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Cortisone Injections...

I have a suggestion to get a cortisone injection in my high hamstring. It has been limiting me for 6 months. It is not a sharp pain, but it is definitely a pain there and I have not deadlifted in 6 months. It is horrid.

However, the doc says that the MRI shows no tear, just some inflammation. However, I am scared of the cortisone injection. Does anyone have experience with one? How long after one can you do nothing? The doc said 2 weeks???

Do they actually help heal it or do they make the tendon weaker? I had one once in my ankle and it just hurt more after I got the injection. (I later got surgery on the ankle)

If the injury is not a tear, purely inflammation can I just work through the pain and as I get stronger will it just go away? The pain isn’t severe, just enough to make me notice it and be scared that I’m doing more damage if I try to dead…

Thanks so much!

Without personally examining you, take this with a grain of salt… however, it might actually be helpful to have the injection, especially knowing that you have an MRI to document the specific problem. I doubt it would be harmful unless repeated multiple times (as far as making the tendon weaker), although I do agree with taking it easy for about 2 weeks following.

It sounds from your description like you might have some sort of tendonitis or possibly a bursitis, both of which are common indications for corticosteroid injection. The injection itself may be difficult to hit the right spot, especially since I’m not sure what you mean by “high hamstring.”

Alternatively, you could try NSAIDs (ibuprofen or naproxen) for some time to try to reduce inflammation, assuming there are no reasons you couldn’t take them. In most cases, I would say the side effects from NSAIDs are greater than in injection, but this is a case by case basis.

In either case, rest is probably needed, and I doubt “work[ing] through it” would do anything but delay recovery, but again, I haven’t examined you myself.

If you are questioning the diagnosis or treatment, consider a second opinion from a sports medicine specialist.

[quote]sarah1 wrote:
I have a suggestion to get a cortisone injection in my high hamstring. It has been limiting me for 6 months. It is not a sharp pain, but it is definitely a pain there and I have not deadlifted in 6 months. It is horrid.

However, the doc says that the MRI shows no tear, just some inflammation. However, I am scared of the cortisone injection. Does anyone have experience with one? How long after one can you do nothing? The doc said 2 weeks???

Do they actually help heal it or do they make the tendon weaker? I had one once in my ankle and it just hurt more after I got the injection. (I later got surgery on the ankle)

If the injury is not a tear, purely inflammation can I just work through the pain and as I get stronger will it just go away? The pain isn’t severe, just enough to make me notice it and be scared that I’m doing more damage if I try to dead…

Thanks so much!

[/quote]

i tore my rotator cuff in a high school wrestling match. i found the cortisone was very helpful in easing pain during recovery. the shot hurt like a bitch though, party because they had to get the needle in to the ball and joint i think.

[quote]paulMD wrote:
Without personally examining you, take this with a grain of salt… however, it might actually be helpful to have the injection, especially knowing that you have an MRI to document the specific problem. I doubt it would be harmful unless repeated multiple times (as far as making the tendon weaker), although I do agree with taking it easy for about 2 weeks following.

It sounds from your description like you might have some sort of tendonitis or possibly a bursitis, both of which are common indications for corticosteroid injection. The injection itself may be difficult to hit the right spot, especially since I’m not sure what you mean by “high hamstring.”

Alternatively, you could try NSAIDs (ibuprofen or naproxen) for some time to try to reduce inflammation, assuming there are no reasons you couldn’t take them. In most cases, I would say the side effects from NSAIDs are greater than in injection, but this is a case by case basis.

In either case, rest is probably needed, and I doubt “work[ing] through it” would do anything but delay recovery, but again, I haven’t examined you myself.

If you are questioning the diagnosis or treatment, consider a second opinion from a sports medicine specialist.

[/quote]

I’m in the Sports Med. field and I agree.

Thanks for the replies. It’s kind of scary having to go into this knowing I can do NOTHING with lower body for 2 weeks afterward (that’s what they say anyway…)

What will my state be after the 2 weeks of taking off? Will it be better off than if I had just taken 2 weeks off without an injection? Does the injection actually help HEAL the tendon, or is it just to get rid of pain? I can deal with pain. I only want the tendon to heal.

This has been a really weird and hard injury. I FELT it in a sharp pain Dec. 31 while doing SLDLs. Since then it has gotten a lot better, but I haven’t been able to do any deads. :frowning: It’s just nagging now.

One thing I should mention is that through the last 6 months I have been horribly underweight and went through a terrible illness where I lost 20 lbs in a month (I had diarheah the entire time and ended in the hospital in a foreign country. :frowning: ) So this whole time I was in bed. I thought it would heal then but it didn’t. It has been 3 months since then.

What I wonder is if I just got healthy again by gaining weight if it would just go away or if I should do this injection. The pain isn’t severe, but then again I haven’t pushed anything since I’m scared. Right now I just do squats not even to parallel and ham curls and some light lunges. Any form or dead bugs it…it’s right up where the ham attaches to the glute…

I discourage you from getting the steroid injection. While the cortisone may very well reduce the pain, it won’t do anything to heal the underlying tissue damage that is causing the inflammation. The danger here is that the shot will provide a false sense of recovery.

[quote]sarah1 wrote:
Does the injection actually help HEAL the tendon, or is it just to get rid of pain? I can deal with pain. I only want the tendon to heal.
[/quote]

The injection does NOT promote tissue healing. In fact, cortisone can actually weaken the tissue.

[quote]belligerent wrote:
sarah1 wrote:
Does the injection actually help HEAL the tendon, or is it just to get rid of pain? I can deal with pain. I only want the tendon to heal.

The injection does NOT promote tissue healing. In fact, cortisone can actually weaken the tissue.
[/quote]

Good point!

[quote]belligerent wrote:
I discourage you from getting the steroid injection. While the cortisone may very well reduce the pain, it won’t do anything to heal the underlying tissue damage that is causing the inflammation. The danger here is that the shot will provide a false sense of recovery.

[/quote]

this is why they don’t want her doing anything for a couple weeks. the time is probably longer than she needs to heal, but is recommended so she doesn’t injure herself more due to a false sense of healing.

they did that with my shoulder too.

I think the key is that rest is important, no matter what your choice regarding the shot may be. Two (or even more) weeks of rest is not going to hurt you in the long run… you won’t wilt away or anything. Letting this progress into a more serious injury, however, really could cause much longer problems and lead to worsening atrophy.

Grr. This is confusing. :frowning:

I tried laying off it for 4 months - it didn’t heal.

Now I try slowly moving back into things - it doesn’t heal.

The cortisone injection also doesn’t help it heal? Then what is the point of it? I don’t want to give up the mobility I do have for nothing. Like water running, etc does not aggrivate it, but they say I’d have to give that up were I to get the injection. So I’m just confused. :frowning:

[quote]sarah1 wrote:

The cortisone injection also doesn’t help it heal? Then what is the point of it?
[/quote]

I think it’s just a reflection of our medical culture. The sad fact is that most patients and physicians are satisfied with the mere pallation of symptoms. Everyone wants a quick fix for pain. And maybe that’s fine for your average sedentary person, but it has never been a valid approach for athletes.

[quote]belligerent wrote:

I think it’s just a reflection of our medical culture. The sad fact is that most patients and physicians are satisfied with the mere pallation of symptoms. Everyone wants a quick fix for pain. And maybe that’s fine for your average sedentary person, but it has never been a valid approach for athletes.

[/quote]

I agree. I had a shot in my elbow for pain and it felt great for about a week or two, but the problem came back. I went to physical therapy and I had an imbalance. After a month of physical therapy I had no pain. I think the key is to find out what is causing you pain and fix it.

As for damage to soft tissue, it really depends on the dosage and the number of shots you get.

Like the others say, cortisone breaks down tissue. It’s a last resort before surgery in my opinion.

I had to get one in my shoulder after a lot of pain and restricted joint ROM. I tried everything first. My injection was into the subacromial cavity and not actually any muscle or tendon so it would do minimal damage and it didn’t hurt at all.

It gave me some ROM back, so I could then push on with more rehab.