Steroid injection into hip

Lilymary

I’ve suddenly got an appointment for my steroid injection next week (woohoo!). I’m not getting my hopes up too much, but fingers crossed I’ll be one of the lucky one ps who benefits.

My question is, how long does the actual procedure normally take? It’s in Wigan, but as this area has just been slapped with local Covid restrictions, my husband is reluctant to find a coffee shop till it’s over, and doesn’t fancy 3 hours in the car waiting.

Also, when the beneficial effects of the injection wear off, what’s the procedure to getting another or going to the next level? Or does the consultant say in advance when you can next have one and you just have to sit tight and wait?

stickywicket

Everything is different right now I'm not sure that any estimate of time would be useful. Hospitals are doing things differently. If my husband's experience of an x-ray and mine with blood tests are anything to go by there's no waiting room. You go straight in at the appointed time and things happen quickly. If you're not advised in advance what to do I'd ring up and ask.

I've not had steroids into hips, just knees and shoulders. I don't remember them taking more than, say, 15 minutes at the most, even pre-covid, maybe a little longer if you need fluid removing first.

I know there's a limit as to how many we can have. I think it might be 4 annually maximum. You might be able to find out on other bits of this site. I don't know of another level. I'd be interested to hear about it if there is one. I'd guess you'll have to be referred each time by your GP or orthopaedic consultant.

I hope it works for you. I've had mixed results. It might be worth asking about resting for 48 hours afterwards. I think it's still recommended for knees. It enables the steroids to stay where put rather than dispersing quickly. Good luck.

Shell_H

Hi Lilymary, Sadly I can't say how long it will take - although I'm going to guess each hospital has different ways to go, as opposed to Stickywicket I have had a waiting room for an X-ray, and the waiting did take longer than 15 minutes. But I do have a link to some more info on steroid injections, which may give some more info:

https://www.versusarthritis.org/about-arthritis/treatments/drugs/steroid-injections/

frogmorton

When I've had them it really hasn't taken too long it just depends whether you get in in time as much as anything. My husband is always happy to sit in the car reading his paper though.

You will be given a leaflet all being well and need to rest for 24/48 hours so the drug has plenty of time to work in the area it has been placed.

I hope also that you get a great result and it lasts ages.🤞

If it works you can be referred for another and some hospitals put you on a rolling programme so you have them regularly although we can only have so many a year of course.

Best of luck Lilymary ((()))

Lilymary

B****r. My appointment for my steroid injection has just been cancelled, as someone forgot to come out and swab test me for Covid. We've just been self-isolating for 3 days, for nothing. And my hip has been vile this week. B****r.

stickywicket

B****r indeed. Exactly what you didn't need. And of course the hip has been making it's presence felt. Do you have a new date yet? If not I'd be inclined to keep reminding them. Especially in these uncertain times.

Lilymary

@stickywicket , not yet, they only told me this morning when they were doing the final health questionnaire over the phone, and the penny dropped with them that they'd missed out on the covid test. It should have been done on Sunday or Monday when I started isolating. I don't suppose my surgeon's too happy about it either, that's valuable theatre time wasted. I think they put me in after a cancellation, as I wasn't expecting to hear from them for months. Hope he can find me another one. 😥 My poor hubby missed out on all that lovely weather for nothing - he needs his daily outdoor fix.

stickywicket

I hope you get a new appt. asap. Did you tell them you could take a cancellation? It can sometimes get us a quicker appt. One thing we learn on here is to do our own administration and not wait for it to - possibly - be done for us. Good luck.

Lilymary

Well, after a slew of phone calls this morning, it turns out I should have gone down to Wigan for my covid test before I started self isolating, and they forgot to tell me. They should have made an appointment for me for the test, they forgot that as well. I gather quite a few other people had the same problem, and for those that did actually turn up for a test, the test results didn't come back in time for them to be admitted for surgery. 🙄 I know we're all having to make things up as we go along in these strange times, but honestly....

Anyway, thanks to this chaos they have another cancellation for next week, so I grabbed it, and we're back to self isolating again next week. Sadly I will have run out of work to do at home by then so my OH and I will be fighting for rights over the TY remote (I may have to suggest a Game of Thrones marathon) while the poor chap starts climbing the walls with cabin fever. He's out on his bike today getting the last three days out of his system! Thank heaven for understanding partners.

Lilymary

Well after all the drama of organising the steroid injection etc, it was a total waste of time. No improvement whatsoever. Not helped by my consultant tactlessly complaining that he was supposed to be in the Dolomites, but instead had come into surgery. (I think I was supposed to utter gasps of gratitude.) I'd like to be out in the mountains too, I can't even stagger round a field at the moment, but he is blissfully unaware of that as he has never asked me a single question except, once, when folding my leg in the air, "does that hurt?" at which point I decided the reply I had in mind wasn't going to go down well.

He saw me looking at my xray after the procedure had ended, as it helps me to visualise what's happening to my body and I haven't had a chance to look properly before. He noticed me doing so and proudly showed me the work he'd just done like he wanted a pat on the head (and which hurt like crazy as he waited only a nanosecond after allegedly anaesthetising it and going in with the dye and steroid). When I tried to ask him about all the jagged bits around the edges of the ball joint he just dismissed it as "a perfectly well maintained joint" and ushered me out of the room. I now have the distinct impression he thinks I'm making this up and is just bored by yet another middle aged patient complaining that their leg hurts.

Is is possible to change consultants under the NHS? This man just leaves me morbidly depressed instead of giving me any glimmers of hope, which during my first consultation he totally extinguished anyway in an over-zealous attempt to manage my expectations (before telling me what he thought of Andy Murray's surgery and the inefficacy of flue jabs, at length, so I couldn't get a word in edgeways). Will it put me back tot he bottom of the waiting list? I'd go privately but frankly I resent paying all that money to get exactly the same treatment by the same doctors in the same hospital on the NHS, with just a bit more hand-holding. Plus I can't afford that big a dent in my bank balance when the roof needs reslating.

frogmorton

Lilymary you have to rest that leg now keep the steroid in place as long as possible. Avoid walking or moving too much. It is unlikely to work straight away and can take several days to improve. Don't give up yet ((()))

As for changing consultants I believe we do indeed have the right to a second opinion in this country.

Are you on the list now for replacement? If not what have you got to lose?

Sending ((())) and some

Lilymary

@frogmorton, all he said was not to run a marathon. However, as it happens I have no choice but to rest it, as I can’t do otherwise even if I wanted to, and 4 days later there is still no improvement. But I have to work this week, just the one scaffold today, tomorrow is another desk day.

I am seriously considering switching to an alternative surgeon who doesn’t do “one size fits all.”

Thank you for the flowers and hug, much appreciated. Xx

crinkly1

Sorry to hear about the disappointment of an injection not working for you. That is a real 'let down' but, sadly, they don't always provide good, or any, pain relief.

Having had successful knee injections and totally ineffective shoulder ones I know what it's like to expect magic and receive nothing. That's tough so try to be extra kind to yourself while the fact that you have not been one of the fortunate ones remains raw.

I've no experience of second opinions/change of consultant but hope you find it helpful if you decide to investigate that route.

frogmorton

Have a think about it Lilymary and if you have a kind GP maybe a chat to him/her about getting a 2nd opinion with a different consultant.

Don't forget to let us know what you decide to do ((()))

Oh BTW some people find better results with steroid injections under Xray if that's the right way of explaining what I mean, but you have clearly lost confidence in your consultant anyway.

Lilymary

Thank you @frogmorton and @crinkly1 , it's left me feeling pretty desperate tbh. The injection was done under xray, so I can only assume he put it in the right place, and I watched it as he injected me (if only to take my mind off the pain).

I'm sure he's a very competent surgeon, but his people handling skills, despite his cheery demeanour, are shocking. My fear is that he is hugely underestimating the effect this is having on my life, as the xrays don't seem to match up with the pain levels and massive loss of mobility. He's made his clinical decisions entirely based on the xrays, and isn't interested in anything else. He hasn't asked me a single question other than "did that hurt". I know from my own experience that anecdotal evidence is equally, if not more, important than visual evidence, and he has completely ignored this. I just feel despair.

I'll wait a bit longer before doing anything else. Meanwhile I'm just trying to get on with life again.

crinkly1

You may have hit the nail right in the middle of its head Lilymary with your indication that x-rays rule!

There was a brief time when hip and knee replacements were performed to alleviate pain and improve mobility, regardless of the amount of damage revealed by x-rays but those days have passed. (Probably mainly due to financial restraints on the NHS.)

I (having had to retire from teaching at 50) have struggled with OA knee issues for years. X-rays and scans showed the presence of bony nodules forming at the back of both kneecaps and impinging on the head of tibia with every movement.

I was told these bone growths can be removed via a TKR and almost had a moment of optimism until I realised that, where I live, the sole criterion for TKR is the complete absence of cartilage in the joint. Having a little remaining meniscus means I do not qualify for the surgery that would assist with my pain and poor mobility.

With current additional demands on the NHS I'm afraid that x-rays do indeed rule - unless one has access to private health care or is admitted to A & E due to a joint-damaging accident.

It's quite a bitter pill when it is first dealt out to you so take your time to explore the best ways of getting on with your life while making changes that will minimise your pain and disability where possible.

One day, thanks to VA's support of research, there will be other treatment options but when they will be available is the big question. I am just thankful that I am waiting for new discoveries in OA and not in cancer!

frogmorton

I Quote Crinkly1 here:

......One day, thanks to VA's support of research, there will be other treatment options.....

I am certain you are right about this.

For now Lilymary you just rest and regroup. When you've had a knock-back like this and are feeling hurt, unheard and upset that's what a person needs.

We'll all talk again once you are ready ((()))

Lilymary

Thank you @frogmorton and @crinkly1 I’ve just had a chat with my physio (who is also a friend) and aired my grievances. She gave a knowing smile and said orthopaedic surgeons in particular are known for having the patient handling skills of Doc Martin. Hmmmm...... Perhaps I should adjust my expectations.....

@crinkly1, that sounds so painful. Can they not shave off the “nobbly bits” in your knees?

All I have left in my armoury apart from yet more pills, is exercise, so Leon, here I come. 🙄🙁🏋🏽‍♀️🏊‍♀️🧘‍♂️🤸‍♂️🏃🏻‍♀️😬