Cortisone Injection Flare

[James112]

Tessa had her first cortisone injection in the medial side of her left knee on Wednesday at the OS office. The doctor told us, it would likely get worse before it got better, he said she might feel bad for about 48 hours post injection. He also told us that for some people the injections work for several weeks and for others, they don't work at all. Ever since then, she has been in absolute agony. After she came home from the OS office, she has kept her leg elevated and has applied ice about 6 times a day.

 Her knee has swelled up to nearly twice the size of her healthy knee. Tessa can barely walk now even with her crutches. She said her pain level is at a 10/10; she has tried Vicodin, Percocet and Tramadol--nothing helps! Tessa said the pain now is worse than it was before the injection. She cries most of the time and has trouble sleeping because of the pain. It's horrible!

She can barely move her leg without feeling a sharp, stabbing pain. She has let me touch her knee a few times yesterday to try to massage it and I could literally feel the fluid in it. I noticed her knee was very warm, like she had a heating pad on it, which it felt that way when she was diagnosed with patellar tendonitis, but we don't know if it's from the tendonitis or the cortisone flare.

We knew a flare could occur and the doctor did tell us it could be bad, but we didn't know it could get this bad. She is in more pain now than she was before. I called the hospital and was told that if she wasn't better by morning to take her to the emergency room after the 48 hour mark.

Has anyone had this type of flare or reaction to a cortisone injection before? Is there anything I could do to help ease Tessa's pain or make her feel a little bit more comfortable? How long can these flares last?

This situation is almost overwhelming. My heart aches for Tessa. No one deserves to go through pain like this. It's like watching my wife be tortured.
 

[kris_83]

Sorry to hear that your wife is flaring after cortisone. I also have this reaction to cortisone and it is extremely painful. I get the swelling and hot feeling as well. Generally I flare for a full week, then my pain level goes back to wherever it was before the injection. (So I have sworn them off!)

I haven't found anything that helps the pain, other than rest. After my last injection, I took a couple of days off from work and tried to rest for a full weekend in addition. Ice causes me more pain in general but that is a solution for some people. Elevation doesn't improve matters significantly, but I am definitely worse off if I don't do it.

I've been told that for some patients, the cortisone "crystallizes" in the joint, and this is what causes the flare. I have no idea if that's true or not, but I know the pain is different than any other knee pain I've experienced- pre surg, post surg or otherwise.

Hang in there... I wish I had better advice but this is just one of those awful things that we knee geeks need to ride out. Good luck to you and Tessa.

[eaglemom]

Oh my I hate she's is in so much pain.  I've had several injections and several have made me swear off ever having anymore.  The worse one I did call the OS office and they said to ice elevate and immediately when the ice bag is off to stand and with crutches go for a short walk.  I laughed but the OS said do it when knee is cold from ice - yes it will hurt like heck but it will move the fluid around.  Short walk, less than 10 minutes and immediately reice. Do this 3 times - ice for 12 minutes, 12 minute walk (no more total, length of walk), ice, walk, ice walk ice.  Then just let the knee be.  This should have moved the fluid around.  For me it wasn't fun but it did get me some relief.  I did that 2 times daily and it helped some.  Hope she's gets relief soon. eagle

[TwoBadKneesUSA]

I have had flares too.  Mine last a week or so.  Now I do not get these shots in the knee.  If nothing works to bring the swelling down, she may need to have the knee drained a bit to get some relief.  I did not get much relief for my week of pain either.  I hope that for all this pain she gets kind of relief out of it.

[James112]

Thank you all for the replies! Tessa's flare lasted a full week. It was the most miserable week ever. She now refuses any more injections. Her pain and swelling have since came back down to the pre injection levels.

Oh my I hate she's is in so much pain.  I've had several injections and several have made me swear off ever having anymore.  The worse one I did call the OS office and they said to ice elevate and immediately when the ice bag is off to stand and with crutches go for a short walk.  I laughed but the OS said do it when knee is cold from ice - yes it will hurt like heck but it will move the fluid around.  Short walk, less than 10 minutes and immediately reice. Do this 3 times - ice for 12 minutes, 12 minute walk (no more total, length of walk), ice, walk, ice walk ice.  Then just let the knee be.  This should have moved the fluid around.  For me it wasn't fun but it did get me some relief.  I did that 2 times daily and it helped some.  Hope she's gets relief soon. eagle

Tessa tried this. She was only able to do it once a day and had to work up to the 10 minute mark, but she said it did shift some of the fluid around. The walking hurt her badly, but she said it felt a little bit better to not have the fluid sitting on one spot all day.

Unfortunately, Tessa did not get any relief from the injections. All it did was cause her even more grief. She went through that torture for nothing!

[irentat]

Never get a cortisone shot again in a joint!   It stops any healing that would take place for a minimum of 3 months.  I have had literally a hundred shots in my joints over the years (not one was a cortisone shot) and never anything this bad but further, every  shot I have ever had went towards healing the joint.  Cortisone cannot and will not heal...period.  It is meant to reduce pain.

My advice is to research on this forum the injections we have been discussing if you want to look towards your Wife recovering.

[dancinonwater]

Never get a cortisone shot again in a joint!   It stops any healing that would take place for a minimum of 3 months.  I have had literally a hundred shots in my joints over the years (not one was a cortisone shot) and never anything this bad but further, every  shot I have ever had went towards healing the joint.  Cortisone cannot and will not heal...period.  It is meant to reduce pain.

My advice is to research on this forum the injections we have been discussing if you want to look towards your Wife recovering.

This information is very incorrect. For many things, cortisone does not only help, but can be a cure! And cortisone has NOTHING to do with reducing pain! It is meant to bring down inflamation that cam be the cause of pain. Please don't listen to this incorrect advice! This may not be helpful to your wife, but it is a cure for some people.

[Siearl]

I am sorry to hear of your reaction and i can sympathise with you, I had a cortisone injection at the beginning of Janurary and like Tessa i had exactly the same reaction, my knee swelled up to a massive balloon the pain was unbearable and i was not mobile one bit, it ended up 4 days later phoning the hospital and like yourselfs they were not very helpful, just saying it may have got infection and to see my GP which like most an emergancy appointment is anything from 2-10 days time away.

In the end I just increased the pain relief i was taking ( i know probably not the best idea without advice) and gritted my teeth and about 10 days later it had settled down, as you can imagine its not something i am going to go through again.

[60schld]

I have been taking cortisone injections for a while to delay TKR.  Usually, they are a little sore for a few days and then wonderful for months. 

This time, it was wonderful for 4 days and more painful and swollen for 5 weeks!!

Don't know what happened.  I took prescription Ibuprofen for 21/2 weeks, and now, finally, it has calmed down.  I won't be taking anymore of those, that's for sure!

[tiredmom]

So I'm experiencing this cortisone flare also - had injection yesterday. 

QUESTION:  My OS said if this injection doesn't work, we could try a cortisone patch.  Anyone has experience with this??

[helenhelen]

i am scheduled for a cortisone injection in a few weeks, as a precursor (one week before) a durolane injection. my doc says that results with the durolane tend to be better with a cortisone injection first. last time, i got a durolane injection, i opted not to get the cortisone and my knees swelled up and reacted very badly.. i could not walk the next day, and it took a month for my knees to fully heal. i am going o try the durolane one more time, and trying it with the cortisone this time.

i am just wondering if a reaction is common with a cortisone shot? i have my appointments scheduled a week apart and am wondering if i should schedule the rest of the day, plus the day after, off work or work from home? last time, i went in to work right after and my knees got progressively worse throughout the day. the next day, i couldn't walk at all and had to take a sick day.

just trying to prepare for what is to come and notify my boss in advance this time...

thanks for any info!

[60schld]

Hi helenhelen~

I don't think there's any way of predicting the reaction to cortisone shots.  The first few times it went well.  I some discomfort the first few days, then it was great for months.
But the las time was a disaster as you can read from my previous post. 

Good luck!