care,
James.

Hi Lisa,

Thanks! I hope I feel better, too. This is getting ridiculous. It could just be that I have RA or something like that and it's really, really flaring. I will talk to my docs.

~Moll

Hi James,

Thanks for writing. I don't think that is what happened, but I'll ask my doc if that's possible.

~Moll

hi molly,

in 1998, i had my tq tendon injected and in 2006, i had my ulnar wrist injected. when i went for those injections, the tendons or ligaments were so inflamed / so much scar tissue had set up, that any movement set up more inflammation and then more scar tissue. so when i finally got the injections, things were pretty bad. for both of these cortisone injections, i remember that each got really really sensitive after the injection and i had to be so careful not to use the hand / wrist for weeks (for the dq tendon) and months (for the ulnar wrist) and i was in therapy for both for months to keep the inflammation down (contrast baths, ultrasound, ionophoresis) and to keep the scar tissue from forming again (gentle stretches, heat) and then strengthening (very light exercises for the dq tendon with washers and finally bolts on rubberbands (husband used to make fun of my "weight lifting program") and for the ulnar wrist, just slowly using it for very light tasks as it was too frail for even PT exercises. it took a long time and a lot of being careful and a lot of PT work, but the dq tendons are pretty good now (just "normal" tendonitis) and the ulnar wrist is still healing (can type, peel and chop food, can do most light activities, but can't do any weight bearing and can't rotate wrist or keep it in a slightly rotated position without pain).

i only go through all of this to show that sometimes it can take a long time of little to no use and PT.

and i can't imagine how i would have been able to be that careful with it if it had been my ankle instead of my wrist.

it sounds like you've been on it quite a bit, and i haven't heard you speak of PT. if i had simply been given the cortisone shots with no instructions to be careful and no PT, both would have gotten worse again, i'm pretty sure.

of course your problem may be completely different from mine, but it could be the same.

in both cases, i had an orthopedist give me those shots, prescribe my PT, and follow my progress.

i can't remember if the rheumy gave you the shot or an orthopedist, but maybe going to an orthopedist if it was the rheumy, maybe that would help. certainly getting in to see a doctor ASAP is a smart thing to do, as you are doing.

also, i never had anything swell up from a cortisone injection. just get a lot weaker, a lot more painful, a lot more "fragile", but the cortisone really did break down the scar tissue for me which is what i needed especially.

sue

Hi Moll,

I just recieved my second shot in my knee today. The first one worked great, lasted a few months without any pain. I am still sore at the injection site, but hoping for the same results as last time.
I hope you can feel some relief soon.
MB

Hi Sue,

Thanks! Yes, the rheumatologist did this injection. I originally went to an ortho about this, a very well-regarded one, who put me into the boot (this was early 2008). Then, when he got the MRI results, he said that there was nothing wrong with me and he didn't know why I was in so much pain. Actually, after reading the MRI report myself, recently, it says clearly that I have achilles tendinosis. Along with a host of other tendon tears and swelling and a talar bone spur. So, I guess he was not quite correct. Anyway, he's no longer on my insurance, so I can't go back to him. Will ask my docs if a podiatrist would be helpful.

I have gone to PT a few times for it, but it's so sore and inflamed that they don't want me to stretch it or anything. They did some ultrasound and e-stim. Didn't seem to do much. I ice and use heat and voltaren gel and diclofenac patches. I use Ultram. I rest pretty much all day long.

So, I am at a total loss and really feeling rather down about it all. I think I need a total skeleton replacement.

~Moll

Hi MB,

I'm glad it's helping you! Good luck on continuing to get better! It's always encouraging to hear.
~Moll

not a total skeleton replacement, we just need new tendons and ligaments, that's all yeh, right, that's all

for me, orthopedists seem to fall into either extreme, the ones who help me more than most other doctors. the others (which turn out to be most of them, the majority) that respond like your doctor did with an xray and/or MRI and "nothing i can do for you" response. xrays won't show a thing (for tendonitis) and most mri's won't show anything unless its a serious rupture or tear. a more minor tear (which can be very painful and cause a lot of disfunction) usually isn't "seen" but my doctors treat them anyway.

for my dq tendon, i had to shop around quite a bit, and it was my PT that i went to first that was making some progress but not enough who recommended the hand orthopedist that finally helped me. and for the ulnar wrist, i had been to an orthopedist for my "hip" (which turned out to be a torn IT/TFL tendon/ligament), for the hip, he took an xray of the hip joint, said "i can't help you, you need a rheumatologist" but he felt comfortable shooting my wrist with cortisone. so i guess what i'm saying is, "i hear you." finding the right person to help us with all of this soft tissue stuff can be a challenge.

my physiatrist is probably the most helpful of all the doctors.
that and a copious amount of PT.

and please just hang in there....there have been body parts that have gone so far downhill, i just couldn't imagine they'd ever get better, but "by golly" they did with the help of the right doctor and the right PT. sometimes it does take a bit of doctor and PT shopping though.

and the PTs that think exercise is the answer to everything.....well, i've never had that work for me.....instead its things like lots of ultrasound and joint mobilization and manual things.....i've been lucky to have a few really outstanding PTs over the years, and what they've told me which i believe is true from what i've seen with my own body "you can't work on strengthening until the inflammation is settled down / until you're out of the acute stage" or something pretty similar to that.

over the years, i've had a torn rotator cuff that healed "100%" far as i can tell, that IT/TFL band heal "100%" far as i can tell (and i couldn't even walk or climb stairs at all for 3 months and it took over a year before i could take a walk or bike), PF that felt like walking on glass that is much better, etc etc.....

i really do feel like "if i could heal" then anyone can,
and if i had placed a bet on those things healing, i would have lost the bet.
and you'd think after so many of these experiences, i'd have the positive attitude of "this will heal too" whenever something new happens. but no, instead, each time, all the old fears come back, all the doubts, all the worries of "maybe this time, it just won't get better."

i have to say, though i've had no luck in figuring out the root of the problem (the "why is it happening") and thus no luck at prevention, i've had some pretty good doctors and therapists putting me back together. i truly feel like humpty dumpty some days

i do feel for you, i know what you're going through, but i'll place my bet that it will get better....at least that has been my experience.

sue

Hi Molly, I had a similar reaction last week on my arm after a blood draw, the doctor said it was a hematoma and mine is better this week, so I think she's right but when it first happened, I Googled it and I came across some articles on nerve damage at injection sites, I'll try and find it again and post it here for you to read....

Thanks Sue. That's very helpful to hear. I do have an excellent primary doc, and I think my rheumatologist is great, too. But I'm afraid of not getting better and then having to again face the "I don't know what else to do" face. I'll not hold my breath until then. But I will ask my PT if they would be willing to do more manual/ultrasound type of therapy until I get less inflamed.

~Moll