A few questions about steroid injections.

I saw my specialist nurse last November because I hadn't been getting on too well, I was offered a steroid injection, but to cut along story short I decided not to have it and to wait till I saw my consultant, I knew I was due to see him in January.

I had the appointment last Tuesday told him how I'd been and how I was feeling. I've been taking paracetamols since November when I've needed them, along with my burfen retard tablets.

He did examine all of my joints, looked at the previous blood test results and said that he thought my pain was not due to the RA, it was muscular pain and offered me a steroid injection. He did add that there may be some underlying inflammation that was not picked up on the blood tests. I reminded him that even when my inflammation levels where high when I first saw him, I never had any visible swelling.

This time I had the injection.

Now, while I will accept up to a point that the pain in my arms could be muscular, I don't think that the stiffness I experience in the evenings and first thing in the morning is muscular. That the pain in my shoulders, wrists, knuckles and toes are down to my muscles either. I know he's got more knowledge of RA than I have, but at the end of the day, it's my body and I think I should be aware of if the pain is in my joints or muscles.

I have to see him again in 2 months time. I asked what he will do then, he said it was down to what I tell him I've been like and suggested that I should write a diary of how I have been feeling.

So what should I expect from this steroid injection? How long should it take to work? How long does it work for? If it does work, does it mean that it is the RA or is it muscular? Or is a steroid injection just a wonder drug that treats RA and muscular pain? If it does work and then the pain starts to come back again once it wears off, do you think he will add something else to what I'm already taking?

If a steroid injection is only temporary, which I think it is, then why did he give it me if I will be back to feeling bad again once it's stopped doing it's magic?

Sorry it's alot of questions but I'm confused again.

Paula

Hi Paula,I'm in a similar position as you regarding a steroid injection.I have OA and RA but my last blood tests were good and my Das score was very good so my consultant lowered my Hydroxy dose to just one a day.However,the past few weeks I've been getting very bad shoulder/top of arm pain and the consultant said a steropid injection would probably help and to see my Gp about having it done.The 4 x rays I had done of the shoulder apparently doesn't show up OA so my Gp says the pain is a muscular problem. Instead of giving me the steroid injection he has put me back on Naprosyn and Omeprazole for two weeks to try and get the inflamation down.If after two weeks it's no better,then he will give me the steroid injection.The pain is so bad at night I can't sleep.It seems to get worse once I lie down.I have heard good and bad reports of the steroid injection but I'm willing to give it a try.I was on steroid tablets last year for several weeks and it cleared the pain completely but my Gp thinks the injection will get right to the hub of the pain.Perhaps the Naprosyn will help but only time will tell. Brenda

Hi Paula,

Was it an intra-muscular injection, ie into you backside? When I have had one of these, I generally feel better within a few days, but the length of time they last might depend on the amount of steroid they inject. I had one done once by a registrar, and my rheumy consultant said that the amount he gave was too conservative - she gives me a big whack! With an injection into the joint I have had varying degrees of relief - the ones done under ultra-sound are the best because they are more accurate.

I hope you were told to rest for at least 24 hours to give the jab the maximum time to work.

I sometimes had steroid jabs long before I had RA, when I was doing a lot of sport, so they are not solely for RA, but I agree with you that you know your own body, and feel that it`s coming from the RA rather than anything else.

Keeping a diary is a good idea, and don`t pull any punches, so you can tell your rheumy exactly how it is.

Take care,

Kathleen x

Thank you for your replies

Well it's Friday now, and nothing has happened, in fact this morning my arms felt worse. This is really beginning to get me down. The consultant wants to see me in two months time, I just don't want to be like this for two months. Had a little cry to myself this morning. What makes matters worse is that we/my husband has decided to decorate the bungalow, every room, ready to sell it in the spring and I feel so guilty because at the moment I just don't think I will be able to help. Did some housework yesterday and it took me twice as long to do it. Still got to tackle the kitchen. I did stop taking the paracetamols but have taken some this morning along with my normal pain killers.

Tina

We both seem to be in the same boat then regarding it not working, but I have read that sometimes it doesn't, if it had to happen to anyone it had to happen to us. There is different strengths of it I think, perhaps we both got one that wasn't very powerful. The consultant may of thought that because my bloods are OK and my joints as well I didn't need much, I don't know.

Kathleen

I had the injection in my bottom, I asked the nurse if I need to rest afterwards and she said 'Well don't go running a marathon and get your husband to do tea'
I did go into Morrisons and did some shopping, but Keith did do the tea. The only good thing about it all is that for the first time I did tell him that I wasn't too good and told him about the injection. I'm afraid he has the opinion that if I take my prescribed tablets then I will be OK. At least now he knows that that is not the B all and end all of it.

Babara

You said that I might be having a RA flare. I was always under the impression that a flare was constant really bad pain. A volunteer rang me up from the NRAS when I was first diagnosed and when she spoke of having a flare I asked what it was. She said that it was the most horrendous, unimaginable pain that you can ever experience, well I wouldn't say that that was what I am like at the moment. It's mainly my arms and wrist that are causing the most problems. My toes, knuckles and knees sometimes like to remind me that they are there. My arms do hurt a little during the day when I am moving about but when I sit or am in bed, they really start to hurt. Moving them is very painful, the pain does go into my shoulders and sometimes up the side of the neck, (the consultant did ask if I got pain in my neck and I said sometimes), then like I said he announced that it wasn't the RA but a muscular pain. My wrist are bad and sometimes like this morning when I moved a chair I actually cried out with the pain. Picking up plates, the kettle, saucepans etc have started to be really painful again. Does all of that sound like a flare, or is it just general aches and pains of RA? I've always said that apart from odd times when things have dipped down a bit, I have had pain that I could cope with, unlike this. Don't get me wrong, I'm not sitting in a heap crying with it like I did when it first started, but heaven knows what I would be like if I wasn't taking all of this pain relief. I do compare myself with others on here and I do realise that I am nowhere near as bad as others, but it is still painful and I don't like it.

Brenda

From what you put I must be lucky, the consultant did write the prescription and one of the nurses at the monitoring clinic did it for me after about a 10 minute wait.

Amanda

Me going to be for two days.........well I only do that after I've had lots of wine.

Hi Paula,

Please try not to beat yourself up about the decorating, your health must come first, and it is a fact that we`d all LOVE to be able to do more, but sometimes we just CAN`T. I think flares come in different shapes and sizes - in a really bad flare I feel flu-like, ache all over and my joints are screaming, but it`s not always like that. You can have a flare in various joints, and it sounds like your wrists are really bad right now. Do you have some wrist splints?

With regard to pain-killers, my GP said it was very important to take them regularly, so as not to allow the pain to build up. I have 3 different ones, of differing strengths, and when he was explaining how to take them, he called it the "analgesic ladder," so that even if you felt your pain was under control, if you were due to take something, then to take it. I find this works quite well, though in pre-RA days I hardly ever had tablets in the house!

Hope you feel better soon,

Kathleen x

Dear Paula,

So sorry that you feel miserable. Take all the painkillers that you are allowed and as regularly as you are allowed and see what happens. Hope to goodness that it works as shoulder and wrist pain really hampers you trying to sleep.

Eleanor x

Hi Paula, sorry to hear you are suffering. It took about 3 days for my last depo to kick in but whatever the nurse said - resting does make a difference for all of us so even though you are frustrated in not being able to get on with the decorating - please listen to your body and don't do it. I also agree that flares come in all sorty of forms with pain to varying degrees. When I was going through a similar time I had a tantrum and said to the rheumy 'well if there's no inflammation then you must be wrong about me having RA cos I'm in bloody agony!' The steroid injection did help - but if it doesn't for you - please let them know and they might give you a short course of oral seroids. I also agree that you should take the painkillers - maybe discuss with your GP taking a step up from paracetamol to something a bit stronger for a while. Hope you manage to rest and relax this weekend. Take care.

Julie

Hi Paula

Sorry, bit late catching up on this thread.

In my experience - which I must admit is limited to myself and members of the forum - it seems that the way RA affects people differs from person to person. Most of my pain is in my hands and wrists and is permanent and has been from the start. And I've never had swelling in them either. Some days are worse than others, but the pain is always there, as it is in my shoulder and upper arm now, as well as my feet and ankles. So yes, I feel the pain in my muscles as well as my joints.

When I first saw my rheumy my right knee was really bad and I had a steroid injection which really eased the pain a lot, and for four or five years it didn't trouble me at all.

I hope the improvement continues and that you continue to not pitch in with the decorating!

Anthea x

Hello Paula,
Hope u enjoying your curry and red wine and feeling a little brighter,
it does sound like you've had a flare up, i can empathise with your descriptions and also feeling weary and a bit low are other tell tale signs of a flare - i think so anyway & can empathise with these too xxx
Like others have said we all experience slightly different "flares" but like Melly described really well we can each have different level of flares at times too.
No wonder we get bewildered by it all.
Keep resting - i would! ...and DONT feel guilty - think of yourself as operation co-ordinator! xxx
& best leave the GMTV dancing for now i used to think Mr Motivator was energetic ~ but that lot tire me out just watching!
Take care and lots of love ~ Liz xx

Hi Paula

Sorry to hear you're going through a bad patch at the moment, it does sound like a flare. They can be very different at different times, someitmes very painful, sometimes less so. I don't think you're a moaning minnie, you have to let it out to somebody, and we know where you're coming from.

While I have improved a great deal whilst on enbrel, I still have lots of pain in my feet and hips. According to the consultant and physios, it's not caused by the RA, but it seems very strange to me, my toes are bending over, and the whole of my pelvic area is painful. They don't know all the answers, and as you say, you know your body and probably have a good idea of what's going on.

I hope the steroid injection finally works for you, it can take time, so make sure to rest, and NO DECORATING!!

Lyn