Can I get a cortisone shot in affected arm?

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BayouBabe
BayouBabe Member Posts: 2,221
edited December 2016 in Lymphedema

I have developed de Quervain's in my left wrist.  The issue is not resolving and is actually getting more painful.  Can I get a cortisone shot?  Would this be asking for trouble?  Are there alternatives?  I am so tired of the pain and am looking for some relief before damage is done to my wrist, thumb, and arm.  Ideas anyone?  What has worked for you?  My doctor thinks this is what I need, but is unsure with the LE.  

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Comments

  • Binney4
    Binney4 Member Posts: 8,609
    edited January 2014

    BB, the pain itself is a problem for your LE, because pain draws extra lymph fluid to the area. If you've tried other alternatives (PT, simple support with a brace) and still have no relief, then it's reasonable to consider the cortisone shot. You might want to review the guidelines for surgery and other procedures on an arm with LE. They're here:

    http://www.stepup-speakout.org/Emergencies_and_Med...

    There are other women here who have done this, and I hope they'll be along soon to share their experiences. Be well!
    Binney

  • BayouBabe
    BayouBabe Member Posts: 2,221
    edited January 2014

    Thank you Binney for the link.  PT and the brace have almost irritated the issue and made the pain more intense.  My doc and I decided that we are now going to try a custom made brace, rather than the off the shelf one.  We will give it a few more weeks trial.  If no change, then it looks like the shot.  Ugh.  I just want some relief without all the LE drama.  Sigh.  Hope someone comes along who has had surgery and or a cortisone shot and have had positive results!  Anyone?

  • lekker
    lekker Member Posts: 594
    edited January 2014

    Hi BayouBabe,

    I don't have LE but I did have a cortisone shot in my right shoulder last September (had BMX Oct 2012 and right SNB Aug 2012). Conservative treatment wasn't helping and I couldn't raise my arm at all if my elbow was bent. The shot worked wonders but the pain started up again last month and now is much worse than before. No sign of LE so far. I don't know if this helps but you weren't getting a lot of responses so I thought I'd chime in. 

  • kriserts
    kriserts Member Posts: 224
    edited January 2014

    I've had two cortizone shots in my left arm after developing lymphedema. One in my shoulder, for helping with a frozen shoulder, and another in my wrist, for rheumatoid arthritis. I did not have any complications.

  • MagicalMoon
    MagicalMoon Member Posts: 12
    edited February 2014

    Hello ladies,

    I have a similar dilemma about whether to have a steroid injection or not.

    Since breast surgery and radiotherapy at the end of last year, I have got Shoulder Impingement Syndrome and Rotator Cuff Tendonitis.  I cannot take anti-inflammatories or strong painkillers to help relieve the painful symptoms.  My arm movement is restricted due to the pain and stiffness.

    My GP has recommended a steroid injection in my shoulder joint but I am very frightened of getting Lymphoedema.  I know I would find it very difficult to 'live with' Lymphoedema if I was unlucky to get it.

    I had two sentinel lymph nodes removed (both clear) and a lumpectomy.

    I am feeling very stressed at the moment because the constant pain in my shoulder joint and top of my arm is getting me down.  I am having to dress a different way because I cannot move my left arm up my back to fasten my bra or place my arm in a certain position.

    Normally, I would not have hesitated to have a steroid injection, but now my lymphatic drainage system has been compromised from breast surgery, I am scared to have an injection in my shoulder joint because I do not want to develop Lymphoedema.  However, I am also very concerned that my shoulder joint pain and movement will get much worse if I do nothing.

    Thanks to the ladies who have posted helpful information.

    Peace and Positivity,

  • carol57
    carol57 Member Posts: 3,567
    edited February 2014

    MagicalMoon, keep in mind that pain draws lymph to the area in distress, and the added lymph could conceivably push your lymphatic system to overload, especially if it's continuous pain.  I think you're weighing two unequal LE risks--risk from a one-time injection, and risk from the stress signal sent by continuous pain.  Do you have the opportunity to discuss your needs and options with a qualified lymphedema therapist?  I hope you can talk this through with someone knowledgeable.

    So sorry it's come to this kind of worry.

    Hugs coming your way...

    Carol

  • MagicalMoon
    MagicalMoon Member Posts: 12
    edited February 2014

    Hello Carol,

    Thank you very much for replying. I was really impressed by your knowledge when I read your helpful posts about Lymphoedema therefore it is lovely that you have responded.

    I am so frightened about getting Lymphoedema.  I didn't even know what it was until I went to a Lymphoedema class after my breast surgery.  In fact, I never gave a thought to my Lymphatic System and how it operated.

    What a steep learning curve I have been on since my cancer diagnosis!!!

    Thank you for telling me about the stress signal sent out when in continuous pain.  I didn't know this or the fact that this can also impact on the lymphatic system.  Something else I have learnt today.

    Since my first post, I have spoken to my GP and a physio at the hospital today.  I have an appointment to see both of them this Thursday to discuss my shoulder joint impingement/rotator cuff tendinitis and my concerns about Lymphoedema.

    From my discussion with them today, the medical consensus seems to be that a one-off steroid injection into soft tissue within a confined space inside the shoulder joint is less likely to compromise the lymphatic system than injections into the vein, mosquito bites etc. The latter are more risky because the extra fluid or potential disease circulates around the body in the blood stream.

    I am beginning to get my head around risks versus benefits of a steroid injection and the fact that the extra fluid will be contained inside my shoulder joint.

    The hospital was unable to put me in touch with a Lymphoedema specialist.  Maybe this is because I do not actually have Lymphoedema.  I will follow this up again when I see the physiotherapist on Thursday.

    Carol, now you have also made me aware of the stress signal and lymph implications, it has helped me to realise that a one-off injection is likely to be the best option.

    I think if I do not have an injection, my symptoms and constant pain are likely to get worse and my arm movement will not improve.

    Hopefully, when I have seen my GP and the physiotherapist on Thursday, I will be able to make an informed decision about a steroid injection and get my fear of Lymphoedema into perspective.

    Thanks again.

    Peace and Positivity,

    M

  • crystalphm
    crystalphm Member Posts: 1,138
    edited February 2014

    I have the same diagnosis and was fortunate to find a physical therapist who had his LE training and he was a golf specialist, so he really knows shoulders. All of my pain issues were resolved in 20 or so sessions. I have to keep doing the exercises of course, but for now, I am putting off surgery. I have a touch of swelling in my arm, so I am thinking for me, surgery would just bring on LE full speed. But I don't know.

    It sure is a wicked pain...

  • carol57
    carol57 Member Posts: 3,567
    edited February 2014

    MM, whatever I know about LE came from my own quest to understand this condition that is so poorly explained to us, despite how common it is after BC treatments. I learned so much, just when I needed the information, from other forum members such as Binney, Kira, LindaLou and others. It seems we help each other the most by pooling our information, and I'm glad to contribute when I can. I'm glad you'll be seeing the physio, and I hope you'll be candid with him or her in asking about experience with LE. 

    Here in the US some of our LE community have had unfortunate experiences with PTs who have no LE training. For example, using therabands (resistance elastic bands) is standard therapy for lots of injuries, but they're generally not a good idea for LE patients (or those at risk, many believe) because it's not possible to measure the amount of resistance and increase it slowly in small increments. A PT who is also trained in LE would find other ways to add resistance, such as low-weight dumbbells or weight machines set to very low resistance. Or at least work with the patient to be incredibly aware of the need to add resistance very cautiously and slowly.

    Good luck on Thursday and let us know how the meeting goes. 

    Carol

  • MagicalMoon
    MagicalMoon Member Posts: 12
    edited February 2014

    Well I have done it.

    After much pain, worrying about having a steroid injection in my shoulder joint (BC side) and the possibility of developing Lymphoedema, my GP gave me the injection Thursday.

    He was very understanding about my fears of getting Lymphoedema. He reassured me that the injection went into soft tissue within a space in the shoulder joint and therefore didn't present the same risks as having systemic injections into the blood stream which could lead to Lymphoedema.

    My shoulder and arm ached after the injection but today I have been in less pain so hopefully the inflammation is starting to reduce.  Fingers crossed.

    The Physiotherapist's views on the injection and LE were the same as my GP's. She said my risks of developing LE were lower than those of a lady who had had a full auxiliary clearance. To be honest, my GP gave me more confidence than the Physio who had to ring a colleague for LE advice to pass on to me.

    I was given 7 different shoulder/arm exercises to do four times a day until my appointment next week. None of the exercises use a resistance band.

    My breast surgeon and GP said I have got Shoulder Impingement Syndrome whereas the Physio said it is a frozen shoulder. I wish they all thought the same. Personally, from my research on the Internet, I think I have the symptoms of Shoulder Impingement.

    I promised myself that if I went ahead with the injection, I would try my very best to get my fear and anxiety about developing LE into perspective.

    So I am going to make sure I practice Mindfulness to stop any LE thoughts/worries from escalating to a frightening level.

    Notwithstanding this, I am always going to ask LE questions whenever the medical profession recommend treatment to my left arm (BC side).

    Peace and Positivity,

    M :)

  • carol57
    carol57 Member Posts: 3,567
    edited February 2014

    MM, that's a great and reassuring report!  Please let us know how you feel in the week to come, when hopefully you'll get increasing benefits from the intervention and from the exercises you're doing.  You did all that you could to seek care while minimizing LE risks.  That's a major accomplishment.

  • MagicalMoon
    MagicalMoon Member Posts: 12
    edited February 2014

    Thanks for your kind words Carol and for your informative comments in enabling me to make a decision.

    Have a good day.

    Peace and Positivity,

    M :)

  • crystalphm
    crystalphm Member Posts: 1,138
    edited February 2014

    Magical, Keep us posted. That pain is so wicked I do understand getting the shot. This last time around (it has flared twice now since the mastectomy) I took Celebrex for 10 days and began physical therapy on the 8th day...I have relief for now.


  • BayouBabe
    BayouBabe Member Posts: 2,221
    edited February 2014

    Definitely check in Magical and let us know how you are doing.  I am in OT right now, getting a custom splint made today.  Doc says if no improvement by end of month, shot is the next step.  Ugh.  So sick of cancer/AI drama.  I was so healthy and mobile before all this.

  • MagicalMoon
    MagicalMoon Member Posts: 12
    edited February 2014

    Hello Crystalphm,

    I agree the pain is terrible.  I have always thought I had a high threshold of pain having had to deal with severe headaches and migraines most of my life.  However, this shoulder joint pain has really got to me but maybe it is because my body is still recovering from my recent operation and radiotherapy.

    I can't take oral anti-inflammatories or high strength codeine so my options are limited to relieving severe pain.

    Pleased to hear you have got some relief now.

    I've been able to do some of the physio exercises since the injection.  Rolling my shoulder, pendulum swings forwards/backwards, left/right and drawing an imaginary circle are all OK.  But I cannot do the overhead arm raise or put my arm up my back.  These exercises cause excruciating pain so I have decided not to do them until I see the physio again this Friday.

    Rang my GP to check that I was right to avoid the very painful exercises and he agreed.  

    Wishing you a good recovery.

    Peace and Positivity,

    M :)

  • MagicalMoon
    MagicalMoon Member Posts: 12
    edited February 2014

    Hello BayouBabe,

    I hope your custom splint works to relieve your symptoms so you do not need an injection.

    However, if you do need a steroid injection it was painless when given.  I was just very stressed because of my fear of getting Lymphoedema.  As I have said in a previous post, my GP was very understanding about my fears of LE.

    He normally gives the dose in two injections into the shoulder joint from different points.  However, he gave me the full steroid dose in one injection to minimise any risks as much as possible and also reduce my stress.

    Can fully understand how you feel about being sick of cancer/all drama.  I'm fed up too at the moment.

    I was so looking forward to getting my life back to normal after the BC roller-coaster ride but I have learnt that it is not quite that simplistic.  It is the knock-on effects and risks you suddenly become vulnerable to like LE, painful joints (Tamoxifen.....Grrrrrrrr!!!)

    I have no family or close friends to support me and therefore it is imperative that I am able to function and look after myself.  I HATE feeling vulnerable.

    To my dismay, I feel like I have aged 20 years since taking Tamoxifen and I only started taking it 3 months ago.

    Rant over!!!  I need to do some 'Mindfulness' while pouring myself another large glass of wine.

    Good luck with your recovery.

    Peace and Positivity,

    M :)

  • MagicalMoon
    MagicalMoon Member Posts: 12
    edited February 2014

    Hello from UK,

    Two and half weeks since I had my steroid injection for shoulder impingement pain.  Thought I would post an update about my progress.

    After much anxiety about having the injection (due to my fear of developing LE), I am now glad I went ahead.  The injection really helped to relieve a lot of the pain and inflammation to enable me to start doing physiotherapy exercises.  I have had two appointments so far with the Physio at the hospital and continue with the exercises at home.

    At the first appointment, I was shown a number of shoulder/arm exercises and particularly liked using a shoulder rope pulley so I purchased one at the hospital shop to use at home.

    At second appointment, my Physio was pleased with the increase in movement I had achieved in the space of two weeks especially the 'arm up my back' exercise.  Still some way to go before I will be able to fasten my bra behind my back again but I am happy that I am beginning to see improvements in my arm movement.

    Peace and Positivity,

    M xxx

  • crystalphm
    crystalphm Member Posts: 1,138
    edited February 2014

    Thanks for reporting in and letting us know how this is going. Good to know the injection is a possibility!

    Take care!


  • MagicalMoon
    MagicalMoon Member Posts: 12
    edited February 2014

    Thanks Crystalphm.

    The steroid injection was certainly a turning point for relieving the constant pain which drained my energy and got me down.

    Feeling much more positive now.

  • Sharon1942
    Sharon1942 Member Posts: 272
    edited April 2014

    I have also just developed de Quervain's tenosynovitis in both wrists!  I'm wondering if it is from taking Arimidex for 2 years & if it will go away!  Ugh!

  • doxie
    doxie Member Posts: 1,455
    edited April 2014

    Yesterday I got a cortisone shot in the base of my thumb.  I have severe trigger thumb on my BC side, probably from AI meds for two years and/or taxol.  Was also having pain in my other thumb.  I waited five months to see if it would go away.  Not.

    I have very mild LE and it was surfacing in my thumb and broader area even though it had never been below my elbow.  I was also in a lot of pain and had lost most of the function in the thumb.  So I took a chance on infection and expanding LE and had the shot.  Wow!  Instant relief with the injected pain medication and today pain is so much better.  Still triggering though.  Amazing how willing we are to tolerate severe pain in this journey.   

  • crystalphm
    crystalphm Member Posts: 1,138
    edited April 2014

    Doxie, Keep us posted....I am so glad you are getting relief. You are right, I tolerate so much pain so I don't trigger LE...or have to have another test.

  • doxie
    doxie Member Posts: 1,455
    edited April 2014

    It's now been two weeks since getting a cortisone shot  for trigger thumb on my LE side.  I no longer have pain, which had gotten pretty much unbearable.  There is still a little triggering, but the swelling is almost totally gone.

    The best is that the shot didn't result in an infection or LE elsewhere.  

  • BayouBabe
    BayouBabe Member Posts: 2,221
    edited April 2014

    just wanted to check in and let everyone know of a new option my PT is exploring with me.  It is an "IontoPatch".  It is like a large battery bandaid.  Water goes on one side, cortisone meds go on other, patch is placed on spot for about six hours, and the electrical charge from the battery forces the med under the skin without an injection.  Feels a bit tingly while wearing, like your arm is going asleep or small little prickles, not painful.  It takes several applications, but I am seeing some improvement, and no additional LE risk from an injection.  Worth checking out!  Time will tell if this is the magic bullet for me; fingers are crossed; so tired of painful use of my left hand.

  • Tomboy
    Tomboy Member Posts: 3,945
    edited April 2014

    wow, bayou! that sounds so cool! i want one! i did finally have a cortisone shot into the base of my thimb several mos back, and so far so good. it was LE side too, so i was frightened of worsening LE, but it was fine! he told me i could have two more shots, but i dont think so! it hurt very bad, even with that freezing spray, thats just topical, isnt it? that shot hurt  like the muffer! me, at least. i only got le in my hand, when i would over do, and before i got proper sleeves and gloves. now almost never, but i am so glad my thumb is better. but i am developing probs with my shoulder now, ca side.... sigh..

  • PITA2015
    PITA2015 Member Posts: 6
    edited January 2016

    Hi MM. I have a similar dilemma about whether to have a steroid injection or not. I am about to lose my mind! I had a double mastectomy in May 2015 and have had terrible pain in my arm/shoulder for 7 months! I have been doing PT for 3 months and not helping. I just had an EMG yesterday and no nerve damage, thank goodness. Dr thinks all my pain is stemming from my shoulder. I had MRI and diagnosis was tendinitis, capsulitis & bracitis in shoulder. Dr wants to do cortisone shot in shoulder but nervous about getting Lymphedema. However, can't live with this pain anymore! How are you doing since the cortisone shot? Hope u are doing well:) 


  • Moderators
    Moderators Member Posts: 25,912
    edited January 2016

    Dear PITA2015, Welcome to the community. We are sorry to hear about your shoulder pain and so glad that your reached out here. We notice that this particular thread has been inactive since April of 2014. You could consider sending the member a Private Message to learn more or you can also start a new topic that might gain some response and renew the activity on this subject. Let us know if you need help. The Mods

  • PITA2015
    PITA2015 Member Posts: 6
    edited January 2016

    Thank you. How do I start a new topic?

  • Moderators
    Moderators Member Posts: 25,912
    edited January 2016

    Dear PITA2015, Go to the Lymphedema Forum if that is the topic that interests you. At the top of the page you will see a red button that says Start a New Topic. You might want to browse the forums and find what fits for you. Perhaps you can raise a question in the new topic. The Mods

  • crystalphm
    crystalphm Member Posts: 1,138
    edited February 2016

    Pita, How are you doing? I am in the same place, serious shoulder pain and I am not taking action because I am afraid of LE. PT did not work for me, neither did the ionto, but it is certainly worth trying.

    I wish I had answers too. Denise

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