Sacral-iliac joint setroid injections

Hi,

I have been diagnosed with Ankylosing Spondylitis with inflammation in both of my sacral-iliac joints. My specialist has recommended having steroid(cortisone) injections as the way forward.

Does anyone have an experiences of having steroid(cortisone) injections in either one or both of their Sacral-iliac joints?
Did it work for you? How did/does it effect your running? And anything that may be useful to know!

Many thanks.

Sean.

HI - Nice to meet another anky sponder!

I'm a little surprised your specialist should recommend steroid injections for what sounds like a routine treatment (correct me if I'm wrong). They are normally used as a last resort treatment for chronic pain and inflammation because of the side effects.
For example, patients have injections into their fingers to keep them moving and to reduce damage when nothing else is working, or into their feet to enable them to walk. Some patients with AS could have steroid injection into their eyes if the inflammation there does not respond to other treatment.

Are you not taking any daily medication or has anyone suggested a more long-term solution? The disease often shows itself in the sacroiliac area in the first instance, but will affect other joints so it would probably be better to find another treatment. Steroid injections cannot be used regularly because of the side effects, including reducing bone density, which with AS is already a problem.

Where are you? Where are you receiving treatment?
Don't know if you've done much reading about AS, but you should, just so you get a bearing on what it does - check out the arc.org.uk website for starters. the NASS website also has lots of info.
Good luck

Lanky Limper,

Hi. I must admit it is a club I'd rather not be a member of!

I am 36.

Basically, I have been on Diclofenac Sodium's (Voltarol's, 3 x daily) for 11 out of the last 12 months so I would guess that the aim of the steroid injections is to stop me from taking the Diclofenac Sodium's. At the end of the day I guess the cortisone is the lesser of the 2 evils for me for the time being.

I'm in Mid Bedfordshire and seeing a Rheumatologist at Lister Hospital Stevenage. My next routine appointment is in April 06.

I have done a reasonable amount of reading on AS, but things have progressed so quickly since I saw my Specialist at the end of Nov. From needing a new MRI scan, finding the SI joints were scanned, confirmed inflammation of the SI joints and having cortisone injections (all inside 3 weeks).

Where are you at, within the AS symptoms and treatment cycle? Long term prospects?

Its already been a long road and the end doesn't appears to be getting near.

Many thanks and good luck yourself.

Hi again - well yes, it's a bit depressing sometimes. But there are worse clubs. You're older than me too, I've had it for about four years and I'm 34.
I had serious difficulties in even getting a diagnosis, despite obvious signs of arthritis (and my mum's had arthritis for 30-odd years). It wasn't until 2004 when my left foot swelled up to the size of a football and I couldn't walk properly that I had any definitive diagnosis.
I'd been on anti-inflammatories for about two years by then anyway, but managed to get onto a drugs trial at my local hospital for one of the new style biologic drugs.
It got me walking again, and it's not been too bad.
I can still feel the AS at work, and that worries me since in four years it's damaged my jaw and my ankle/foot forever.
But then, I reckon I'm still pretty lucky. It could be so much worse - I was tested for MS when my symptoms first showed and that's really scary.
Anyhoo - I'm not taking any drugs at the minute but that will probably change this month when I go back to see my rheumy. I was on Vioxx which was withdrawn, then celebrex, which was withdrawn but which I had a reaction to, so didn't bother trying anything else because I didn't feel too bad. I tried Voltarol in the early days and it really didn't agree with me. How's it with you?

I get pain in my feet still, in my back annd occasionally by arms/feet and I'm one of the lucky few who get problems with my eyes too. Oh joy.

It was odd really because I had only just begun running when my symptoms started. Bad timing. It was a real test - sometimes I could fly round my training runs but other times I couldn't do half without feeling like I was towing concorde behind me. I also had terrible pains in my neck for a while and don't bother running if you get that - there is no way to hold your head comfortably while running if it locks up.
I have no idea what the long-term holds. I've started running again - but only in the gym so far. Have agreed to do a 10k in May, so I'll pick it up this month and start going out more regularly.
I have found that exercise does improve some symptoms but often you have to grit your teeth to get through the first few minutes.
My hospital - leeds - is a regional specialist centre for arthritis so I'm in much better hands now. Hopefully, things will be more steady now. At least it feels better when you know the name of what you're dealing with.

I've avoided steroid injections in my joints because I"m a scaredy cat and also because I have needed steroids for my eyes and don't want to take too much because of the risk of thinning bones. I reckon AS is enough to deal with without osteoporosis.

Well good luck - if you get any other concerns, drop in a message and I'll see if I can help. The steroid injections can take up to two weeks to show any full benefits but can last up to six months - but everyone is different.
The only advice I can really give is to ask your doc about anything that's bothering you, even if it seems silly. Don't be wary of complaining when the treatment isn't working - they're your bones, not theirs.
Best wishes.
LL

LL,

Firstly, Happy New Year.

I must really be in the fairly very early stages of AS.
My symptoms really started in July 04. Suffering with horrendous sciatica and a dull ache/pain in the lower back (which appeared during the dead of the night and combined with the sciatica leaving me unable to return to sleep or to even breath deeply).
I spent 6 months (privately) seeing chiropractors, osteopaths and sports physiotherapists trying to nail down the problems - thinking that the problems were skeletal based.
After seeing another osteopath (for a 2nd opinion), he told me that my back was swollen and advised me to see my GP for blood tests. Basically, the blood tests confirmed that there was inflamitorries in my blood and that my thyroid was under-active too. Two for the price of one.
Anyway, My GP referred me to the Rheumatologist and prescribed Voltarol's. I get on very well with the Voltarol's and don't suffer any of the common side effects either, albeit I'm too keen on in potential damage to the internal organs etc. I can run 50+ miles a week when I'm on them. When I'm off them I cannot run at all, not to mention the return of the dull back aches and sleepless nights too.
I managed to run the Amsterdam Marathon back in Oct 05 in sub 3 hours 30, but haven't ran in the 3 weeks since I stopped taking the Voltarol's and had the cortisone injections. The chap who actually injected my SI joints advised against any impact sports too, but I may start running again in the next week oe so and see how I get on.
As I said previously, everything happened so quickly, with regards to the cortisone injections. I'm pretty familiar with the timeframes and the differing success's of the injections. Again, as I said previously, until I go back to the Rheumatologist I don't know what the long terms plans are (if there is any?) and even what the long term outlook is for me. I'm pretty content to see how the cortisone injection pans out. In the meantime, I'm in limbo till April.
I've wrote directly to my Rheumatologist about something I wasn't happy with in the past and he acted on it. I'm not afraid to rattle his cage once more if the need arises again.

All the best.