3 weeks post intra-articular steroid injection in hip

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How time is flying by, it’s already been 3 weeks since the hip injection and even 2 weeks since the thumb one too.

Since then I’ve been active on our weekend away, getting into some exercise routines and just generally loving the improvement. Only marred by that in the hip it’s not a total fix. After activity it soon flares up again.

My thumb on the right hand however is awful. As soon as my left had its injection I needed to rely on my right one more, which has caused this one to flare up the same way. So although my left is feeling 90% better, I can’t escape splints and pain because of this stupid one starting up. Roll on rheumatologist appointment and maybe request a steroid in this as soon as possible.

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We haven’t done any of our couch to 5k for over 2 weeks simply because real life have taken over and it’s been difficult to fit it in. However I have done physio or weights or that other workout on most days.

Monday we decided to do week 4 run 1 and OMG I felt like I was dying. It’s 3mins run walk for 1.5mins then 5min run walk 2.5mins and repeat once more. In the runs I’m shuffling along as upright as I can, as fast as I can to increase the heart rate and lung functions, and practice my walking unaided. But I soon felt piriformis pain in the back, so waddle returned on the second set. But I’m still impressed, less resting, using uneven ground. The walk is getting straighter.

Tuesday’s physio appointment consisted of

Hip Bridges with Football between knees 25reps

Front leg raise and abduction red banded 25reps

Lie on front, bend knee and lift red banded 25reps

Sitting red band around knees hip abduction 25reps

Swiss ball between knees and squeeze adduction 25reps

Side steps red band around knees 80 steps

Came out barely able to walk!! Combined with Mondays couch to 5k and this physio session I’m done. Feels like walking on a dagger in the joint. And my lower back is aching. Need hot water bottle and rest now.

Had good discussion about a replacement with physiotherapist, but I’m still unsure. Whereas before my steroid injection I was deadly sure, so although the pain isn’t 100% gone it’s obviously improved enough that my mind has changed. Ever mindful that it will wear off soon though.

Wednesday is Mama Moons birthday so all exercise is halted as it’s a day of family and celebrating!! Wish I could spoil her more, but what do you buy the lady that has everything already?

 

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Thursday is #WyattWedding prep, we are invited to our Nephew’s wedding, so of course I had to make some hairpins for myself

 

Didn’t do my hand any good, but I enjoyed the relaxing craft (though it’s difficult on my hand – right hand, left one still wonderful). Now just to pack and ensure everything is already, and we are all prepared for the next few days ahead.

Nails I’m wearing are #Primark nails as I totally rate them, they are my favourite go to nails. I buy a separate brush on glue 99p from #HomeBargains or #BM and they easily last me a week, usually 2 weeks.

So that’s me I’m 43 weeks post #hiparthroscopy and due to steroid injections I’m enjoying life with some niggles.

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42 weeks post #HipArthroscopy

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Well if I was pregnant I have now done a full term and then some… But I’m not. However I do feel more in a position to judge the arthroscopy surgery and it’s results so far.

Am I pain free? Quick easy answer is NO. but I’m coming to terms with its unlikely to be that painfree ever.

Am I more mobile? This is more difficult to answer, Yes I am doing more, but mainly because my mind isn’t as broken as before. And the realization that this may be as good as it gets forever, spurs me to make the most of it regardless.

Before my mind was truly broken, I didn’t trust my ability and stamina, I definitely didn’t trust the legs.

This past 9 months has been going to basics, working the muscles from absolutely nothing into legs I do trust to hold me up, they are stronger, I am fitter. (Sadly not lighter though)

It’s been 2 weeks since the steroid injection and it’s been ok, but it’s not been the magic pain free injection I hoped for. But I did have some improvement, so I can’t complain really.

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This week it’s been about getting into an exercise routine once more, though I needed Monday off completely to recover from our barmouth weekend.

Tuesday I did the basic post hip replacement physio exercises

Glute squeeze 20reps x 2

Quad activation 20reps x 2

Heel Slide 20reps x 2

Hip abduction (lying down) 20reps x 2

Short Arc Quad 20reps x 2

External hip Rotation 20reps x 2

Bridging 20reps x 2

Pull in stomach breathing 20reps x 2

Hip flexion (ankle weights) 20reps x 2

Hip abduction (ankle weights) 20reps x2

Hip adduction (ankle weights) 20reps x 2

Hip extension forwards (ankle weights) 20reps x 2

Hip extension backwards (ankle weights) 20reps x 2

Heel to buttock (ankle weights) 20reps x 2

Mini squat (ankle weights) 20reps x 2

Hip pendulum (on step ankle weights) 20reps x 2

Looks like a lot, but broken down in an overall day of physio. It’s done slowly and methodically, with resting at times. All its for is muscle activation and strengthening.

Wednesday to rest the lower limbs it was a weights day. I’ve read that if you have Arthritis you should try and lift between 5% to 10% of your body weight, so you don’t lift too heavy and speed the disease up. I use 7kg for my arms now, but I started slowly and light at 2kg at first. I don’t do much as hands and elbows are in a joint flare up today.

Bicep curl 10reps x 2

Shoulder press 10reps x 2

Lateral raise 10reps x 2

Bicep row 10reps x 2

Tricep kickback 10reps x 2

Chest press 10reps x 2

Tricep overhead 10reps x 2

Kettle bell swing 10reps x 2

Again it looks more than it is in reality, and the sets are broken up between morning and afternoon. It’s to lubricate and activate, more than anything.

Thursday I can feel a change in the air, my joints ache, mainly my fingers and elbows. Although hip is niggly too. Opt for a day of mostly rest, painkillers and hot water bottles. I discovered I can’t even lunge my left foot behind me due to ankle issues ( I rolled it in may 2017 and it’s still not right now. Perhaps I should see someone) I did try some compound exercise for physio though, only 5 exercises but they killed me off.

Goblet Squat 10reps x 2

Three point row 10reps x 2

One dumbbell reverse lunge 10reps x 2 (actually can’t officially lunge, it’s more of a step back, and letting leading leg take weight, super easy for most folks but for me it’s painful and very difficult)

Single arm chest press 10reps x 2

Supine marching 10reps x 2 (this really pulled operated legs glutes into action, but also hurt my groin. Don’t think hip is ready for this? It’s meant to work your core, but I felt it all in the hip??)

Friday I honestly feel bodily broken so it’s probably a curl up on the sofa, hot water bottle and Netflix kind of day. Frustrating as brain says go, body says NO. But I’m pleased I managed 3 days of various physiotherapy exercises, so if I don’t do anything today that’s still self care and productive in my healing.

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Weekend away with family

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Day 9, 10, 11, 12 post #intra-articular steroid hip injection, and day 2,3,4,5 for post steroid hand injection. Both have been tested greatly in our weekend adventures.

Sunny Barmouth has been glorious this holiday!! We loved swimming in the sea, I got to have my nephew’s swimming with me, and such giggles we had all round.

The cottage was amazing, it was 300yrs old,the history and tales it could tell. All higgledy piggledy and full of character.

Walked along beaches, which is still hugely problematic hip and mobility wise. Hip is 80% better than before the steroid, so it’s not fully pain free. Hand however is absolutely fabulous. Aches yes at the end of the day, but I expected that. Beach walks take A LOT out of me, and pain levels soon rise quickly.

So now we are home, it’s time to rest for a while, to settle the hip down and see how long it stays angry for. But I’m definitely impressed with the hand pain which had totally crippled me up until that steroid injection. I wonder how long it will last for?

Day 7 + 8 post #intra-articular #steroid injection in Hip.

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It’s been a week, and Wow that time has flown by!!

Today it’s a MiCats appointment for my hand, and I honestly expected nothing, except maybe a referral to a rheumatologist. Which did happen, hopefully appointment in 6-9 weeks time, but also I was offered the #steroid injection into the CMC joint today. I said yes, though nervous. Nicer to get it out of the way.

The doctor was lovely, she confirmed again there is no Rheumatoid Factor but high levels of inflammation. And the DIP joints ( finger top knuckles) as well as basal thumb joint all show wear and tear indications it’s Arthritis, or my Ehlers Danlos Syndrome. Something is happening, so it’s a process of elimination now.

Injection did smart a bit, once again I had Marcaine, Lidocaine and Kenalog injection. I’m happy as so far it’s just been hair loss as a side effect.

This is in the evening, so looks ok. Super stiff and achy though. Hurts to use, so having 24hours off. Been instructed to brace it as well.

Hand swelled up too, so I’ve removed my rings just in case.

Hip wise I confess it’s been nagging, bit grumbly and not quite right. But it’s nearly that time of the month, which usually sends ALL my joints haywire and extra painful too. So it could be that. That groin pain has gone again though so that’s all good.

Day 8 it’s mad dash packing day, why do I leave it until the last minute?? Only popping to barmouth in a cottage with family, but should be a giggle. 2 nights 3 days away, hope this weather lasts!! Packing one handed is pretty difficult I might add.

Woke up with a super stiff right shoulder and neck, not entirely sure why though? Going to need hot water bottles and ibuprofen today. Hand feels pretty good, just braced to limit its range for now.

Hopefully all will be ace while we are away, and I will be pain free too. Have a lovely weekend my lovelies xx

Steroid injection day 5 + 6

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Pleased to say all is quiet on the hip front, although clearly I did too much yesterday as my operated leg quad muscle was aching all day on day 5. So that prompted a total lower body rest. Boring but I feel necessary, as I have Physio the following day anyways at the Hospital.

I chose to do free weights so I’d at least got a workout done, making me feel productive and it helps mentally as well as physically. And not forgetting to sunbathe, seriously can’t believe the luck we’ve been having with all this glorious sunshine and warmth.

My new appointment for my 6week post injection date came through, it’s for August 21st. Here I think I’ll push for more answers on scar tissue and if there’s any point in delaying a hip replacement now?!

Day 6 saw me at the hospital for physiotherapy, so I can ask advice and let her assess if there’s any movement improvement, better range or stamina. As it’s so hard to gage it yourself. Awoke with awful Glute pain, not sure why though? Seems weird it was the Quad muscle, now it’s the opposite Glute muscle?

Front leg raise

Then front leg raise to abduction

Football between knees hip bridges, then into sitting up and hip adduction.

Prone lying on front, bend knee and raise.

All these actually eased off some muscle aches. But it did hurt the groin so I’m having to rest up and increase painkillers. Bored though, so I think I best watch the football to entertain me.

Steroid injection day 3 + 4 successes!!

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What can I say, I woke up feeling great today, though sticky from all our UK heatwave. But I’m not complaining, this heat is glorious. I expected at least 2 weeks of grumpy hip issues, and a catalogue of side effects like in 2016. But this time I’ve not really had any, a small extra amount of hair loss, but I have such thick hair it’s not too bad!!

Gently gently I’ve done some post operative physio exercises, and some days the groin pulled, but today on day 3 it didn’t!! And I’m not walking with a limp as much. Been eating light and well in this sunshine, so that’s a bonus.

So on Day 3 we decided in the gorgeous sunset to complete our week 3 of #couch25k. Crazy probably, but my god we did it. Hip coped fine, though I activated my #piriformis pain near my glute scar. I must stress I’m not actually doing the required times like a normie would, it’s all adapted to me and my disability and abilities.

Day 4 slightly sore knees, not sure if from just arthritis in general or from the steroid?? Side effects seem to be near to zero, whereas before I had 2 weeks of hell. Though last time I had Kenalog I got vertigo?! Wonder if that happens again.

Felt fine with physio exercises, so I introduced

  • Swiss ball pelvic tilts 20reps
  • Swiss ball hip glides 20reps
  • Swiss ball knee lifts 20reps
  • Swiss ball knee extensions 20reps
  • Swiss ball hip adduction squeezes 20reps

Then I continued with

  • Heel slides (lying down) 20reps
  • Front leg raise (lying down) 20reps
  • Front leg raise+ abduction (lying down) 20reps

It aches afterwards but that’s to be expected, and I rest well afterwards too. Only taking 1 x ibuprofen 400mg when really needed, often choosing hot water bottles even in this heatwave.

 

Intra-articular steroid injection Day 1 + 2

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On the 27th I had my injection and this time round I had

  • 1ml Kenalog 40mg
  • 4ml Marcaine 0.25%
  • 5ml Lidocaine 2%

So that’s 10mls in total inside the hip. I had a different steroid in 2016, not had Kenalog since 2012? Or 2013.

I slept pretty well, the hip feels tender and bulky, so movement was restricted and I needed Ibuprofen 400mg as soon as I got home and 1 again for bed time.

Woke up feeling good, managed a few heel slides, front leg raise and hip abduction while lying down, just to lubricate the joint moving. But after a couple of these, I felt a sharp groin ache.

So that was my cue it’s too early to aggregate hip. Which means I should probably sunbathe and rest up as much as possible.

Lets see what the next few days bring, I have to do a pain diary for 6 weeks, until I see my Consultant, so I can give him as much information as possible.

Had a brilliant BBQ outside, so that was a lovely way to spend my evening. I am managing well with my walking stick, just pulls as I walk (perhaps that’s the hip flexor?)

Today I’m attempting some hip flexion, hip abduction, hip extension while standing, but only 10 reps of each, to assess its working. My aches are mainly felt in outer hip under my glute scar. And of course the dreaded groin ache too. But they are dull manageable aches at least. Still taking ibuprofen 400mg.

It’s another sunny day, so no doubt more sunbathing and resting at least for now. Hoping it all kicks in soon, so we can continue with our couch25k walking and not lose our progress.

Steroid injection day!!

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In the run up to this day, we’ve had a birthday party for our brother in law Simon, cue hilarious evening all round. I even won prosecco pong!!

But I did drink a tad too much, so Sunday morning was a hangover day!!

Monday came and went so fast, we had glorious sunshine and we sunbathed outside while we can. Feeling a tad poorly and snotty at this point. Stressed out they may cancel my steroid injection! Eek!! That would be awful.

Tuesday is here and I feel better in myself thankfully. Just a small cough and bit snotty but nothing like yesterday. So I’m going to try and do my appointment, as it’s not a general anaesthesia it’s only local. Throughout the day I felt better and better, I took an antihistamine and it cleared up the runny nose, so I’m thinking it was hayfever??

Wednesday is here and it’s the day I get the injection. Packed light overnight bag just in case, with just sone PJ’s in, I’m wearing easy leggings and t-shirt and flossy shoes, so everything is easy to slip in and out of. Packed a book. #ReadyPlayerOne headphones and phone, that should be me all set!

Sidenote this heat has been perfect for my hand pain, it’s not gone entirely but overall it’s amazingly different. So that’s a bonus.

Got there and had an hour’s wait straight away. This was 1.30pm. Nothing too major. I was then called through, weighed and measured height. Then off to a ward to wait.

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Ace it’s empty or so I thought, I get pulled into theatre and get my arrow. This was 2pm.

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Then I’m told to wait in the waiting room, gutted I thought I was being done now.

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Finally at 3.10pm I’m called through, it’s my turn. Easy quick check that I am who I say I am, that I know what they are doing. Then it’s time to lie down.

Steroid done, and omg that HURT, so much more than before. Last one like this was 2 yes ago. Also he said ‘what on earth is that? oh must be scar tissue, I haven’t seen it that bad on someonebefore’ he told me that’s why it was extra painful.

It was painful! The initial needle was ok, but it needed moving around, the sensation is odd and I flinched a few times I’m embarrassed to say. Holding my nurses hand to stop me moving too much. The air had to be blown into it, to ensure correct area, weird tightening feeling but at least not too painful. Then finally the steroid is pushed into joint, and I could feel it going in, odd feeling but at least it didn’t last long.

Once done it was time to wiggle hip to work it in, and then off to sit on the ward to wait 20-30mins before I can go home.

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Least I have coffee and biscuits to ease my shellshockedness. Once I knew I was free to go, off I went to find my husband. Free to go home and relax at long last at 4pm. Bit of a long day, but could of been worse. And though it HURT I still rather do it this way, than be under a general anaesthesic because I get to go home, eat and move so much quicker.

So that’s me for now. I have to keep a pain diary and see my consultant in 6weeks time.

5 days and counting to steroid #couch25k

Archive, Health, Hips, Hypermobility, Hip Arthroscopy, SURGERY, Triple Pelvic Ost, Femoral Ost, PAO

As you know I’m 39 weeks post #hiparthroscopy and I’ve been doing all I can to increase my muscle strength, lose weight (not actually losing which is annoying) and generally trying to be healthier and fitter. Though I’ve not lost any weight, I feel better, feel stronger and not as bulky!!

This week 3 run has been a nightmare, it’s 1.5mins run (walk unaided for me) then walk normal 1.5mins, then 3 mins run, 3 mins walk. Do this sequence twice. But this sudden leap up from 1.5mins to 3mins has made it very hard. So as I write this I’ve managed 2 run out of 3 (3 runs or 3 outings each week is set) per week. How everyone gets out 3 times in a week is beyond me, and way beyond my pain threshold too.

So last Friday on 38 weeks post op we did run 1 week 3, and today it’s Friday and we are finally doing run 2 week 3. At least we have stunning scenery to do it in, so the fresh air and sights heal my soul as well as physically.

In my defence we’ve had family get-togethers, physio at hospital too, then an awesome #LennyKravitz concert and the following day my grandson came for the day, so seriously not had energy or will to do it.

Pain wise it’s been HARD this week, and not my hip either. My left ankle has been awful and rolling inwards lately. Plus my left hand is dreadful. But more worryingly my right hand is having some stiffness, my elbows both sides often feel strange. It’s like one minute I was fine ish, then suddenly over the last 3 months it’s spread it’s more days of feeling like I’ve been hit by a train. I’m hoping come July I will have a better idea of what’s going on.

Saturday it’s carnival time and seeing family again, so no exercise persay, but me doing stairs certainly feels like an epic battle! And much needed physio to help strengthen my legs up. But my groin is on fire, it’s grinding as I walk, so I’ll have rest as much as possible too.

39 weeks post #hiparthroscopy on a countdown…

Archive, Health, Hips, Hypermobility, Hip Arthroscopy, SURGERY, Triple Pelvic Ost, Femoral Ost, PAO

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It’s my 9 days countdown to the #intraarticular #steroidinjection in the hip!! I’m excited, nervous, terrified yet chilled about it. I’m literally every emotion under the sun!!

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Though it’s an awake procedure, and I should go home around 30mins afterwards, I do have to go prepared with an overnight bag just in case. So in this I will pack minimal.

  • Medication
  • Glasses
  • Dressing gown
  • Slippers
  • Phone charger
  • Headphones
  • Tablet to watch downloaded shows
  • Book

So not too much, but enough to entertain me, and cover me up should I need to walk around to the loo. Obviously I’m taking my walking stick too. As I know from experience, the leg feels dead and numb. So walking is awkward even with a walking stick.

I’ll be wearing shorts, so no need to strip off. I can do absolute minimum and be more time efficient. So what is an Intra articular Steroid Injection? What does it do?

Intra-articular Steroid Injections for the Hip

Intra-articular steroid injections are a prescribed treatment for relief from joint-pain. The steroids administered through the intra-articular injections are used to decrease the inflammatory reaction associated with osteoarthritis and rheumatoid arthritis.

This means the intra-articular steroid injections are administered with the aim of providing 2 to 6 weeks of pain relief for patients with hip osteoarthritis. (God i hope longer!!) However, the higher-dose steroids with or without joint lavage can provide pain relief for a period as long as 24 weeks. Honestly out of 3 I’ve had the longest relief I got was mere 2-3weeks)

Research shows that the intra-articular steroid injections delivered for relief from the pain related to hip osteoarthritis can produce highly effective results as compared to the standard form of treatment. But those with #EhlersDanlosSyndrome like me, may find it’s limited in terms of longevity.

Often patients who were administered intra-articular steroid injections showed a significant improvement in all the symptoms including pain, stiffness, physical function and global assessment as against those given the conventional form of treatment and medications. I’ve experienced this, in 2016, but it was only for a few weeks. It was heavenly though.

Hip Osteoarthritis

Intra-articular steroid injections are extensively used for treating the pain associated with hip osteoarthritis. In addition, steroid infiltration into the arthritic joints is now a very common means of treating pain. This form of treatment is also done to differentiate pain in the hip from that in the low back or knee. All of my previous 3 steroid injections were used as diagnosis points. This one is specifically for pain relief. Will it work?

There are various types of preparation of steroids that have a different duration of effect and action. The guiding principle which determines the effectiveness of each of these preparations is their solubility.

The insoluble preparations are known to have a longer duration of effect and are the most preferred. For the benefit of analysis, here we briefly list each one of the preparations of the intra-articular steroid injections.

Aristospan (Triamcinolone HEXACETANIDE) – These are the most soluble and preferred preparation for intra-articular injections. The duration of effect is usually 6 months.

Aristocort (Triamcinolone ACETONIDE) – Highly insoluble, this is the preparation normally preferred after the above. This particular preparation normally has a duration of 3 months.

Depo-medrol (Methylprednisolone acetate) – This is highly soluble and should only be used as a last resort. The duration of effect in this preparation is only 5 weeks. (Think this is the only one I’ve had? I definitely had Depo last time 2016) before I’ve had a kenalog one.

we’ve listed the basic steps involved in using an intra-articular steroid injections for the hip.

  1. Selection of preparation to be used for the injection is done, after careful consideration of the extent of the problem and patient history.
  2. The steroid is injected into the joint
  3. At the same time, a local anaesthetic (lidocaine 1%) is injected. This is to confirm whether the pain is relieved by the injection.
  4. Once done, an iodinated contrast is injected to observe immediate distribution of the steroid and local anaesthetic and confirm which joints are being treated.

Specialists dealing with intra-articular steroid injections generally instruct their patients to maintain a simple diary of pain for at least a week’s duration after the injection. The commonly recommended entry in the diary is pain vs. previously expected pain or same physical workload.

A majority of professionals in the field of pain management support the use of intra-articular steroid injections for the treatment of pain that arises due to osteoarthritis of the hip.