Cortisone injection for painful long biceps tendon?
Posted , 8 users are following.
Anyone have any experience of this? I know tendon and muscle problems can be part of Sjogren's, which I've had for more than 20 years.
I've had varying degrees of pain in my left upper arm (biceps area) for 7-8 years now. Sometimes it gets worse and I really struggle and sleep badly, other times it subsides but it's always there, and limits my movements. It's improved by ice-packs rather than heat, which has always made me suspect a tendon problem.
I recently had an ultrasound scan of the shoulder and biceps area, plus shoulder X-ray. The report on both just mentioned vaguely "tendinopathy" of the long biceps tendon, plus the fact that the tendon appeared "frail" and irregular, but without peri-tendinous effusion. The head of the humerus was smooth, with no crystal formation or signs of osteoarthritis.
Now my GP - who I trust on the whole - wants to do a cortisone injection into the painful area. Does anyone have any experience of this? I'm generally a bit suspicious of this kind of thing, as I know it can sometimes make the condition worse. Also, I'm not sure how specialised my GP is in these conditions - though he seems to think he knows all about it.
I'm a former nurse but I cheerfully admit I was always rubbish at the skeleto-muscular system in my training (I specialised in neuro) so I'm pretty ignorant about all this.
All the reading I've recently done suggests that damage to this tendon presents as pain either in the shoulder or just above the elbow - the areas where it attaches to the bone. But the pain I'm suffering is always right in the middle of my biceps muscle.
Does anyone have an opinion/advice on this? Is it likely to be part of SS or just some age-related thing? (I'm 74.) And would this injection be a good idea?
0 likes, 12 replies
christine00342 lily65668
Posted
Hi lily, yes I had a cortisone injection for a very painful shoulder & it was wonderful, it worked very quickly but that was before I got Sjögren’s- not properly diagnosed yet, just had lip biopsy, have to wait 2 to 4 weeks for results, can’t have ANY medication until they have a firm diagnosis. Thoroughly fed up, each day something different !!!
Have you had memory problems, or anger problems ? Xx
lily65668 christine00342
Posted
Thanks Christine. Yes, I've heard of cortisone injections into actual joints (shoulder, elbow etc.) but my doctor says he's planning to put it into the painful area in the middle of my biceps muscle, which I haven't come across before.
Still, it's good to hear that it worked for you. That encourages me a bit!
I don't have anger problems but for several years now I've had increasing problems with forgetting my words in the middle of a sentence. It's quite embarrassing, especially at work. I also periodically forget how to operate household appliances, though that's been going on for nearly 20 years. When it happens I just walk away and do something else, and when I go back I find I can do it again.
I've also realised I'm getting increasingly lethargic and apathetic in the past year or so, with more brain fog than usual. However, I don't know whether this is down to Sjogren's or my age. Or both, of course.
christine26761 lily65668
Posted
I had one in the knee joint under a cat scan so they could pinpoint it...it only lased about 3 months but was great..be blessed lily and have a lovely weekend.,😍😍💐🙏
Megheart lily65668
Posted
Hello Lily,
My experience has been, when the diagnosis is correct then the cortisone injections have worked well. When the diagnosis is incorrect then 😩........like the time my GP said I had bursitis in the hip which I knew full well was not the case. The injection did no good at all as I had a totally worn, bone on bone hip joint with effusions, shredded labrum etc etc. A THR was all that could 'fix' that.
The other thing that has really helped me when eg. my shoulder, which has a partial tear of the supraspinatis tendon, becomes generally very painful because of other tendon and muscle compensatory stressors, is Myotherapy. Two or three sessions and it is transforming.
I think when we have an injury or weakness we forget that other muscles and tendons have to work harder to compensate to enable movement. Over time the pain can become debilitating. It may not be the original problem causing the pain directly but the surrounding tissues responding to that injury by having to work harder and becoming strained.
Educated massaging of all those knots and tight areas can bring things back into balance.
lily65668 Megheart
Posted
Thanks for that Megheart.
I have actually had my GP write me up for a course of physiotherapy, which I haven't started yet (having only seen him three days ago). This was because I've recently noticed I'm losing core strength at an alarming rate, which is clearly down to ageing. These days, if I get down on the floor for some reason I can't get up again. I have to crawl across the room till I reach an item of furniture on which to pull myself up!
I do exercise regularly at home, but I'm still doing the movements I started around the menopause, nearly 30 years ago, and some of them are simply too painful these days. The aim is to learn a new set of exercises, more suited to my current age, which I can do at home. There's a physiotherapy clinic just round the corner from me where they seem to be doing this sort of thing, so I'll go along and see them next week.
I think lack of general muscle strength is also contributing to the many falls I've had in recent years - the last one only about six weeks ago. I drag my right foot slightly due to a mild congenital hip deformity, and this has always caused occasional falls when I stub my right toe and trip over forwards. In the past I could usually compensate for this by breaking into a little run to regain my equilibrium, but these days I tend to fall heavily on my face every time. I think if I could improve core and thigh strength, I'd be able to prevent actually falling when I trip.
My GP thought this was an excellent idea, and also said he thought it might help the tendon pain, as weak muscles put more of a strain on the tendons in general. He also suggested I take the ultrasound report along for my first session, to get some work done directly on that arm.
I'm grateful for all the input I've received here, and reassured about the cortisone injection, should it become necessary. However, I think I'm going to give physiotherapy and a custom-designed exercise programme a go first.
irene47920 lily65668
Posted
lily65668 irene47920
Posted
That's an interesting point Irene. I know some posters on here swear that SS affects muscles and tendons, whereas others say it doesn't. I'm actually not too bothered either way, as I don't plan to take any of the medications prescribed for SS anyway - e.g. DMARDs, immunosuppressants or systemic steroids. I'm more interested in treating the symptoms.
Even when symptoms are caused by SS, I think the waters get muddied when we get into our 70s, by which time the body is inevitably showing signs of wear-and-tear anyway.
irene47920 lily65668
Posted
Well said as I'm not far behind you. I have had SS for 27 years and after reading some symptoms on this forum I consider myself really lucky. My main problem is swallowing/choking. All my food has to be bland/blended soups etc. I can very rarely eat out due to this as it becomes a problem. Any medication I take has to be liquid form/crushed. My eyes are dry but by using drops daily the problem is resolved. These are my only symptoms. Have no joint pain either. Here in Italy where I live there is no medication given out for SS as there is no cure. Unfortunately I don't know anyone else here who suffers so no confrontation is possible. Take care.
shaq26875 lily65668
Posted
Hi Lily
?my tendons are definitely affected by SS...I didn't take plaquenil for 6 months (only painkillers )and I became totally debilitated ..recently after a year, even the plaq. is not a 100% effective and my palm tendons are swollen as is tendon on a wrist...now prescribed methrotaxate (sp) also now have a boney lump under a big toe...sometimes painful to walk on and sometimes not ..rheum said was a bunion (or could be age ..I am 66) from wearing tight shoes..i wore uncomfortable shoes when 1 was teenager in London and since then have gone for comfy soft leather sandals ( for last 30 years have lived in hot climate so not worn shoes...just open toed sandals) so not sure if caused by tight shoes worn over 45 years ago. Getting blood tests soon.
?I have had a painful neck shoulder upper arm elbow for 18 months......had 3 lots of physiotherapies....nothing worked....now do resistance training on neck...has helped...but still have painful upper arm ....esp if I lift heavy items... so don't know what to do.. may go to ortho Dr and ask for another xray or ct scan ...my bicep is now weak from lack of weight training
?
aitarg35939 lily65668
Posted
Tho I have docs all hot to give me injections in various parts of my body, no one has ever suggested injecting muscles/tendons/fascia despite me having problems that date back to an accident 28 yrs ago and a spasm that I've lived with in my back for all that time.
I let them inject repeatedly into my SI joint from '91-'92. I was in my mid-30s & I now believe that those 4 injections caused my osteoporosis, DXed at 39 or 40. I overcame the osteoporosis then with hard work that I can no longer do -- stationary bike & lifting 3 lb weights plus miacalcin & calcium. But osteoporosis is a known side effect. So are headache, whole-body flush up to 2 weeks, and sleeplessness.
I have lots of problems generally with injected & ingested steroids. Nonetheless I let the foot doc inject what he swore was "such a tiny amount that you couldn't have a reaction" into, well I'm not sure what body part on the bottom of my foot last summer. I had a bad reaction but I also had 8 pain-free months up until just now. It was heavenly to be without that pain, and it's still not as bad as before.
I have had myofascial release work on my left upper arm & shoulder. It was great but it's also brutal & can leave bruises. Deep breathing during the releases helps, as does drinking tons of extra water afterward on that day. If possible, I'd go for wet-dry PT for both core strength & the arm. They might include myo work as part of that. I'm younger than you and the only way I can do good core work now is in the water.
Good luck, Lily. I hope something helps.
lily65668 aitarg35939
Posted
Hi aitarg,
Yes, my GP mentioned what I believe is the myofascial release you're talking about. He described it as "unhooking" the tendon, but also mentioned the word brutal! I will, however, discuss it with the physiotherapist when I get there, and will take a copy of the ultrasound and X-ray reports with me. I have a fairly high pain threshold, and if it relieves the constant, restricting pain in my arm every time I try to use it - and often when I roll onto it in my sleep too - then it'll be worth it.
Taking an average of the varying opinions I've received on this thread (for which I'm very grateful) I've decided I'll go the physiotherapy route first, but still keep the steroid injection on the back burner.
aitarg35939 lily65668
Posted
I'd call that a wise decision from a wise woman.