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Author Topic: Risk of cortisone injections?  (Read 138 times)

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Offline react2resist

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Risk of cortisone injections?
« on: January 04, 2022, 08:08:47 PM »
Hello

Iíve posted here before. 30 year old with chronic pfps, no obvious mechanical cause, 2 MRiís show nothing but a tiny tiny amount of cartilage wear, blood tests show no rheumatoid indicators . Much like user suspectdevice/ Richard Bedard etc.

Iíve made marginal progress but was wondering if cortisone may help.

Iím trying to slowly widen my envelope of function. @suspectdevice took Celebrex but when I tried that my blood pressure went through the roof.

Dr Dye has given his patients Kenalog injections (cortisone) to allow pain free movement in the initials stages. But when I look online I see a lot of horror stories about cortisone. Anyone got any thoughts on one injection?

Iíve already had 2 hyaluronic acid injections. First injection killed the pain for 2 months. Second for 2 weeks. 

Offline vickster

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Re: Risk of cortisone injections?
« Reply #1 on: January 04, 2022, 08:58:11 PM »
Cortisone can damage healthy chondrocytes so should be used with caution if the cartilage is healthy. Kenalog is also pretty potent as steroids go so certainly discuss in depth with your knee specialist (mine doesnít really give steroid any more in non arthritic knees, an msk rheumatologist may be more willing).

Have you considered PRP (although youíll have to pay for it in the U.K. privately. Health insurance might cover it although a company may equally say itís experimental and not fund). Guessing is £500+
Iím not sure any one has had much success with it and PFS.

Youíve presumably tried the almost total rest modality?
« Last Edit: January 04, 2022, 09:03:34 PM by vickster »
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffaís fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline Petal

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Re: Risk of cortisone injections?
« Reply #2 on: January 04, 2022, 09:39:08 PM »
I've had 4 steroid injections into my knee.  First one was super and lasted a couple of months, others variable results- I suspect it depends in part on whether it is in exactly the right spot which is a hard judgement call.   I too was warned they can damage cartilage but mine was already ruined/mostly missing so didn't matter.
If you do have it I would not have more then one if your knee is otherwise in good shape

Offline react2resist

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Re: Risk of cortisone injections?
« Reply #3 on: January 04, 2022, 10:09:51 PM »
Cortisone can damage healthy chondrocytes so should be used with caution if the cartilage is healthy. Kenalog is also pretty potent as steroids go so certainly discuss in depth with your knee specialist (mine doesnít really give steroid any more in non arthritic knees, an msk rheumatologist may be more willing).

Have you considered PRP (although youíll have to pay for it in the U.K. privately. Health insurance might cover it although a company may equally say itís experimental and not fund). Guessing is £500+
Iím not sure any one has had much success with it and PFS.

Youíve presumably tried the almost total rest modality?

What do you mean by total rest modality? You mean a huge reduction in movement?


Offline vickster

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Re: Risk of cortisone injections?
« Reply #4 on: January 04, 2022, 10:25:16 PM »
Yes, isnít the first step to get everything settled by doing nothing that aggravates the knee before slowly increasing to find envelope of function?
Not something Iíve had to deal with, my knee is worse if I donít move as much as possible!
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffaís fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline react2resist

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Re: Risk of cortisone injections?
« Reply #5 on: January 04, 2022, 10:26:38 PM »
Yes, isnít the first step to get everything settled by doing nothing that aggravates the knee before slowly increasing to find envelope of function?

Sure thing. I just canít remember a time where my knee wasnít aggravated so itís tough to get to the place

Offline vickster

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Re: Risk of cortisone injections?
« Reply #6 on: January 04, 2022, 10:27:46 PM »
Have you seen a physio who understands PFS and has experience of managing?
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffaís fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline react2resist

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Re: Risk of cortisone injections?
« Reply #7 on: January 04, 2022, 10:30:25 PM »
Have you seen a physio who understands PFS and has experience of managing?

I saw Claire Robertson. She came at it more from the angle of treating chronic pain with TENS/chilli cream etc. it did work for a while but recently the pain has come right back.

Offline vickster

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Re: Risk of cortisone injections?
« Reply #8 on: January 04, 2022, 10:32:14 PM »
Ah cool, perhaps get back in touch with her? Did she identify the cause of the issue?
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffaís fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline react2resist

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Re: Risk of cortisone injections?
« Reply #9 on: January 04, 2022, 10:35:49 PM »
Ah cool, perhaps get back in touch with her? Did she identify the cause of the issue?

Not definitively. Same as most:

MRI looks fine
Visual inspection of knees fine
Blood tests good
No audible popping/ creaking etc

The TENS machine did well but then I developed a rash which got infected (lucky me).

Interestingly the pain really crept back up when I got COVID in early DecemberÖ not saying itís a direct cause but could be a factor

Offline vickster

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Re: Risk of cortisone injections?
« Reply #10 on: January 04, 2022, 10:40:11 PM »
Certainly could have. Hopefully itíll start to improve now the Covid has been and gone (hopefully).
Have you tried exercising in water, definitely works for me
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffaís fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline react2resist

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Re: Risk of cortisone injections?
« Reply #11 on: January 04, 2022, 10:44:56 PM »
Certainly could have. Hopefully itíll start to improve now the Covid has been and gone (hopefully).
Have you tried exercising in water, definitely works for me

I havenít really tried water. Not to easy to access. But will work out how I can give it a go. I wish I could find something to knock the pain out for a bit so I could at least walk without pain.

I guess this evening itís just feeling hopeless, whereas back in November I thought I was making real progress

Offline vickster

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Re: Risk of cortisone injections?
« Reply #12 on: January 04, 2022, 10:50:36 PM »
No swimming pool (maybe at a gym as they tend to be smaller and shallower) if you canít access a proper hydrotherapy pool?
Try the TENS and cream again? Ice? Get a cryocuff?
Does a topical anti inflammatory help (or a different type,of tablet like naproxen maybe with a stomach protector)? Or good old paracetamol?
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffaís fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline react2resist

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Re: Risk of cortisone injections?
« Reply #13 on: January 04, 2022, 10:55:31 PM »
No swimming pool (maybe at a gym as they tend to be smaller and shallower) if you canít access a proper hydrotherapy pool?
Try the TENS and cream again? Ice? Get a cryocuff?
Does a topical anti inflammatory help (or a different type,of tablet like naproxen maybe with a stomach protector)? Or good old paracetamol?

Iím sure I can find a pool. Hopefully covid doesnít cause more restrictions.

Voltarol doesnít seem to do much anymore
Currently got diclofenac with stomach protectors















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