cortisone for tendonitis?

Subject: cortisone for tendonitis?
From: MAG (inactive)
Date: 31 Aug 99 - 11:05 AM

An old shoulder injry has knocked me out, again; who has tried cortisone? Does th effect last for months, as the doctors claim? Does the need become a habit?

I seem to have escaped the family curse of bipolarity, am still leery of cortisone, a la Patti Duke; is anyone familiar with that side of the issue?

TIA, MAG

Subject: RE: cortisone for tendonitis?
From: Dave Swan
Date: 31 Aug 99 - 11:33 AM

MAG, I'm no physician, but personal experience with knees full of cortisone says avoid it. The procedure itself isn't entirely benign, the joint can become stiffer and more painful immediatley following the injection, and there can be injury to the lining of the joint. Cortisone may allow inflammation to calm down for a while, but may not address the root cause of the problem. There are alternative injectables which may produce fewer side effects than cortisone, you should ask about them. There may also be oral anti-inflammatories which could work for you. How many opinions have you gotten from orthopods who are well experienced at treating shoulders? It's always a good idea to ask how many times your physician has performed a particular procedure (experience counts) and what success has been acheived. Opinion only, but the older I get, the less I'm interested in letting someone rummage around in my joints. D

Subject: RE: cortisone for tendonitis?
From: Ferrara
Date: 31 Aug 99 - 11:49 AM

MAG, Prednisone (a form of cortisone) is pretty much a necessity after a heart transplant, so I have taken a bunch of it, and they now have me on about the minimal dose they ever use because I have had so many unpleasant side effects. Among other things, it threw me into such a severe manic state that I totally lost touch with reality for weeks, until they could find an antidote. The result was that I had to take *two* highly toxic meds, because the antidote is almost as bad.

I know a man who had two broken vertebrae in the first year after his transplant. My doctor's father-in-law dislocated his shoulder playing tennis because cortisone had weakened his tendons and colloidal tissue so much.

Be conservative. Be very conservative. Explore any and all alternatives. When they had to cut my cortisone dose, they had to put me on a horribly expensive ($1800.00 a month) medicine instead, but the doctor said I should be pleased because "cortisone is nasty stuff. We use it because it's effective, inexpensive and we can titrate the dosage easily; but it causes a lot of problems."

Is this enough horror stories? I don't mean to frighten you, just to urge you to explore alternatives. I don't actually think a single dose of injected cortisone would be likely to trigger bipolar disease, but it can cause some pretty weird mental effects as well as the physical stuff.

If you'd like more info you can e-mail me at

[e-mail]

- Rita Ferrara

Subject: RE: cortisone for tendonitis?
From: katlaughing
Date: 31 Aug 99 - 12:19 PM

I had one cortisone injection in my shoulder last year and while it did help, if I don't keep up my exercises or stay at the computer or whatever too long, in the same position, it really becomes painful. I don't think one would hurt too much, except for the actual pain when they inject, but I wouldn't want to have it done, again. I just got a new program Dragon Speaking Naturally which allows me to dictate my writing to the computer and that helps, since I don't have to use my shoulders, etc. to WP all of the time.

I have also had to use prednisone a lot in the past two years to overcome allergic reactions to various heart medications. I am happy to say I am off of all those, but in desperation with shoulder pain last weekend, took some prednisone and am now having to step it down in increments and BOY do I regret ever getting back on it! Not only can it cause an initial state of euphoria, then manic depression like Ferrara noted, it can also cause a bunch of other problems. If you go off of it too soon all of your symtoms can come back with a vengeance. I am really PO'd at myself for taking it, again. I would not recommend it to anyone. I also have a friend who has MS and has been on it frequently who says the same thing, even though she has to use it at times.

There is a fairly good, informative book on it, Coping With Prednisone and other cortisone-related medicine: It may work miracles, but how do you handle the side-effects? by Eugenia Zuckerman, a world-renowned flutist and her doctor sister, Julie Ingelfinger, at Mass. General.

Also, another benign thing which helps me, as well as the exercises, is arnica gel. Rub it on and it really, really helps. Tiger balm works well, too.

I have also taken a lot of oral muscle relaxants which, for a short time, can help your muscles to relax and get used to being back the way they should be, but there are tons of side effects with them, too and I've not taken any for several years now and am better off for it. I've found a good massage therapist, Reiki healer or Rolfing therapist can be much more effective with no horrible side effects.

Good luck! Hope all of this helps!

kat

Subject: RE: cortisone for tendonitis?
From: Jeri
Date: 31 Aug 99 - 12:31 PM

I had injections (one time in two locations) for a shoulder problem once. The shots weren't anywhere near as painful as I thought they'd be, and they relieved nearly all of the pain.

There is some evidence that cortisone can cause cartilage, bone and ligament and tendon deterioration. I assume this wouldn't happen with one treatment, but I don't know for sure.

Some Info

Some more info at Arthritis Foundation of New Zealand

Some scary information here

Advice: You have to make your own decisions based on all the info you can get. Be skeptical.

Subject: RE: cortisone for tendonitis?
From: Mike Billo
Date: 31 Aug 99 - 12:49 PM

I had a long and painful 3 year battle with tendonitis. The cortisone shots contain a local anesthetic that creates the illusion of relief.

After 3 years of doctors prescribing pain killers and cortisone shots (with no results, and surgery on the horizon), I was advised to seek out an occupational therapist, who cured me COMPLETELY through deep massage, ice therapy, and tendon strengthening exercises.

Find an occupational therapist in your area.

Wish you best of luck

Subject: RE: cortisone for tendonitis?
From: Melodeon
Date: 31 Aug 99 - 02:48 PM

MAG, I was treated with cortisone and or anti infamatory drugs for several years for so called tendonitis in my shoulder until in desperation and I think to shut me up because I am a Registered Nurse my Gp sent me for physiotherapy. Guess what it wasn't my shoulder at all, it was my cervical spine causing all the trouble. I would advise you get the opinion of a Physiotherapist before embarking on potentially damaging treatment.

Melodeon

Subject: RE: cortisone for tendonitis?
From: Chet W.
Date: 31 Aug 99 - 04:01 PM

Mag, Be extremely cautious about this. My experience included 2 injections into the spinal fluid (epidural) for a back injury, and whether due to an allergy or other meds I was taking or whatever, I had a VERY bad experience, including extended dissociative episodes if you know what I mean. Find out if there's any way to tell in advance, maybe with a small dose, to see if you're going to have this problem, especially with regard to the family problem you mentioned, or if you are taking any medications remotely in that category.

Very seriously, Chet

Subject: RE: cortisone for tendinitis?
From: Joe Offer
Date: 31 Aug 99 - 04:28 PM

Hmmmm. The fact that a thread like this can garner 9 messages in five hours is an indication of the average age of Mudcatters - seems most of us are well into the age of aches and pains, but not quite at death's door. I think this calls for a chorus of MY GET UP AND GO HAS GOT UP AND WENT. Any other good aches-and-pains songs?
-Joe Offer, who can't be improved with cortisone-

Subject: RE: cortisone for tendonitis?
From: Lady McMoo
Date: 31 Aug 99 - 04:30 PM

I suffered a bout of tendonitis last year sparked off by playing over-energetic rhythm guitar at large number of 3-4 hour gigs and, being wary of cortisone treatment for the reasons outlined by others above, tried a course of acupressure massage which, with some changes in playing style, helped greatly.

mcmoo

Subject: RE: cortisone for tendonitis?
From: katlaughing
Date: 31 Aug 99 - 05:03 PM

No ageisms, please, dear Joe! I'm not out of my center-aged forties, yet, but today I feel like a hundred! I need all the pepper-uppers I can get today.

Besides, in my case, I don't think it is age related near as much procrastination/laziness related.....I left off fun exercise in my early 30's and am just now coming back to them. That and I know a lot more NOW about ergonomics etc. than ever before!

Please don't seel me the common line about being over the hill and it just getting worse! I refuse to believe the rest has to feel like this!**BG**

Off the soapbox, now,

kat

Subject: RE: cortisone for tendonitis?
From: DonMeixner
Date: 31 Aug 99 - 09:43 PM

MAG,

I skipped all the other posts and went right to this spot. Cortizone can help some people but not all people. Every bodys tolerance is different and some people get several shots through their lifetime while others need only one. A disturbing number of people have their tendon and tendon sheath disolve and blowout and become not only useless but a surgical nightmare.

The therapists I worked with to restore the use of my hands and fingers after reconnective surgery strongly advised no cortizone or derivitives in my case. Deep massage, heat and ice, and a regimen suggested by a good PT will be better than any injection. Save the cortizone till the last resort.

Don

Subject: RE: cortisone for tendonitis?
From: Bugsy
Date: 31 Aug 99 - 10:46 PM

I had recurring Ulcerated Asophigitus(?) for several years and used to go into hospital every 3 months for an Endoscopy and dilation. About 3-4 years ago they dilated and gave me a cortisone injection. I've had no problems since. There is a cream that you can use that has a very small amount of Cortisone in it but I can't put my hands on it to let you know the name. I will try to find it for you later.

Bugsy

Subject: RE: cortisone for tendonitis?
From: paddymac
Date: 01 Sep 99 - 12:30 AM

You might try an otc called "Aleve". It is an NSAID (sodium naproxen?) that I find very helpful for arthritis. It's been around a long time and finally became availabe OTC a few of years ago. I normally take two tabs in the morning and two in the evening, unless I plan on having a pint or two of the black stuff, which I find works just as well and is a heck of a lot more enjoyable.

Subject: RE: cortisone for tendonitis?
From: Ferrara
Date: 01 Sep 99 - 12:53 AM

Joe, I think the fact that this thread got 9 responses in 5 hours just proves that people who've had bad experiences with cortisone have sometimes had --*very bad*-- experiences with cortisone and want to spread the word. Believe me, the word "cortisone" really got my attention.

Anyway, I had my first round of cortisone (about 5 months of it for rheumatic fever) when I was 16 years old. So what's that about age again?

I think there's been a lot of excellent advice in this thread.

- Rita Ferrara

Subject: RE: cortisone for tendonitis?
From:
Date: 01 Sep 99 - 02:25 AM

I had two instances in which a doctor told me that cortosteriods would be the only treatment that would work for me. One was a recurrent shoulder pain and the other was sciatica. In both cases I found that acupuncture brought the pain down to a point where I could not only function normally; but so that I could forget that I had any trouble. This was with no side effects. In the case of the shoulder, an ultra-sound scan showed muscle degeneration. This was not reversed by the acupuncture treatment; but further damage was halted. I am not a physician, alopathic, traditional Chinese, or otherwise, so take this as relating my personal experiences rather than as advice.

Murray

Subject: RE: cortisone for tendonitis?
From: alison
Date: 01 Sep 99 - 02:51 AM

hi,

Here's my piece of advice as a midwife and natural therapist (qualified massage therapist, reflexologist, and iridologist). Leave the cortisone until it is a last resort.... give massage, acupressure, accupuncture, reflexolgy, kinesiology etc a go first. Or go to a good sports injury specialist. Get a lot of opinions. (doctors are often busy and like things that fix problems quickly... other therapists can take more time)

slainte

alison

Subject: RE: cortisone for tendonitis?
From: annamill
Date: 01 Sep 99 - 01:54 PM

I'd like to offer my little bit of experience with tendonitis if I could. Last year I developed very bad tennis elbow (even tho I don't play tennis) and my doctor gave me small exersises with soup cans. For the weight. About that time I started going to a gym and doing weight exersising. In less that two weeks I started feeling better, and in two months the pain was totally gone and now I'm good as new...well, not new..as good as I was before the tendonitis ;-)

Hope this helps.

Love, annap

Subject: RE: cortisone for tendonitis?
From: DougR
Date: 01 Sep 99 - 02:18 PM

My wife was on prednisone for several years. Three 5mg tablets a day. Her skin became as thin as tissue paper. Her hands, arms and legs were terribly bruised. It is powerful stuff and unless it is the Court of last Resort, I'd stay away from it as far as I could. I must say it did do a lot to relieve pain, but the side affects were not pretty.

DougR

Subject: RE: cortisone for tendonitis?
From: katlaughing
Date: 01 Sep 99 - 02:43 PM

Boy, you are right on that, DougR. As I said I took some over this last weekend, started at 60mg, then stepped down to get to just 5mg, yesterday. One of the side effects can be congestive heart failure in persons predisposed. Well, by yesterday, I was having a hard time breathing with any kind of exercise, couldn't lie down without feeling like I couldn't breath. In short, I had all of the symptoms, on top of a leaky heart valve, and that was with my oxygen! That's the first time it has caused such a fast and dramatic change. Don't know why the docs insist on prescribing such things when they know one's medical history. I am happy to say I feel much better today and am over being scared! Sheesh! It's enough to make a person totally renounce Western medicine!

kat

Subject: RE: cortisone for tendonitis?
From: DougR
Date: 01 Sep 99 - 03:23 PM

Katlove:

I am beginning to have STRONG reservations about doctors too!

DougR

Subject: RE: cortisone for tendonitis?
From: MAG (inactive)
Date: 01 Sep 99 - 03:26 PM

Thaniks, all; I saw the orthopod this morning, and went ahead and got the shot. His only concern was that I am diabetic, and told me to keep a close eye on my blood sugar.

Well, when I took my blood sugar it had shot up to 236 (high), so Iwon;t be getting another shot, ever.

The local ansthetic is working, but the cortisone hasn't kicked in yet.

I did have some arnica gel, and yes it does help. I was desperate, as I was pretty well incapacitated; couldn't dress properly, fasten my seat belt, adequately shower, or anything else. I'm on flexoril(muscle relaxer) and darvocet(pain) which enable me to function, tho' it IS hard to type.

Thanks very much to everyone for responding with a range of excellent suggestions.

Subject: RE: cortisone for tendonitis?
From: katlaughing
Date: 01 Sep 99 - 04:16 PM

Glad to hear you are coping, MAG, and also glad the doc warned you about your blood sugar. My is chronically low, if I don't watch the carbs. Two days of this last bout with the pred. I was out running errands and had to stop to eat some cheese and other protein because my blood sugar was so messed up. Pred will also give one the munchies and weight gain.

I hope after all of this the shot kicks in for you. I've been there and I understand the incapacitation, pain, and absolute need for relief. Good luck,

kat

Subject: RE: cortisone for tendonitis?
From: Cara
Date: 01 Sep 99 - 04:54 PM

I had terrible tendonitis in my shoulder as a result of waitressing about 70 hours a week to put myself through college when I was nineteen. The pain was horrible, literally gut-wrenching; I would vomit from it during very bad spells. I put myself on NSAID therapy (Aleve, Motrin or Advil, at the max dosage at first, then morning and evening as mentioned above). Plus I quit that job, and eventually it cleared up. BUT: I subsequently worked in the GI unit at a hospital and the docs there said NSAIDS were terribly destructive to the stomach lining if not used properly (i.e., over-using, not taking with food or milk). They can really screw you up. So if you're prone to stomach irritation or you need to take them for a while, get a prescription for Arthrotec. It has the same effect but w/o the stomach danger.

I still have episodes from time to time, if I'm stressed out or "computing" too much. For short term, the NSAIDS really work wonders. But looking back on how many I took when the pain was really badit's a miracle I still have a stomach at all!

Subject: RE: cortisone for tendonitis?
From: Ferrara
Date: 02 Sep 99 - 02:38 AM

Kat and MAG, thanks for the info about blood sugar. I'll probably be on cortisone (very small dose) for the rest of my life, as well as other immunosuppressants that also mess up your blood sugar. Am now fighting a fierce craving for chocolate and sweets which can do me no good at all. I know the other meds raise blood sugar, but somehow hadn't made the connection between the hunger and weight gain caused by cortisone, and blood sugar ups and downs.

Have been thinking of getting a blood sugar test kit. I'm not technically "diabetic," but my sugar fluctuates a lot. How often should one test one's sugar? My fasting blood sugar went up to 190 and they said get it down or I'd have to take still another medicine. I mostly brought it down with diet and exercise, but it's a time bomb I suspect.

Thanks for all the good stuff in this thread.

Rita Ferrara

Subject: RE: cortisone for tendonitis?
From: Marion
Date: 02 Sep 99 - 05:18 PM

Has anyone tried acupuncture for tendonitis?

I've had pain in my wrists and hands for two months now and rest, ice, and splinting don't seem to be getting me anywhere, so I'm trying to decide what the next step will be. Cortisone is definitely out; I'm thinking acupuncture, conventional physiotherapy, reiki, massage therapy, reflexology, that kind of thing...

It's tricky because they're all so expensive and it feels like I'm deciding which number to gamble on. And once I pick one then I'll have to decide how much time to give it to prove itself before I cut my losses and stop going.

Does anyone have any experience of these "external" therapies for tendonitis? If they were successful for you, I'd like to know how long it took before the success was apparent.

Right now I'm leaning towards acupuncture because the consultation is free and because it would be the coolest thing to tell my friends I'm doing.

Thanks in advance, Marion

Subject: RE: cortisone for tendonitis?
From: Jean
Date: 02 Sep 99 - 05:22 PM

Yes, physiotherapy is good to teach you stretching exercises which will help your tendonitis. You should also try icing it frequently. A 2 lb. bag of frozen peas works really well, but don't use them for dinner after they have thawed out! Just refreeze. They are good because they easily adapt to the shape of your joint.

Also, use anti-inflammatories to reduce inflammation. This includes drugs like ibuprofen, and aspirin. A new one is celebrex which requires a prescription but does not cause stomach upset, or so they say.

Subject: RE: cortisone for tendonitis?
From: katlaughing
Date: 02 Sep 99 - 05:48 PM

Rita, I would urge you to read Dr. Atkin's book, New Diet Revolution. He is a cardiologist who advocates low carbs and high protein with no sugar. He explains, very well, in my opinion, the cycle of what he calls hyperinsulinism, too much insulin and the body's way of not coping through fluctuating blood sugar. Really made a lot of sense for me and I've lost over 40lbs using his methods. Before that I felt like I was starving on low-fat/no-fat and stil not losing!

I crave chocolate a lot, even still (I think it's genetic!). Anyway, he has food bars and shake mixes which are very low in carbs, no refined sugars, and are deliciously chocolate, among other flavours. It seems expensive, but not if one considers what they might be spending on the sweet and salt binges etc. our society is so prone to. He is not the only one to recommend low carbs, just the most successful or ambitious, whichever way you want to look at it. Here is a link to Dr. Atkins.

Also, I would urge you to get and read the book I mentioned before, Coping With Predinisone. It's really the first and, so far, only book I know of written by and for laypersons, although her doctor sister also contributed. There is quite a bit in there about cravings and diet, too.

If it is still only out in hardback, I will send you my copy, for as long as you want to use it. I am NOT planning on taking that drug, again, ever, if I can help it.

Hope this helps. This has been a terrific thread.

Marion, did you read ll of the posts? I think I remember someone saying they'd used accupuncture.

Also, I can't recall if I mentioned this: glucosamine sulfate taken over a long enough period to take effect cna help tremendously with muscles and tendons. Sveral people have told me or said in interviews that they were almost totally incapacitated by arthritic, tendonitis, etc., given up on medicine, until they tried this supplement. Many are now doing very well. I just started back on it and can already tell a difference; I can get up in the morning without feeling like Methusalah!

katlaughing

Subject: RE: cortisone for tendonitis?
From:
Date: 02 Sep 99 - 07:55 PM

First 3 cheers for talking about tendinitis rather than RSI which is a horrible term which describes 2 different problems with diametrically opposite treatments. One is the tendinitis we have all come to know and love which begs for rest and the other is the pain you get in a muscle that gets ignore all week and hammered at a session and begs for exercise lke those muscles that the Good Lord stuck in front of your shins in case you ever felt daft enough to be a drummer! My own experience as a doctor with a melodeon was cured by me having the sense to steer clear of my colleagues and go and see Bob Cann (Lord rest him) who sorted out a few playing techniques and the shoulder soon sorted itself out. Sadly this advice may come too late to some poor souls who may come to need and benefit from steroids the same way the Titanic would have benefitted from a few more lifeboats, but there's no substitute for listening to what your body tells you once or twice in a while just as there's no substitute for missing flaming great icebergs when steering the unsinkable!

Subject: RE: cortisone for tendonitis?
From:
Date: 03 Sep 99 - 07:59 AM

Marian. As I posted, I had acupuncture treatment; but not for tendonitis. My experience and that of others I speak to is that it seems to work after the first treatment, but the effects last for a short time. Perhaps not even to the end of the day. After each treatment the effects last a longer time until they are relatively permanent. When I was treated for sciatica, it almost went away completely after the first treatment, but I began to feel it again on the way home. Now it is six months since I had my final treatment and I only feel the symptoms when I really strain my back or upper legs--and then it goes away after a rest.

Subject: RE: cortisone for tendonitis?
From: Ferrara
Date: 03 Sep 99 - 01:28 PM

Kat, thank you very much for those suggestions. I intend to print out this entire thread. It's amazing! I have my doubts about Atkins' diet for me, because it's so high in sat fat and cholesterol. I have read one of his books, plus a book called "Beyond Pritikin," about using high-fiber foods to stabilize one's glucose and insulin levels.

I'm supposed to restrict fat, salt, carbs and sugar. I restrict 'em, but if I cut them out entirely I'll be reduced to eating grass! - Rita F