Hey guys,
Just throwing it out there in case anyone has any experiences with getting a steroid injection (hip joint specifically) and how long to rest after etc. And Yes I did ask the radiologist who did it! He basically said there’s no hard or fast rules when it comes to injections and to see how I feel and take it easy for a few days…not particularly helpful for someone like me
Any experience or advice? Did you get any flare ups etc… the injection itself was painless but the hip has stiffened up like a good’ un right now
I’m definitely not planning on running for at least a week and cycling for a few days but how about swimming? (I’m a non kicker anyway!)
I don’t have the experience you want, but it might be helpful to supply the nature of the problem (e.g. chronic arthritis vs. recovery from acute injury) and the desired outcome (e.g. just get through some upcoming event vs.seeking long-term improvement)
I had a shot in the knee about 3 weeks ago. Asked the Dr the same thing. He said I should take it easy for three days, only for the reason if something swells up or hurts then we know its the cortisone and not something I did while exercising. I made it two days then went for a bike, could’t make it any longer :). But his advise was sound and makes sense, one less variable if something acts up.
I don’t have the experience you want, but it might be helpful to supply the nature of the problem (e.g. chronic arthritis vs. recovery from acute injury) and the desired outcome (e.g. just get through some upcoming event vs.seeking long-term improvement)
Thanks- good idea . The issues are very complex but long story short, after suffering a stress fracture 2 years ago which has been fully healed for a long time I’m still in daily discomfort and sometimes downright pain. I have labral tears in both hips so the injection will also act as a diagnostic to see if my pain is coming from them or they are asymptomatic and the pain is more muscular/tendon/strength related etc
Have done over a year of PT- gained so much strength but still not able to run very much and cycling is very irritating. Sometimes I can go for weeks without much pain but the past week or two I had a flare up and was hobbling around for a while (nothing particular set it off)
There’s also a lot of tendinitis and bursitis around the hip laterally but generally pain is front/groin
I work as with an interventional pain specialist regularly (providing the sedation) and our normal advice is that you can generally get back to things the following day, just be sensible, ie don’t do anything super stressful on the joint itself. But with a hip, swimming should be fine and most riding, maybe an easy run but no major intensity.
The steroid itself should not normally cause a flare as such, it can take a few days to a few weeks for the effects to fully kick in. The hip joint itself does not have much room for extra fluid inside it, so any potential stiffness can just be from the injectate volume that was put in. Some movement is likely to be beneficial to things.
So I’m an interventional pain physician specialist/anesthesia, and its generally 2 wks for heavy lifting/stressing the area, but I think the biggest problem is why are you getting it.
Alot of phyiscians do it because it takes the pain away, and for some very very specific symptoms I’m ok with it, but generally I think there are tons of risks that are not appreciated. I don’t know your age, almost no-one under 50 gets cortisone in my practice because it decreases the tissue quality (some evidence to say permanently) which can effect any future surgery (talking about the shoulder here).
For knees, I unless you have frank RA with effusion, it helps take the pain away, but I also think prolo or PRP is reasonable to try first/figure out what’s going on. Most injections of cortisone are for “tendinitis” but when you look at these conditions its actually a tendinosis (Achilles/plantar/biceps tendon) which is a ischemic event vs. active inflammation.
If you have ultrasound evidence of active inflammation (frank effusion) I might do it, but generally for alot of joint pathology I get really good relief with some sort of neuromodulation (pulsed nerve to the area + prolotherapy/etc).
If it is a “tendinitis” I would first ensure that there is active inflammation, if its not - I would try and understand is this a tendinosis or some sort of tear - then if a tendinosis focus on why the tissue is ischemic (for the heel stuff its often valgus adduction of the hallux) which can compress alot of the intrinsic bones of the foot and actually change the tibeal artery blood flow. Or, if its a tear, physio physio physio… actually physio is most important for everything.
I had a shot into my big toe joint some 7-8 years ago. The podiatrist said that I may come back in 3 months begging for more or I may never need to come back. So far it is the “never” option.
I’ve had 6 shots in my shoulders over the years. 1 worked a treat, 1 worked for a few months, 1 had a very slight effect, the other 3 did nothing. Shoulders are good now though. I also had a hip issue, 3 shots, 1 guided, none of them worked at all.
I had a shot into my big toe joint some 7-8 years ago. The podiatrist said that I may come back in 3 months begging for more or I may never need to come back. So far it is the “never” option.
I also had a shot into the big toe about 7 years ago! Arthritis due to competitive trampolining as a kid! I’ve also never had any problems since…wish hips were as easy as big toes!
I’ve had 6 shots in my shoulders over the years. 1 worked a treat, 1 worked for a few months, 1 had a very slight effect, the other 3 did nothing. Shoulders are good now though. I also had a hip issue, 3 shots, 1 guided, none of them worked at all.
Any flare up of pain in the days after?
Glad the shoulders are all good! What was the treatment for the hip after the shots?
I’ve had 6 shots in my shoulders over the years. 1 worked a treat, 1 worked for a few months, 1 had a very slight effect, the other 3 did nothing. Shoulders are good now though. I also had a hip issue, 3 shots, 1 guided, none of them worked at all.
Any flare up of pain in the days after?
Glad the shoulders are all good! What was the treatment for the hip after the shots?
Same with the shoulders, self treatment via Google and youtube! Physio treatment and cortisone gave me limited success in both cases. So I just tried lots of different things with both running and swimming. Different shoes, different surfaces, different types of running, changing running style. And with swimming working hard on changing my technique so I wasn’t overloading the shoulders. I guess with a lot of injuries that are treated with cortisone, unless the root cause is identified and modified, the injury will return. Which is what I found with my shoulders and swimming.
Thanks for the info. Did you get the shot into the actual tendon or the hip joint? Did it help at all?
I’m not an expert in hip anatomy, but the needle went into what I think was the tendon sheath to get the stuff under the tendon sheath. I envisioned it surrounding the tendon, but I don’t know if that’s the anatomy. It was near where the psoas tendon goes into the ball part of the hip joint ( on the femur bone) if that answers your question. Yes, it worked, knock on wood. Keep us updated as to how you are, okay?
Dont start too soon and be careful with slow build back to target volume. Generally it feels great right away and you feel like you can train heaps, but you still need time to let the underlying issue heal eg the overuse of a tendon or whatever is causing the flare up.
What is the reason for the injection? Do they know what’s actually wrong?
To be honest it’s a very complex case that’s been over 2 years in the making. Basically my surgeon is ticking all the boxes and trying to figure out what’s causing the pain. This injection was to see if it’s within the hip joint or coming from the labral tear
Thanks for the info. Did you get the shot into the actual tendon or the hip joint? Did it help at all?
I’m not an expert in hip anatomy, but the needle went into what I think was the tendon sheath to get the stuff under the tendon sheath. I envisioned it surrounding the tendon, but I don’t know if that’s the anatomy. It was near where the psoas tendon goes into the ball part of the hip joint ( on the femur bone) if that answers your question. Yes, it worked, knock on wood. Keep us updated as to how you are, okay?
I’m glad to hear it worked! Hips are tricky aren’t they…
Do you remember if you had any flare ups of pain following the shot? It’s quite sore today, not terrible but not comfortable!
Dont start too soon and be careful with slow build back to target volume. Generally it feels great right away and you feel like you can train heaps, but you still need time to let the underlying issue heal eg the overuse of a tendon or whatever is causing the flare up.
Swimming prob ok.
Thank you for the advice!
The tricky thing is there doesn’t seem to be a whole lot of pathology on the scans etc. (And I’ve had about 20 MRIS in 2 years….yes really!!)
He basically said there’s no hard or fast rules when it comes to injections and to see how I feel and take it easy for a few days…not particularly helpful for someone like me 
