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Author Topic: Cortisone Is it safe and does it help  (Read 1285 times)

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Offline Radiance

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Cortisone Is it safe and does it help
« on: June 08, 2006, 03:41:32 AM »
Hi every one. Well today I took my 15 year old daughter Brandi to see the orpthopedic surgeon. He looked at her x-rays and ultrasound scan .He didn't tell me anything new about her knees at all. He said that she had osgood slatters disease (which I already knew) and he said that she has patello femoral pain syndrome(I already knew that as well). He has basically said that the left knee with the osgoode slatters disease will always be the same.He also said that the pattelo femoral pain syndrome that she has in both knees , she will eventually out grow. He has suggested that she get cortisone injections in both knees to help with the pain as well as continue with physiotherapy. Also to take advil or motrin. My question is "Is cortisone safe to give to a 15 year old girl? Brandi is terrified of getting this done and I wonder is this the answer or should I seek out a second opinion?

Offline emphatic

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Re: Cortisone Is it safe and does it help
« Reply #1 on: June 08, 2006, 06:18:05 AM »
Cortisone injections are a bit of an information minefield. There is quite a bit of research that several injections damages the connective tissue of the joint in time. While your doctor is only suggesting one injection, they eventually add up. Some doctors believe in giving them as a "jumpstart" toward calming down the inflammation in the area.

Cortisone injected directly into the joint is just a super-duper steroidal anti-inflammatory being dumped exactly where it's needed. Some people get some pain relief, lasting from hours to months, and some get none at all. The first 24-48 hours following the injection can be extremely painful, though.

Going on over-the-counter (OTC) non-steroidal anti-inflammatory drug (abbreviated as NSAID), such as motrin or advil (which are both ibuprofen, I believe), might really help her. There are issues with stomach problems and such, which your doctor should review with you, but many people tolerate them very well when taken with food and if she takes them at the recommended therapeutic doses (not just here and there), she might get a lot of relief. It could be worth a shot.

The advice to continue with PT and try the NSAID is probably what you'll hear over and over. And it's probably the best advice at this point. She needs to strengthen the musculature around the knee as much as possible, while keeping the inflammatory processes as quite as possible. The PT and NSAID would do this. At this point, you might want to pass on the cortisone shot, and see what the OTC NSAIDs do for her.

Good luck!

Meg

Offline Radiance

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Re: Cortisone Is it safe and does it help
« Reply #2 on: June 08, 2006, 12:19:27 PM »
Thanks for the info Meg! i have researched this on the internet and as well has discussed this with my daughter. I think that  we are  going to exactly that.We will continue with the physio as well as the advil. She also has to do the exercises at home.       

Offline blackbeltgirl

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Re: Cortisone Is it safe and does it help
« Reply #3 on: June 08, 2006, 01:06:56 PM »
I had a cortisone shot at 17, and many of my friends had had them at earlier ages.  If, after 2 weeks at anti-inflammatory doses of ibuprofen (which means 600-800mg, not 200-400 like it says on the bottle) your daughter hasn't seen an improvement, I'd say try it.  A good OS will only allow 2-3 max a year, and cortisone shots are not a long term solution.  But for many people, they are also a diagnostic tool.  Once the internal tissue is inflamed, it changes the pain you feel.  reducing that swelling can actually allow the OS to repeat the exam with a better feel for the joint mechanics, not the swollen joint mechanics.  In many cases this allows a physician to improve his diagnosis and treatment plan.  Especially with physical therapy - if you're doing the worng exercises for your problem you can actually make things worse, not better.

I guess, overall, my advice is that 1 cortisone shot is "no big deal".  Not that it's not a real issue, but 1 shot isn't likely to change anyone's life, or ability to heal, etc.  (I'm not a doctor, and I'm sure there's someone here who can/will refute this, but it's still my opinion.)  It may hurt like the dickens getting the shot, as they place the needle where it already hurts (that's what I was most afraid of at 17), but I've had a couple and found they don't hurt too much.  And for me I get about a month's relief, which is appreciated. 

I hope your daughter feels better soon.
Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
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Offline *Tiffany

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Re: Cortisone Is it safe and does it help
« Reply #4 on: June 08, 2006, 01:13:11 PM »
Just my opinion here, as there are many opinions and many variations in the results.  I have had quite a few cortisone injections.  I haven't experienced any muscle or tendon damage (yet?)  There is also the chance that you don't get relief.  Sometimes they work wonderfully and sometimes they don't help much.  It usually takes 24-48 hrs for the relief to begin. 
I go with the jumpstart threory myself.  I get a shot in each knee post-op or before pt regimine begins, and then try to build up the knees and learn to manage the long term pain.  I haven't had shots for  a long time now.  Not sure I want to get dependant on them again to manage pain. 

So, in the long run, it is your call, and what your os is willing to do.  I think they are better than pills, especially narcontics. 

tiffany
Age 8/Bilateral -Lateral Release '85
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