I am 45 and was looking having the BHR this past August but decided to wait until early summer of next year as my pain was tolerable and timing with my family (I coach basketball, it is my son's senior year etc) schedule made it difficult to do it now. I am wondering about steroid injections or cortisone shots as a pre BHR measure to help reduce the constant low grade pain and discomfort. Can anyone give me feedback on their experience and how effective the injections were especially as it relates to pain reduction and ability to be more active? My doctor has said that it works in about 90% of patients. I have also heard some fairly negative things about injections i.e. may increase likelihood of cancer, short lived, may advance the deterioration of the joint. Thanks for your help.
When I was doing competitive sport more than twenty years ago, it was well known then that cortisone injections could only have short term benefits and potentially serious long term problems. I do not know why they are still an option. If you are a sports coach, don't you know this?
If you have physical deterioration of your cartilage or bone, injecting anything will not fix it, especially steroids that weaken the bone, that should need to be strong to be resurfaced.
Don;t do it. Please read my post Hip Resurfacing Vs Hip Arthroscopy. I have been unable to walk and in unbearable pain after my cortisone shot. I missed the Ironman World Championship because of the shot and can't work. It is going on five weeks.
It's not worth it in my opinion. Don't take the risk. I have never felt pain like this before. Plus the medications they give you are toxic and addictive. Ask any questions you like. Yes, the shots were given by a radiologist under x-ray.
I have talked to many hip specialists who feel that cortisone injections into the hip will rapidly increase the deterioration, more than in any other joint.
Mine didn't help at all. Just made my hip sore for a fews days. :(
Thanks for the feedback. I was hoping there had been some medical advancements in the use of injections but it doesn't seem that way. Again thanks for the feedback and I will persevere until my surgery in the spring/early summer.
Hi mwelliott,
I had the same experience. They gave me the injection under a radiograph (to insure perfect placement) and it is quite uncomfortable. I did not get a minute of relief from my hip pain. I have been told by horse vets (this is used on horses a lot, too) that is does deteriorate the joint more rapidly in the long run.
I will never do a cortisione injection again, in any joint in my body. Lu
Elliot, I just found out that the shot gave me a bacterial infection.they now want to do a hip aspiration to determine the type of bacteria and surgery to clear it up. I am at a lost for words. I poster earlier and got this bad news today. They tell me I will be on IV for six weeks to clear bacteria. I am confused and do not know what to do about HR, Artroscope, surgery,, etc.
They are trying to rush me because of the infection. What's funny is that in my previous 5 post cortisone appts to discuss my negative reaction, not one doc said anything of this possibility. All was said was that it was a Flare and it would go away.
I walked out the hospital today because it is all coming at me too fast. I need to speak to some docs. All of this would have been avoided if I did not get the Cortisone shot. think hard and ask tons of questions about nerve damage, infection, tissue degeneration. All are real and I am proof
Thanks again for the concern and advice. Ed@ydrf, I wish you well and hope you heal quickly. Take care.
Hey Ed,
You definitely do need to rush with taking care of the infection. I was also on IV antibiotics for 6 weeks. You can get through this. I pm'd you as well. Call me.
best,
spencer
Coach,
Dont waste your time or $$$. Find a good doctor in your area, get his/her opinion, and decide what is best for you. I have had both of my hips resurfaced, and find myself asking, "why did I wait so long ?"
Hi
I understand that using steroid injections does speed up the wear process of cartilage in the joint..
But I have had several over the past 6 years or so. I had on in my right shoulder clavicle (this was preventing me from sleeping the pain was so bad) about 6 years ago, the relief came after a couple of days and shoulder is still ok. I have had both knees done as the pain when walking got quite bad, again after a couple of days knees felt much better and finally I had left hip done approx 10 months before it was replaced (4 injections placed with Xray). This removed pain and gave me almost full range of movement for approx 6 months so was worth it (for me). I was only allowed 1 injection in each joint, but would have gladly had more because of the relief offered. I am now 48 years old, and cycling, and swimming regularly without problems...... Everyone is different and it worked for me. If your surgeon thinks its worth a try then why not!
I has an arthroscope done last week. It showed no signs of infection although my levels were high. It seems that the Cortisone was the culprit. I am trying to get copies of my xrays so I can show the rapid deterioration in my hip joint within the three weeks of the shot.
Doc wants to wait six weeks to see how I recover and determine if we go to surgery. I am bone on bone now and just want to get it done. I will meet with him on Monday and push for surgery. The pain is about an 8 every time I stand on my right leg. Can't walk with crutches.
Had cortisone injection in August before major car trip. Got relief from tightness and other issues within 3 days and unfortunately it only lasted about 2 months. Doc told me average was about 3 months. Worked for me although I see from posts not for everyone.
Quote I like best on cortisone shot for someone needing resurface or THR is "like putting a band aid on a gunshot wound"
I'm 45 and had a left BHR two weeks ago. I myself put it off for a long time and got two cortisone shots which did absolutely nothing. The first one helped for about three weeks and the second caused more pain. Right now I'm on the road to recovery. You know, when you think about getting the resurfacing, is there really a perfect time to get it done? There was always something going on so I figured I would just get it over with as soon as possible and now I'm glad I did.
Best of luck to you in the spring!
Johnny G
I have a question. When I had a steroid shot for my herniated disk there was something about people with diabetes needing special care and for some it's not an option. Does the steroid shot mess with sugar levels?
Since my back doctor - herniated disk - wants to try another shot to coast me along until my gait improves enough to see if my back problem will disappear (fingers crossed) I asked about the effects on sugar levels. Yes it does raise them, temporarily on those without diabetes, a big problem for those who do have diabetes. I hate doing another shot but at almost 3 months out from my new hip, it's my back that is making me walk like and old woman and I don't want that to cause bad wear on the hip.
I don't know anything about the steroid injections, but I can relate to the back problems related to the hips. I am having my first hip surgery in mid-January, the second on the 1st of March. I am confident that in the end I will be rid of my hip pain, but also very much hope that it will help with the lower back pain. Lately it has gotten out of control, and I'm sure a lot of it is because of stiffening and compensating for my sore hip joints. I am just really eager to see how much better it's going to get after the hip surgeries. Hopefully, a lot!!!
I had a generally positive experience with steroid injections. I had them done at California Pacific Medical Center. The first one didn't help much, but I asked my doc if I could try a second one -- and that one really has helped. Before, my back had begun to seize up because the constant bad limp was throwing it out of kilter. The second shot reduced the pain so much that the limp was much less, if at all. It also has enabled me to get a bit more exercise, including using gym machines on leg/hip muscles, which I'm sure will help me recover from my surgery scheduled 12/13. I got the shot a month ago, and only now can I begin to feel it starting to wear off.
If anyone is doing this in the SF area, I *highly* recommend Dr. Mall or Maars, something like that, in the Cal Pacific Med radiology dept. His approach was very different than with my first shot -- much less painful as well as much more effective. He has done thousands of these injections.
I had one steroid injection in the left hip and it was amazing. All the pain went away for awhile (couple months), just starting to come back a little. I agree that you probably don't want to do it too much. I heard that you could degenrate the joint so badly that RS wouldn't work. Then I heard from another surgeon that doesn't think cortizone does long term damage. Who knows. I guess I would think a couple injections wouldn't be all that bad. However, you probably aren't gaining much time anyway, so why do it? just go straight to the RS.
Bumping this old topic as seems to be the most comprehensive one dealing with Cortisone / steroid shots.
Would appreciate any updated thoughts on the subject as my surgeon is suggesting shots could be a "good" option yet the feedback I have read so far is less encouraging. Guess the 4 potential outcomes are;
- it gives relief for a while so does a job
- it makes zero difference
- it makes things worse to the extent that you go from holding off on surgery to having to get on with BHR
- it makes things worse and necrosis takes BHR off the table
Thoughts?
Interesting HippyD - My personal experience is a choice between 1 & 3 - My Cortisone/Steroids shot in August/12 made me feel great for about 5 weeks. I went to the gym and no pain whatsoever during ellipticals, walking or weight routines
September the pain in the right hip came back. In November/December it was substantially worse making me think the reflections of previous posters is more correct towards your answer #3
I am now booked for BHR right side in late March/13 after reading here about why I should not postpone any further, and get on with it.
The opinion that I heard from a few of the top surgeons involved with arthroscopy and other types of hip repair not involving replacement, is that cortisone may make it feel better of a short time, but it will severely damage the joint, likely shortening the time to a replacement. Some said that though they could not explain why, it did seem to them that the negative effect of cortisone was substantially worse on hips than on other joints.
I had a cortisone injection into my severly arthritic left hip using floroscopy to be sure it was injected correctly. My surgeon said it was normal procedure as a last resort to relieve pain in the hip. It really seemed to help for a few weeks with the pain and some of the stiffness. But, in hindsight, temporarily restoring some range of motion and temporary relief of the socket pain just allowed me to grind it up even more without knowing it. Once it wore off in a few weeks I was worse off and my xrays showed it.
I had cortisone injections in my hips for two years before my surgeries. I've also had them in my back. For me they worked at removing inflammation and therefore removing pain. My first injection in my right hip got me about nine months, the next six, next time was in both sides and didn't even get me a week. Then I knew it Wes time for surgery
I had 3 cortisone injections and 1 shot of Euflexxa at $1k out of pocket. Each gave minimal relief and for a shorter duration each time I had them. Kind of a false hope if you ask me. I suppose the docs have to follow the standard protocol with degenerative arthritis so everyone gets a slice of the pie along the way. No one really wants to have a major surgery like the BHR or THR, so as a patient any glimmer of hope thrown at you is grabbed before the inevitable.
I think most of us say after the fact that if we knew the outcome would be what we now have, a rebirth of activity without pain, we would have opted for the surgery sooner.
With that being said, I am sure some whose OA is not too far advanced enjoy an extended period of pain relief from various injections. So I think the answer is yes to all 4 of your potential outcomes.
Relating to Davids last post, a few months ago I had an injection in my other not-yet-operated hip of Durolane, which is very similar to the Euflexxa that David mentioned. It was pretty sore for the first couple of weeks, but so far I have had a good three months of 70% relief, and would do it again at this point. I do not believe that this type of injection runs the same long term risks as cortisone.
Yes John, Durolane and Euflexxa are similiar hyaluronic acid based injections.
Yes totally different methods of action than cortisone.
Glad it is helping you on your other hip.
I'd continue to put it off as well getting 70% relief for 3 months.
Is that covered by insurance for a hip injection?
Got two shots spaced about two and four months before I did Kona. The local anesthetic was more help than the shots. A rebuilt hip was my answer.
Jon
I had very short term relief from bilateral injections, but that short term relief was pretty welcome. The inflamation and spasms created by it were so bad that I was ready to try anything. At the time, THR was recommended and I was just starting to research resurfacing. I was very happy and amazed for about 3 weeks and then gimped up again.
I am one of those would had great luck with injections - both steroid and viscosupplementation (Eufflexa, Synvisc, etc). I am young (37) and now have 2 HRs but I really had to try and stretch my hips as long as they would go because I just could not justify going into this surgery at such a young age without trying a lot of other things. I have had as much as 8 months relief from one injection - when I had both the Synvisc One and cortisone I got even longer relief. I almost was not sure whether to have surgery last year because I was still having relief from the injections and wasn't in much pain when I actually had the surgery (but I had been in plenty of pain previously and wasn't very eager for that to come back).
I do think cortisone can degrade a joint but honestly I think it takes repeated injections in excess of 2-3 per year for a few years to do that. I had 3 or 4 over a span of like 3 years and I was fine. Others may have had a different experience.
Amy
I had two shots. The first shot was great, and allowed me to complete a half marathon 2 months later. I got a second shot 6 months after the first one and it did nothing.
There is concern for permanent damage if you get a lot of these shots, but doctors assured me that 2 cortisone shots would not be a problem.
Thanks guys and all feedback much appreciated as we are capturing a real cross-section of responses here which should hopefully become a good thread to benefit knowledge of others in the future. Still not sure what I am going to do but continuing to take lots of supplements such as Hyaluronic acid, Glucosamine, Chondroitin to take any help I can get
If you are bone on bone It probably will give you little relief. It lasted 2 months for me.
Ross