Hi--I have only posted here a few times; but I read often & have gained comfort and good info. here. I have been Dx with RA for 31/2 years. One of my first symptoms was shoulder joint pain--it would come & go; be quite limiting-then just aching. I recently had an MRI which showed tendonitis and " impingement". Went to an orhopaedic surgeon who did a subacromial Kenalog injection. The pain was at first the same, but the past few days has been worse than before the injection! I do not think it is an infection; but am not 100% positive. Anyone else have more pain after an injection? Thanks, Lou
If you are going to have regular injections you might consider looking at buying a JointHeat heating device.
you can see them here,
One of my first signs of RA was bursitis of both shoulders. The shots helped to ease the pain, but most of the pain and loss of range-of-motion was helped by physical therapy. The exercises seem kind of limited and almost silly, but they really work. I continue to exercise my shoulders to keep the bursitis away. Its my understanding that the injections are primarily used to help ease the inflammation so you can go to PT and get better.
lou, it depends on what is happening within the joint. They tried both injections and PT which did not work. In fact, I feel like in this case the PT worsened the condition.
I would go to a second surgeon or at least back to this one and tell them that it didn't help. Mine consisted of a bone spur, a bone cyst, tendonitis and shoulder impingement to the point at times I cannot use my left arm.
The first surgeon said he couldn't do surgery. The next two said that they could. So, if this one doesn't have a solution go on to the next. Try to find one that has done hundreds of shoulder surgeries.
I get my surgery March 22nd and am very excited about it. I think there is a solution for you.
What about epidermal (sp) shots in the cervical spine? They should do a MRI of that area first if they haven't already. Crunchy had that done. My Rheumy didn't think I should have as much pain as I do. Then I told you about the differences in opinion with the Orthos. Since you are a PT, you know all the other options.
The deciding factor is what you feel is best for you. Shoulder impingement is very limiting and I would think it would make your job excruiating at times. I can't imagine how you manage to stretch someone out with a bad shoulder. If cortisone and PT are not getting the job done and you are getting worse, then something else needs to be tried. I do have the tendons in my neck, shoulder and upper arm all swell. The more activity, the more solid and painful the arm and then my hand becomes, almost seeming paralysed. Even doing dishes or laundry are too difficult.
Ask your patients that come in for shoulder therapy what their experience has been. And ask about how they feel about their doctors. It might help give you a broader perspective.
Deanna---I had to stop working as a P.T. 1 year ago. It became literally impossible to work with the children I had been treating in school districts. I worked alone--one on one aides won't do lifting or assist with exercise programs. The neck and shoulder pain became severe. I really hated to stop working; but i guess 31 years as a P.T. was it. Since I first wrote the left shoulder pain has decreased--actually I think it is a little better than pre-injection. My cervical spine will eventually require surgery I'm quite sure; but the thought of it scares the hell out of me. For now, if I'm "careful"--no heavy lifting or quick neck movements--it's not really bad. Laparoscopic shoulder surgery for your conditions usually has a very good outcome. I wish this for you next month. If you don't mind my asking--what drugs are you on & what have thay recommended about stopping prior to surgery? Lou
Lou, I'm on a lot of medications. But this terrible Rheumy took me off the MTX and I had to quit Enbrel before that. So for RA, I am only on pred, mobic and plaquenil with vicodin or morphine for pain. The rest of my meds are to deal with all the side effects.
So far, they have not given me my preop instructions, but I do believe they insist you go off the MTX and the biologics as well as things like tylenol.
Did they do a cervical MRI yet? That is very, very important with RA as RA can cause sudden death if it really affects the cervical spine. I have OA in the cervical and it hurts. But they might not have to do surgery. That is the last resort they use with the cervical. Sometimes they can do the injections, exercises as you know, and a cervical collar to stablize it. I certainly would push for answers on that one. But you are more likely to have the OA like me and that's not serious just really painful. Check it out so that you know for sure. You still may be able to work that out.
lou m. I wanted to mention that a small amount of people, I happen to be one of them, after having cortisone injected their bodies crystalize the cortisone for 2 to 3 days. This crystalizing is more painful than the original problem then it does begin to actually help. I learned this the hard way with my first and last cortisone injection. So far I have turned down any further cortisone not wanting the agony. The agony was a felling like I was actually on fire though I have never been on fire that is what I think it would feel like. It is called a Cortisone Flare. As Deanna said it can also cause tendonitis to worsen and did in my case so I had to have surgery. Just something else to think about.
Take care.
Bonnie---Thanks for the info.---I do believe that's what it was. It is now feeling better than before the injection; we'll see how sleeping on that side goes tonite. it's really too bad there is no predicting reactions beforehand, eh? Tomorrow i'm about to try enbrel for the second time--first time 2 years ago i got ear infections one month after starting it. My dr. at that time said no more biologics ever--new Dr. thinks this was an extreme response and i never got a chance to see if it would help. Sounded right when we talked; but now that i have it , it's scarey. Always some new decision to make---maybe( hopefully this time) I'll get something right. LouI have had many cortisone inj in serveral different joints. Only one left me worse off - my 1st one into a knee. It was quite a long while before I consented to a knee injlou m. I am taking my first ever Enbrel injection Wednesday. I am sure that I will post as soon as I do it so you all can join me in saying yeah!
Lou, Enbrel will probably be a cinch. It can make you more susceptible to infections, true. But likely you had an ear infection already and didn't know it.
Good luck to both you and Bonny.
My past experience of cortisone injections revealed the following impact:
1. the cortisone injections caused weakness, feverish and numbness in the injected surrounding area;
2. when the medicine became ineffective it caused more pain - i.e. the body had weaken in condition and thus immuned to the drug;
3. the body would continue to weaken whereby disease would then increase its aggressiveness and advancement.
No need drugs and injections but right herbs and natural foods can solved the problem. Knowing the solution is so simple.
When drugs could not work, some opt for surgery!
Instead of reversing the severity, many are advancing and the condition get worse and worse.
Nursing back to better health need right herbs & natural foods, time, determination, lifestyle change, awareness etc. It is a reality.
Finally, only by systematic building up healthy body then one can "negotiate" the toxic causing cells in the body and repel the disease gradually.