# Cortisone Injection - Shoulder



## fossyant (7 Feb 2010)

OK

Anyone had one, and does it hurt ?  My bro-in-law had one recently...pretty painful.

Looks like that's on the cards for me in a week or so - back to the Specialist, but the PI report recommends it also first, see how it goes, and then surgery. As it's been over 12 months since the accident, I can't see it doing much good, but must follow due process..... I hate hospitals.


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## Rohloff_Brompton_Rider (7 Feb 2010)

my doctor said as i walked in. "are you sure you want to do this? it is the most painful thing you can have done whilst awake" he was not wrong. i had an elbow one. it is horrible and made me feel unwell for a week. i'm about 90% back to normal and have some physio on tuesday. be aware tho, it is only a painkiller and inflammation reducer, if you don't build up your strength slowly you can rupture the joint. apparently according to googling most people assume they are back to normal then completely **** themselves up. my doc said that he only did 3 as a max then it's surgery after that, i hope the physio sorts it out.


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## longers (7 Feb 2010)

I had a couple years ago in a shoulder and despite being told it would hurt they didn't really. Your mileage may vary. Maybe they did them wrong?


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## fossyant (7 Feb 2010)

My shoulder is stable, hence not really wanting it messed with. It's the clunking, which is as a result of impinged tendons.... The pain is OK, I can live with that, so I don't really see the need. The surgery could balls it up anyway, so I'm after a few answers. Physio sorted the pain issues, up until July, the last time I went to the hospital I had no pain as was having twice weekly sessions, but stopped after the visit. Pain has come back, but there is only so much money you can keep laying out....


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## Rohloff_Brompton_Rider (7 Feb 2010)

physio should be free on nhs shouldn't it? mine is private and is being paid for by the other party insurers. the acupuncture the physio does works brilliantly. my injection was right into the elbow joint. they have to inject it directly into the inflammation hence the most painful part of the joint ergo massive pain. unless it's different in the shoulder i don't know. as a pain killer it is only temporary 3 months i think the doc said. it's a bit dodgy as well can do damage elsewhere. just do a google. like i said it has helped me but i won't have anymore. if it doesn't reduce my inflammation first time then there is no point of any more.hth


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## fossyant (7 Feb 2010)

Not had physio on the NHS, paid for it, then so far have got half back via the third party's insurers, but they've owed me £1k since last July.....


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## Rohloff_Brompton_Rider (7 Feb 2010)

oh dear? mine was organised by my solicitor and a company called medicare? my first appointment was within a few days and i've had 12 sessions. i got the injection thru nhs as i was not happy about the rate of recovery. i rang my solicitor and he has arranged some more starting tuesday. but the other party have already admitted liability. have yours?


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## ColinJ (7 Feb 2010)

It's funny that this should come up now because I spent much of yesterday checking out a shoulder rehab product that I'm thinking of promoting. I bought it a couple of years ago when I buggered my shoulder up.

The author is a very good American physiotherapist (or physical therapist as they call themselves over there).

He says that injections can vary in effectiveness from very little improvement to being a big help. Sometimes they give you enough relief that you can carry out rehab exercises which would otherwise be too painful. He also says that you should have a maxiumum of 3 because the cortisone can start to degrade the tissues it is injected into.

His view is that surgery should only be considered after severe trauma or once rehab has been given a good length of time to take effect but isn't improving matters and if the current condition of the shoulder isn't acceptable to you. 

Multiple surgeries rapidly reduce in effectiveness because of the build-up of scar tissue so if you are going to have surgery, you really want it to be effective first time.

He also quoted the stats for keyhole surgery and open surgery. The results were very much better for the keyhole surgery but the surgeon has to be much more skilled to perform it properly.

It's well worth a read. There's a 105 minute MP3 file to accompany a powerpoint demonstration which explains the anatomy of the shoulder and what goes wrong it. Actually, having watched/listened to that I'm amazed at how well shoulders normally work and that they don't go wrong more often!

A complete illustrated rehab program is provided, together with some video files showing the exercises being performed.

If you are interested, you can buy it through this web page ->

http://www.rotatorcufftraining.com/

(Don't worry folks - that isn't my affiliate link, it is direct to the author's sales page and I won't make a penny from it. Don't let his sales pitch put you off, he knows his stuff. The cost would be about £26 + VAT)

Oh, and I should add that my brother-in-law has had several cortisone injections in a painful shoulder over the past few years. It gives him temporary relief but then he ends up aggravating the injury again. 

It makes perfect sense to me to give your shoulder the best chance of recovery by doing a graduated programme of rehab exercises. 

And the bad news is that no matter what you have done, your shoulder will probably never be quite as good as it was before the injury. Hopefully it will be good enough. 

In my case, it was so bad that I couldn't even lift my arm over my guitar. 2.5 years later it aches a bit and it isn't as strong as it was, but I can put up with the level of discomfort that I now have.


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## mangaman (7 Feb 2010)

longers said:


> I had a couple years ago in a shoulder and despite being told it would hurt they didn't really. Your mileage may vary. Maybe they did them wrong?



I agree - pretty painless I'd say

The least painful joint to have injected if you had a choice!

(Of course make sure the injector isn't a 1st year medical student)


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## fossyant (7 Feb 2010)

Cheers guys. The shoulder is stable, a little weak, compared to the right


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## ASC1951 (8 Feb 2010)

Years ago I had a cortisone injection into the attachment point of a foot tendon. Excruciatingly painful! Not because I'm a wuss - a couple of years before that I thought for several days that I had sprained my ankle, when I had actually given it a Potts Fracture.

My steroid injection relieved the inflammation but had absolutely no effect on the underlying problem. In the end I went to a physio, who sorted it out permanently in three weeks. I remember being disappointed that neither my GP nor the specialist had any suggestions apart from drugs or surgery; but this was 30 years ago, when they were still Gods in White Coats and many GPs saw sports physiotherapy as only one up from burning chicken feathers.


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## ChrisKH (8 Feb 2010)

I had one years ago. Little or no pain during the procedure and the relief for a month was heavenly.


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## fossyant (8 Feb 2010)

ChrisKH said:


> I had one years ago. Little or no pain during the procedure and the relief for a month was heavenly.



Lots of questions for the Consultant next week....


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## ASC1951 (9 Feb 2010)

Come to think of it, fossyant, I have also had a cortisone injection in the shoulder. I had forgotten about it because I was expecting it to be as painful as the one in my foot, but it didn't hurt at all.


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## fossyant (9 Feb 2010)

ASC1951 said:


> Come to think of it, fossyant, I have also had a cortisone injection in the shoulder. I had forgotten about it because I was expecting it to be as painful as the one in my foot, but it didn't hurt at all.



Phew. Might be good for the Cheshire Cat then.... might just funk my shoulder right up charging up Mow Cop and Wincle thinking now't hurts...


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## postman (10 Feb 2010)

I also was given the cortisone may years ago did not last long .And it took an op to put the prob right .
But i did think they tried everything else first before cutting into me .
Maybe it was a cost thing .Pills pills rest .Then surgery .


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## craigwend (11 Feb 2010)

Year-ish ago - had a cortisone injection done via ultrasound, given a local anesthetic before, no pain at all, even the local was a great relief; however once it began to wear off - even with good physio I ended up having an op - 9 months on shoulder 'perfect' 


https://www.cyclechat.net/


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## mangaman (12 Feb 2010)

postman said:


> I also was given the cortisone may years ago did not last long .And it took an op to put the prob right .
> But i did think they tried everything else first before cutting into me .
> Maybe it was a cost thing .Pills pills rest .Then surgery .



As a doctor, postman, I go by the medical slang expression always try to do as little medicine to your patient as possible.

My avatar shows a tear in the cartilage behind my kneecap - it's now 2 years old. The orthopaedic surgeons were itching to inject it / operate on it. I refused and found building extra quads strength to support the knee/losing weight etc have made the problem almost disappear

Cartilage won't ever heal as it has no blood supply, so I always have a tiny amount of pain, but if you can avoid people sticking things into your body I would (because of the risks of infection etc)

I agree rest /elevation / ice / anti-inflammatories first with physio +/- injection with surgery a last resort.

If I were Mark Cavendish I would have had the op as I would have been on the bike again straight away, but for me the idea of chopping away bits of cartilage (which are nature's shock absorbers)may lead to arthritis in later life and as keyhole joint surgery is fairly new there is no data on arthritis incidence in 30 years time.


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## bauldbairn (12 Feb 2010)

I fractured my Calcaneus(heel) in an industrial accident 22 years ago. I was told if the pain was too much I could go back for a cortisone injection. They said would prefer not to give me it because I was so young - and there could be side effects(damage to tissue I think).
However in Rehab(physio) I met a guy I knew, who had broken both heals and both elbows(falling from a lorry backwards). This guy had it(cortisone) in all four injuries and said if he'd known just how painful it was he would have refused - but he would also have been unable to do his physio. It's swings and roundabouts I suppose.
Personally, I went down the same route as Mangaman - increased my weight-training(I'd already trained prior to the accident) to make sure the joint/heel could take the punishment. The harder I pushed my heel in training the sorer it was in training. But the sorer it was in training the less sore it was in normal activity. It seemed to work - to this day its only a wee bit stiff for 5 mins every morning and never notice it all day.

Good luck Fossyant, whatever you decide to do.


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## ColinJ (12 Feb 2010)

mangaman said:


> As a doctor, postman, I go by the medical slang expression always try to do as little medicine to your patient as possible.


I think that's a really great attitude! 

My problem with many doctors is the God-complex where they think that they know everything, can fix everything, and that we mere mortals should shut up and do as we are told.

It seems that 90% of the health budget is spent on patching people up, whereas I think much more should be spent on keeping people healthy in the first place

I have only been to a doctor about 3 times in 40 years but the last time I went I still managed to fall out with him... 

I was arranging to have a hearing test because I'd noticed that I was not hearing things that other people did. I ended up asking if my perforated ear drum had anything to do with the problem. 

He looked down at my records and said "You haven't had a perforated eardrum!" I told him that I had but I hadn't seen a doctor about it. He got really irritable and told me that I wasn't qualified to self-diagnose. I told him that he was arrogant! 

I explained that I'd been swimming around at the deep end of a swimming pool, trying to pick up a rubber brick. I'd gulped underwater and something went _Bang!_ in my right ear, I felt sick as waxy chlorinated water started coming down the back of my throat. If that wasn't through a perforated eardrum, then what was the _Bang!_ and where did the water come from?

He told me that (a) I'd _imagined_ the water and ( Even if the eardrum _was_ perforated, there was no way for water to get through into the throat.

I looked him in the eye and said - "What about the Eustachian Tube then?"

He went off on one and started ranting about how many years he'd spent at medical school, how many years he'd worked at this hospital, that clinic, how many years a GP and so on and _how dare I_ contradict him!

I just wanted him to talk to me like an intelligent human being not a 3 year old in a nursery.

I'd obviously seek medical care if I'd done serious damage to myself or had a serious illness, but I believe that 99% of the time my body will look after itself. I eat a healthy diet, exercise frequently and my family do not have a history of serious health problems. Most live into their 80s, 90s, or even 100s. So far, this attitude has served me well. 

I'll probably go and catch something really nasty now, and delay seeing a doctor until it is too late! 

Anyway - good luck with your shoulder Fossyant!


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