Steroid injection in knee recovery

I had my epidural steroid injection done a week ago. I did not start to experience any relief in my lumbar region until yesterday. The only issue I have now since the shot is kind of a heaviness in my chest and a cough. I know it is from the shot because I did not have this issue until I got the shot. I thought at first that it was a bad heart burn but after a couple of days realized it was attributed to the shot. It is a little better as time has gone by but it still lingers and bothers me. Otherwise, my leg pain is much better. I still have the back pain but I think it is also a little better.

I have been suffering with piriformus syndrome for the last year and the pain is excruciating. I have had several (over 8) injections of steroid, lidocaine and one of toradol. All of these injections have been done either under xtay in the hospital or under ultrasound in my Dr.’s office. Thay have not given much relief so i inquired about botox about 8 months ago. So i was referred to another Dr. In the same practice. I met with him 4 weeks ago and he thought i might get some relief with the botox. I was scheduled today and went in this morning. This Dr. Was going to have me lay on the table and give me a botox injection in my piriformus muscle. I asked how he was going to find it. He said by pushing to see where it hurt and then inject into the pirifomus till i told him where i feel the muscle jump. I told him i cannot tell by pushing on it. It doesnt hurt like that. Well he assures me that it takes skill to do these injections and he knows where the pirifomus muscle is. He left the room to mix my botox shot and i got even more nervous thinking to myself this is wrong. How is he going to be sure he’s injecting the right place and with botox of all things! When he came back i was almost in tears. I said im not so sure about doing this without ultrasound. I felt like an idiot and i was wasting his time. I apologized and said i would be more comfortable under ultrasound. He said he doesnt do ultrasound. So i decided to wait for the injection even though im in terrible pain. He said he would put my mixed needle in the fridge for next week so my other Dr. Can do it under ultrasound. My other Dr. Doesnt do botox injections so i dont know what will happen. This Dr. I saw today said that my original dr. Will give me a trigger point injection and i said ok but with the botox right? He said it doesnt matter whats in the needle. I said well ive been waiting for this botox for 8 months and of course it matters whats in the needle! Ive tried all the steroid and lidocaine etc and i want the botox to help ease my pain. He made me feel stupid. I know im not a dr but i believe that i made the right decision to not just let this man stick a needle full of botox in my butt without a 100% guarantee that it is in fact going in my piriformus muscle. I have no ides what he wrote in my file but he said that he agreed i shouldnt get the shot. Now i dont know if i insulted his intelligence by actions and words. So i have 2 questions for you #1 Do you think i made the right decision? And #2 will this mixed botox needle be ok in the fridge for a week till i can have the injection under ultrasound? Please respond to me. I am desperate and in pain and now im afraid that this Dr. Put some thing in my file that im paranoid or anxiety ridden. I was nervous today. I always am. I dont like needles. But i felt very torn today because i want that shot!

I never had any symptoms until one night I had a bad stomach ache . I went to the emergency room and had a CT and ultrasound done and found a 5 cm tumor in colon. I had a colonoscopy the next day and found out I had stage 3 colon cancer . Only 22 and I found out I had the same thing my mom died of. Now I am doing chemotherapy using oxaliplatin and Xeloda . I had the mass removed through surgery. I still have swollen lymph nodes that could be from surgery or live cancer cells. It has only been a month and a half since I found out.

An epidural steroid injection places this powerful anti-inflammatory medication directly around the spinal nerves. Traditionally epidural injections were administered without any special equipment, by inserting the needle by feel in the area around the spinal nerves. More recently epidural injections have been administered with the aid of imaging tools to allow your physician to see the needle going to the proper location. Either real-time x-ray called fluoroscopy, or CT scan can be used to 'watch' the needle deliver the medication to the proper location. 

We’ve known for awhile that local anesthetic and steroid shots can produce side effects for stem cells and cartilage cells . Local anesthetics are a common component of knee steroid shots. We’ve been amazed at the toxicity of one commonly used numbing agent in knee steroid shots called Bupivicane (also known as Marcaine). A recent literature review on the topic I performed for another project was so unbelievable, I thought I had to share these studies. In one study,  Chu et al. confirmed a lasting toxic effect of bupivacaine on  cartilage cells in an animal joint. A full 6 months after they injected a knee joint with a single usual dose of bupivacaine , cartilage in the treated joints had a 50% lower density of chondrocytes (cartilage cells) compared with cartilage in control joints. Talk about side effects! Think about that for a second. A common numbing agent that gets injected into knee joints everyday because it lasts a little longer than other numbing medicines, was able to wipe out 50% of the cartilage cells by 6 months? Even if it only killed off 5% of the cells that would be equivalent of dropping a nuclear bomb inside the knee joint. How about other numbing medicines like Lidocaine? While this is a bit better than Bupivicane, local anesthetics containing l idocaine are significantly more toxic to mature human joint cartilage cells than a saline injection. How about the most common injection given in the United States for a swollen or painful joint with knee arthritis? Usually doctors will combine a steroid medication with a numbing agent like lidocaine and inject these to control pain and swelling. However, the combination of the steroid shot and local anesthetics has an synergistic adverse effect on cartilage  causing serious knee steroid injection side effects.  This means that the combination of anesthetic and steroid hits the knee joint cartilage cells harder than simply adding up the negative impact of each component. Another common practice is for pain management doctors to inject steroids and anesthetics into a neck or back facet joint (the small joints found at each spinal level). However, a lab study has now shown that these medications also may  hit the cartilage in these small joints as well . The upshot? We abandoned the use of Bupivicane several years ago and will only use low doses of lidocaine. We’ve also stayed away from using any anesthetics around stem cells. This new data has now forced us to get rid of even the lidocaine from our joint injections. We’ve spent hours searching the medical literature for a numbing agent that won’t hurt cartilage and have finally found one. We’ll begin using this new numbing agent in all of our joint procedures next week.

SUPARTZ is indicated for treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative non-pharmacologic therapy and simple analgesics, ., acetaminophen. You should not use SUPARTZ if you have infections or skin diseases at the injection site or allergies to poultry products. SUPARTZ is not approved for pregnant or nursing women, or children. Risks can include general knee pain, warmth and redness or pain at the injection site. Full prescribing information can be found here or by contacting customer service at 800-396-4325.

Steroid injection in knee recovery

steroid injection in knee recovery

An epidural steroid injection places this powerful anti-inflammatory medication directly around the spinal nerves. Traditionally epidural injections were administered without any special equipment, by inserting the needle by feel in the area around the spinal nerves. More recently epidural injections have been administered with the aid of imaging tools to allow your physician to see the needle going to the proper location. Either real-time x-ray called fluoroscopy, or CT scan can be used to 'watch' the needle deliver the medication to the proper location. 

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