hydrocortisone injections

[Guest Posts]

I am having regular (3-4 annually) hydrocortisone injections into swollen finger joints.
This gives me some relief from pain, but ready for next injection before it's due.
How safe is this treatment, does hydrocortisone change tissues/ ligaments.
Is there any alternative treatment you can recommend?
Thanks Sharon

[Arthritis Action]

In a study of patients with knee osteoarthritis over 2 years, patients who received regular steroid injections had no better pain relief after 2 years than those who had no injections, and they also had more cartilage damage at 2 years. Injections therefore may cause a temporary reduction in pain, but may cause joint damage, although similar studies have not been done on the finger joints. Most rheumatologists would not inject a single joint more thn 3 times a year, because put simply, if injections are needed more often, they are not working, other than by a possible placebo effect. Osteoarthritis is known to be associated with so-called cortical sensitisation whereby pain pathways in the brain and spinal cord become over-active and cause pain that is more severe than it should be. Pain-management techniques including distraction, relaxation or meditation, improving sleep and treating depression can be effective, and keeping the joints moving with gentle exercise all over can also help a lot. Rubbing on anti-inflammatory creams or gels can be effective and as a last resort, surgical fusion of very painful joints, or even joint replacement (PIP joint replacement) can be considered. Good luck.

Dr Wendy Holden
Medical Advisor to Arthritis Action and Consultant Rheumatologist

Arthritis Action
56 Buckingham Gate
London SW1E 6AE

020 3781 7120
www.arthritisaction.org.uk

[Tracy Corbett]

Hi, Sharon

If your GP is able to refer you to a local Hands Therapy Unit, the hands therapists will be able to advise on:

- suitable exercises for your fingers
- assistive devices, including pain relieving devices such as compression gloves, taping, coban wrapping, etc

They may also be able to help with manual therapy for your hands, if appropriate.