Anyone else get general improvement after a cortisone joint injection?

Posted Sun 12 Jun 2022 19.14 by Hooverfish
Psoriatic arthritis but no psoriasis. Have had it for probably 25 years, diagnosed last year. On the "drugs might work" trek.

Hello. I've found one other thread here that describes two people who experienced a good general effect on their PsA symptoms after a joint steroid injection. I'm 61 and received an injection in my knee 2 days ago (I have general peripheral joint problems diagnosed as PsA, but the knee pain/swelling is mainly wear-and-tear wrecked, from a fall 13 yrs ago that took away my ACL ligament). I am feeling great! Not only is the knee behaving but all my other joints as well, except for the dactylitis tenderness I have in two toes. Tiredness and confusion reduced, can skip up the stairs for the first time in ages, and much less discomfort being woken up by PsA pains at night. Much more energy and optimism, but I think that's just what happens when you get a belt of cortisone... NSAIDs (difene) work for me too, but obviously you have to try to keep the dosages to a minimum. I had looked up the research, and it says if you are going to get a good effect from a steroid injection, it will happen within 48 hours (mine improved about 6 hours after the injection). Then it's just a question of how long it lasts... You have a 41% chance approx of the improvement lasting for more than 3 months. You have a higher chance of being one of the 25% of people for whom the improvement is very temporary if you have a particular gene for Macrophage migration Inhibitory Factor (MIF), rs755622. Unfortunately although I've had my DNA done in the past, I'm not seeing anything in my results for that gene using Promethease. The orthopaedic surgeon who did the injection said if the improvement does last three months, it can be repeated around every 4-5 months but I see from the research papers unfortunately this comes with an associated risk of soft tissue damage. I don't mind, if it puts off a knee replacement for a while AND improves the PsA, then I'll be delighted. Just wondered about the experiences of others with PsA who have had steroid injections? I'll be well p'd off if it only lasts a week or two! The surgeon said if it doesn't last a couple of months, it's not worth doing it again. Thanks for any info. Fingers crossed this lasts!

Posted Sun 12 Jun 2022 21.08 by toothlady66

Hi Hooverfish Ive had injections in a finger and it worked really well and its been over a year. 3 weeks ago I had one in a toe with dactylitis .less than 12 hours later the pain had gone. But I do take methotrexate.In my experience they have been really helpful. Fingers crossed it will last for you. regards

Posted Mon 4 Jul 2022 18.39 by Pippin1996

Hi, Really glad to here of your improvements, I too had the injection into my left hand index finger as it was so badly swollen at the joint, I really couldn't bend my finger, and that's not good as I climb ladders for work. The injection itself I must admit painful and it was carried out on a live x-ray but it was so so worth it; I felt an improvement after a couple of days and the swelling gradually disappeared over the next month to a point where a could fully bent and use my finger. Its to my relief that I am now at 5 years since the injection and although a very slight swelling has returned its not painful not hinders my daily life. Good luck in the future.

Posted Mon 4 Jul 2022 18.47 by Hooverfish (edited Mon 4 Jul 2022 18.47 by Hooverfish)
Psoriatic arthritis but no psoriasis. Have had it for probably 25 years, diagnosed last year. On the "drugs might work" trek.

Thanks both for your replies. The cortisone effect lasted about 2 weeks for me only, sadly. But it makes me more determined to try and get on biologics, or if not, then methotrexate though, to be honest every single person I've ever met who's been on methotrexate hated it. I find that 1-2 days of NSAIDs has a good effect that also lasts about two weeks but as my GP says I'm only allowed to take them every 2 months or so, that's not doing the trick either.

Posted Mon 4 Jul 2022 19.48 by toothlady66

I’ve been on 20 mg of methotrexate for over 2 years and I find it works well and I have no side effects. This and the occasional steroid shot seems to keep me normal ish .

Posted Wed 6 Jul 2022 01.45 by praashu

Hi Toothlady66! Have you run some liver and kidney tests to check side effects of Methotrexate as you have been taking it longer. I have been suggested to grt these tests done as I have been on Methotrexate 7.5 mg for 6 months.

Posted Wed 6 Jul 2022 06.38 by toothlady66

Hi Yes I had monthly blood checks for the first 18 months and now I have them every 2 months and so far all is clear

Posted Sat 16 Jul 2022 10.03 by Reuben82

Hi I had cortisone injections twice in my shoulder it was very painful for the first 3 days but after that it helped with the pain for a few weeks. Unfortunately it did not last long.

Posted Mon 8 Aug 2022 17.30 by Joanmp73

Hi all , I’ve been getting steroid injections for the last two years I find they really do help with pain in my shoulder, I was given a nerve blocker injection in my shoulder it helped with the pain and to my amazement it cleared my psoriasis, I went back to dermatologist told them about this but unfortunately they dismissed it, Has anyone else had this ?

Posted Mon 8 Aug 2022 18.32 by Hooverfish
Psoriatic arthritis but no psoriasis. Have had it for probably 25 years, diagnosed last year. On the "drugs might work" trek.

Hi Joanmp73, do you know the exact drug that was used on your shoulder when the psoriasis cleared up? It probably was something with anti-inflammatory effects. In which case I'm surprised the dermatologist wasn't interested but maybe they got confused and thought you were saying a painkiller (unlikely) rather than a steroid (likely) helped the psoriasis? I went back to the GP and have now been told that I can take difene (diclofenac) 75 mg once to twice a week, and that is working brilliantly for the joint pain problems although not for my swollen-toe-with-dactylitis, but I find that easier to ignore, as it's just one particular sharp stinging pain that you can just instruct your brain to think of as a "wrong signal", rather than the overall stiffness and pain which I find debilitating and am very glad to be out of for a while. So I'll take that as a win, but who knows how long it will continue to work for...?

Posted Mon 8 Aug 2022 19.13 by Joanmp73 (edited Mon 8 Aug 2022 19.15 by Joanmp73)

Hi , thank you for your reply, My dermatologist definitely did not get me wrong, I’ve been getting steroid injections for years, it wasn’t until I saw the orthopaedic Doctor I was given a nerve blocker that cleared my psoriasis I contacted orthopaedic doctor he was the one who told me to mention it to dermatologist but unfortunately he said I’ve never heard of it and dismissed it , sorry I don’t know the name of the drug but I will definitely find out

Posted Mon 8 Aug 2022 19.36 by Hooverfish
Psoriatic arthritis but no psoriasis. Have had it for probably 25 years, diagnosed last year. On the "drugs might work" trek.

There is an injectable form of difene which is used for orthopaedic painkilling and yes, it's a non-steroidal anti inflammatory drug so yes, find out the name of the drug!

Posted Mon 8 Aug 2022 20.02 by Joanmp73

I will find out the name when I next go to my appointment

Posted Sat 24 Dec 2022 19.35 by Hooverfish
Psoriatic arthritis but no psoriasis. Have had it for probably 25 years, diagnosed last year. On the "drugs might work" trek.

Just thought I'd update this. I am still finding the only thing that does me any good for the stiffness and pain, which I find the worst thing about PsA, is difene (diclofenac). But I've been back to a different rheumatologist this time, who confirmed the PsA diagnosis although he said it could possibly be bad osteoarthritis or mixed. He's put me on methotrexate 20 mg a week, prednisolone 10 mg for a month then tapering, and stomach protection with omeprazole plus folic acid. I'm allowed to keep going on the difene for the moment, and the chemist says I can throw down a few paracetamol if needed too. The good news is that I've done an entire week without feeling sick so far... and yes I do know I have to wait 3 months for it to work. The rheumatologist said generally if methotrexate's going to make you sick, it happens in the first 2-3 weeks. But he also said in his experience it only works for about 20% of PsA patients. I'm not enjoying feeling generally apathetic and depressed and confused, which I think is partly the PsA and partly the drugs. But I am managing to get physio exercises done, and back walking and cycling thanks to the steroids. Planning to get up on my horse, which has been having a winter break because of all that frost, next week too. Getting X-rays next week for sharp groin hip pain and for my knee too. Fingers crossed! Keep moving, you'll only feel worse if you don't. In my case, because I've had Guillain-Barre syndrom in the past, there's not much chance they will chance any TNF inhibitors, and biologicals are expensive and hard to get approved here, so I hope I'm the 1 in 5 the methotrexate does the trick for. Good luck all.

Posted Wed 11 Jan 2023 05.24 by JDarling

OMIGOSH! My psoriasis went away ONE HUNDRED PERCENT due to the one cortisone injection I got this NYE for tennis elbow. Everywhere on my body! I asked my physician about it and he said that’s prednisone and they wouldn’t let us use that. WTF. I get pneumonia multiple times a year and prednisone is the only thing that makes me feel better., and now I find out it eradicated my psoriasis but they can’t give it to me?! I haven’t had baby smooth skin like this since I was 10!! I have to figure out how to do this. I got so sick I’m humira that I had pneumonia for SIX MONTHS. :(

Posted Wed 11 Jan 2023 07.49 by Hooverfish
Psoriatic arthritis but no psoriasis. Have had it for probably 25 years, diagnosed last year. On the "drugs might work" trek.

JDarling do you also have psoriatic arthritis? If so you need to go back to a rheumatologist, and talk to them about the new biologicals, as it sounds like you don't have a good response to humira (too many side effects) and you should be changed to another type of drug. If you have psoriasis only, sorry as I'm one of the 15% of people with no strong evidence of any psoriasis, I have never looked it up properly so can't advise... Obviously, take your doctor's advice, and not the Internet's, anyway. I'm still doing good on the drugs after 3 weeks - just get a bit dizzy and confused the day after mtx plus insomnia the night after the weekly dose. The reason they gave me prednisolone is temporary too - as your doctor said you can't take it for long - to try to give me symptomatic relief until the mtx starts working. I definitely think it has helped with the fatigue/apathy, so a good drug to give you a kick to sort out all the other bits of your life that PsA diminishes. I am definitely slowly improving at the moment, but who knows if that will continue when the prednisolone dose gets reduced next week? My finger joints have gone down, my hip flexors are less stiff, I can do all those basic tasks like getting out of bed for a pee at night without having to steel myself for pain, which is nice! But I have also determinedly been doing physio and a lot more exercise. I am using the arthritispower app for self-management, and trying to be good, and journal all my food too with MyFitnessPal app to be sure I have a small calorie deficit each day as I need to lose 17 lbs. If you read it up, weight loss is incredibly important although difficult, as it makes the drugs more likely to work and reduces pain and enables exercise. I am personally interested in whether they all have it wrong and the reason most of us are overweight or obese is caused BY the disease which doesn't mean you shouldn't still try to lose weight however hard as it's a "symptom" to be tackled. There is a whole area of immunology connected to glycolysis (Prof Luke O'Neill is a good place to start) that suggests this might be the case.

To take part, sign in or register with us