Cortisone injection for tennis elbow

ZiggyStar

Has anyone had cortisone injected into their elbow....or another joint?

I've had constant tennis elbow flare ups since 2009. My doctor said the only thing I can do now is inject it with cortisone which may work for 2 months or up to 2 years. It varies with each person. He'll inject me a couple of times with local anaesthetic so the actual injection won't hurt too much (apparently the injection by itself hurts a lot). So I'm not too worried about that.

However, last night I was doing some "research" online and came across a forum which said a few hours and up to 1-2 days after the injection, it HURTS LIKE FUCK!! I read the following comments:

* Worse pain than my 5 caesareans put together
* The pain feels like broken arm pain....but worse
* Feels like a hammer smashing into your elbow over and over and over
* The worse pain I have ever felt in my life and I'll never EVER do it again

Supposed to go in this Friday. Now I'm shitting my pants. Someone tell me it will be okay....!! :?

:shock:

norm

ZiggyStar wrote:

However, last night I was doing some "research" online and came across a forum which said a few hours and up to 1-2 days after the injection, it HURTS LIKE FUCK!! I read the following comments:

* Worse pain than my 5 caesareans put together
* The pain feels like broken arm pain....but worse
* Feels like a hammer smashing into your elbow over and over and over
* The worse pain I have ever felt in my life and I'll never EVER do it again

was this in regards to a shot for tennis elbow?

yes a cortisone shot will hurt initially but it is supposed to alleviate pain...and they don't last...the pain will come back

ZiggyStar

norm wrote:

ZiggyStar wrote:

However, last night I was doing some "research" online and came across a forum which said a few hours and up to 1-2 days after the injection, it HURTS LIKE FUCK!! I read the following comments:

* Worse pain than my 5 caesareans put together
* The pain feels like broken arm pain....but worse
* Feels like a hammer smashing into your elbow over and over and over
* The worse pain I have ever felt in my life and I'll never EVER do it again

was this in regards to a shot for tennis elbow?

yes a cortisone shot will hurt initially but it is supposed to alleviate pain...and they don't last...the pain will come back

Yes, it was a tennis elbow forum I was on.

I was told that sometimes they work really well for long period of time eg 2 years....and sometimes only a couple of months.

Have you had one?

norm

i haven't had one in about 25 years (not for tennis elbow) but they're really for temporary relief...the pain will come back especially in the case of tennis elbow because i don't think there is a cure for it

the only things that have helped for me is push the top of my hand against a wall (fingers pointed down) to stretch those muscles...also there is a brace that you wear on your arm that helps...i'll see if i can find it

edit: http://www.amazon.com/gp/product/B000F5 ... 9PKKT17HDP

chadwick

good luck with your elbow. that probably smarts real good. does the injection make your fingers erect like?

i eat cortisone injections for good-times and stuff. i get em in my knees. sometimes it hurts like a real bastard when the dr is drivin that shit in. yikes. other times it is not so bad.

i think my knees are bone chips, mush, and rust. i will trade you if you like.

afroannnie

norm wrote:

yes a cortisone shot will hurt initially but it is supposed to alleviate pain...and they don't last...the pain will come back

my mom has gotten multiple cortisone shots in her shoulder...and based on her experience what you've read is true..for a couple of days, it's very painful...then the pain goes away. From her experience I think it only lasts for several months and then she has to get another one. However, she works at a daycare with a million 3-year olds that she's picking up constantly,so I would imagine this is part of the reason her pain continues despite the shots.

ZiggyStar

Thanks Norm.

I whacked my elbow on the wall yesterday and it hurt SOOOOO much. I have skinny little arms and my elbow is quite knobby. I hit it often. Need more fat on it.

ZiggyStar

chadwick wrote:

good luck with your elbow. that probably smarts real good. does the injection make your fingers erect like?

i eat cortisone injections for good-times and stuff. i get em in my knees. sometimes it hurts like a real bastard when the dr is drivin that shit in. yikes. other times it is not so bad.

i think my knees are bone chips, mush, and rust. i will trade you if you like.

Does he give you local first to numb the area?

Jamminonthe1

Google and search on youtube for "The Tyler Twist" - I know the guy it's named after and the exercise he came up with has worked for a lot of people. Couldn't hurt (no pun intended) to try.

chadwick

ZiggyStar wrote:

chadwick wrote:

good luck with your elbow. that probably smarts real good. does the injection make your fingers erect like?

i eat cortisone injections for good-times and stuff. i get em in my knees. sometimes it hurts like a real bastard when the dr is drivin that shit in. yikes. other times it is not so bad.

i think my knees are bone chips, mush, and rust. i will trade you if you like.

Does he give you local first to numb the area?

i guess... i know hefreezes it w/ this liquid spray shit..very cold
then i get two shots. one is way larger than the other.

then he does the other knee...
except this last time he did just the left...

how long you had pain in your elbows?

ZiggyStar

afroannnie wrote:

my mom has gotten multiple cortisone shots in her shoulder...and based on her experience what you've read is true..for a couple of days, it's very painful...then the pain goes away. From her experience I think it only lasts for several months and then she has to get another one. However, she works at a daycare with a million 3-year olds that she's picking up constantly,so I would imagine this is part of the reason her pain continues despite the shots.

Well that's kinda why I'm trying to get it sorted....because I'll hopefully be having a baby next year and it hurts when my bf passes say me a bottle of coke....so constantly holding and picking up a baby is going to aggravate it a lot.

If the shot is that short term ie a few months, I don't know if going through all that pain is worth it though.

norm

ZiggyStar wrote:

Thanks Norm.

I whacked my elbow on the wall yesterday and it hurt SOOOOO much. I have skinny little arms and my elbow is quite knobby. I hit it often. Need more fat on it.

does your actual elbow hurt or does the muscle at the top of your forearm just below the elbow hurt?


and if you need fat, i've got loads to spare :P

ZiggyStar

Jamminonthe1 wrote:

Google and search on youtube for "The Tyler Twist" - I know the guy it's named after and the exercise he came up with has worked for a lot of people. Couldn't hurt (no pun intended) to try.

Just looked it up! Thanks. Worth a shot! (pun intended)

ZiggyStar

norm wrote:

ZiggyStar wrote:

Thanks Norm.

I whacked my elbow on the wall yesterday and it hurt SOOOOO much. I have skinny little arms and my elbow is quite knobby. I hit it often. Need more fat on it.

does your actual elbow hurt or does the muscle at the top of your forearm just below the elbow hurt?


and if you need fat, i've got loads to spare :P

Upper knobby bit hurts. And the muscle at the top of my forearm too. When I straighten my elbow fully or bend it fully that muscle hurts and also the crook of my elbow hurts. The whole fucking region is sore basically. I sleep a lot with my elbows bent and some mornings waking up and straightening it is a bitch!

ZiggyStar

Chad, it's my right elbow and has been sore since 2009.

chadwick

ZiggyStar wrote:

Chad, it's my right elbow and has been sore since 2009.

ouch. is it from when you are chasing and climbing after all the treefrogs? this is when it aches?
i also get bi-monthly cortisone injections in my tongue and john.

green mountain man

I had to cortisone injections in the bottom of my foot for plantar faciitis. They did not relieve the pain one bit. It hurt during the 5 second injection, but not after.
Since overuse is the most frequent cause of TE ,REST is the most important modality. Did the MD take a detailed analysis of your occupation and recreational activities to assist in planning treatment and prevention ? Were NSAIDs and ultrasound tried ? Ask about an epicondylar splint. What about PT ?
Surgical release of the extensor origin may be required to relieve symptoms ( as a last resort )

ZiggyStar

chadwick wrote:

ZiggyStar wrote:

Chad, it's my right elbow and has been sore since 2009.

ouch. is it from when you are chasing and climbing after all the treefrogs? this is when it aches?
i also get bi-monthly cortisone injections in my tongue and john.

hahaha No, not from chasing tree frogs. lol

Your tongue? and john? You're crazy!

ZiggyStar

green mountain man wrote:

I had to cortisone injections in the bottom of my foot for plantar faciitis. They did not relieve the pain one bit. It hurt during the 5 second injection, but not after.
Since overuse is the most frequent cause of TE ,REST is the most important modality. Did the MD take a detailed analysis of your occupation and recreational activities to assist in planning treatment and prevention ? Were NSAIDs and ultrasound tried ? Ask about an epicondylar splint. What about PT ?
Surgical release of the extensor origin may be required to relieve symptoms ( as a last resort )

Where the injections in your foot in the actual joint?

No, he didn't do any of that. I work on my computer all day....with a bent elbow....so rest is basically impossible.

Playing tennis hurts like fuck too. Such a shame....was really enjoying tennis this year.

FUCK! He's emailing me back with an appt time for Friday. I don't know what I should do. Arrggghhh!!

green mountain man

One more thing. They can do those injections with a scope to avoid hitting nerves. Doing it free hand is more likely to cause pain if not done in the right place.

ZiggyStar

green mountain man wrote:

One more thing. They can do those injections with a scope to avoid hitting nerves. Doing it free hand is more likely to cause pain if not done in the right place.

Hopefully the local injections will relieve the actual pain from the cortisone injection....maybe.

What size needle do they use? My bf said the needle is massive....don't ask me how he knows....he's never had one.

I feel ill just thinking about this.... ....but it may relieve the annoying pain.

Halifax2TheMax

I just had a cortisone injection in my neck for a pinched nerve between my C6 and C7 vertebrae on Monday. The injection and experience was not fun and I won't know until 5 to 8 days later if it'll work. But I think why it hurt so much was the location. A long needle going through cartiledge, lots of snapping, crackling and popping. It didn't hurt until they pulled the needle out.

A few years ago I had them in my heels for high arches. The injections hurt but with physical therapy of stretching out the tendons and wearing inserts in my shoes for arch supports, I can get out of bed and walk first thing in the morning and not be hobbled like James Caan in Misery. I'm fine now in the foot department.

I'd recommend getting them as most everyone I've spoken to has gotten relief and you can avoid surgery. I'll let you know in a few days whether it worked for my neck, which is similar in pain to what you describe except it starts in my shoulder, travels down my arm to my elbow, where it feels like I've constantly whacked my funny bone, numbs the top of my forearm and makes the tips of my index and middle fingers feel like they're asleep. So, I feel your pain! And if this doesn't work, its under the knife or grin and bear it, neither of which appeal. If you haven't already, get an MRI or consult with an orthopedic surgeon.

Good luck!

Peace.

green mountain man

The needle size is relative to the area of inflammation.
The doctor should have discussed those other treatment options before deciding on a shot

norm

sus have you tried icing it? 10-15 minutes every few hours combined with some anti-anflamatories might be better than cortisone

gimmesometruth27

ZiggyStar wrote:

Has anyone had cortisone injected into their elbow....or another joint?

I've had constant tennis elbow flare ups since 2009. My doctor said the only thing I can do now is inject it with cortisone which may work for 2 months or up to 2 years. It varies with each person. He'll inject me a couple of times with local anaesthetic so the actual injection won't hurt too much (apparently the injection by itself hurts a lot). So I'm not too worried about that.

However, last night I was doing some "research" online and came across a forum which said a few hours and up to 1-2 days after the injection, it HURTS LIKE FUCK!! I read the following comments:

* Worse pain than my 5 caesareans put together
* The pain feels like broken arm pain....but worse
* Feels like a hammer smashing into your elbow over and over and over
* The worse pain I have ever felt in my life and I'll never EVER do it again

Supposed to go in this Friday. Now I'm shitting my pants. Someone tell me it will be okay....!! :?

:shock:

i work with an orthopedic physician and we do cortisone injections every day. we used to do the lateral epicondylar (tennis elbow injection) several times a week. now we only do 2-3 a month. if that...

the injection is not into the elbow joint. the injection is into the tendon that attaches to the lateral epicondyle. if not the tendon it is a little closer to the muscle belly just below that tendon. it depends on where the symptoms are. this injection is VERY painful because he would be injecting a painful and inflammed area. with this injection, the way the research says it should be done, and the way we do it, it is not just a straight injection. we employ a "peppering" technique which consists of the doctor poking and redirecting the needle up to 20 times to create trauma to help "jump start" the healing process. many times the body will create scar tissue in a chronically inflamed area and the body will "call it good" and stop trying to heal the area. the peppering technique creates trauma to the area and the body's response is to begin the healing process there again.

this injection is something that my doctor will not repeat until 4 months after the prior injection, and will limit them to 3 injections per calander year. side effects such as tendon weakening with increased chance of rupture and thinning of the skin and fatty tissue at the injection site can happen with prolonged repeated exposure to cortisone. we will not inject more than that because the more you inject the more likely those complications can occur.

in our experience patients describe 2-3 days of pretty intense pain and then gradual reduction in pain. the key is to REST for 4-5 days after the injection. sometimes people feel so good afterward that they "overdo it" with too much activity too soon and the injection will have been wasted. we do not use a numbing injection before hand. instead we include marcaine, a local anesthetic, in the injection. just prior to the injection i numb the skin with a freezing spray called ethyl chloride and it lessens the pain of the procedure but it does not numb the deep tissues ebcause the spray does not penetrate.

all of that above said, there is some hope for you, if you can find someone in australia that can do these techniques...the reason we do not do many of these injections anymore is because we have found 2 treatment modalities that are very effective for treating tennis elbow, and all other tendinopathies.

they are called:

1. the ASTYM technique

2. the Graston technique

both are designed to break up fibrosis in the affected muscle group and the entire extremity. we recommend ASYTM more often because the tools they use are acrylic and it is a gentler technique, while the Graston uses metal tools and is a little more aggressive and we have some patients complain that it hurts. it usually takes at least 8 visits of physical therapy with ASTYM to get you over the worst of it. I have had DeQuervain's tenosynovitis and was facing cortisone injection as well. I chose the ASTYM route and got better in 5 visits. It does not help everyone, but it is worth a shot in your case. along with the ASTYM and the other modalities that have been recommended in thie thread, you must use strengthening exercises as well, specifically ECCENTRIC exercises. the current research suggests that eccentric exercise is the most important component of a rehab protocol relating to tendinopathies.

you should google ASTYM and graston techniques and see if there are providers in your area and then ask your doctor if it is something worth trying. it works for our patients, and the proof of that is in the significantly reduced number of tennis elbow injections we have done the last 2 years when compared to the 4 years before that. the 2 doctors i work with swear by those techniques, and if a physical therapy company does not have those techniques, we don't refer patients to them. as a result, every physical therapy location in a 30 mile radius of our office has gotten at least one ASTYM or Graston certified physical therapist. believe me, it is worth looking into. good luck with whatever course of treatment you take!

norm

what gimmie said

ZiggyStar

norm wrote:

sus have you tried icing it? 10-15 minutes every few hours combined with some anti-anflamatories might be better than cortisone

No, I haven't iced it. Strapping it works sometimes....makes it harder to bend.

I can't take anti-inflammatories because I'm trying to conceive.....dammit! :x

gimmesometruth27

here are some links...

http://astym.com/default.asp

http://astym.com/patients/default.asp

http://www.grastontechnique.com/



this last one is the site for my office.....shameless plug :oops: :oops:

http://www.ilsportsdoc.com/

green mountain man

I think you should change your MD, You have recieved better advice in this forum than the Doc's office.

ZiggyStar

gimmesometruth27 wrote:

i work with an orthopedic physician and we do cortisone injections every day. we used to do the lateral epicondylar (tennis elbow injection) several times a week. now we only do 2-3 a month. if that...

the injection is not into the elbow joint. the injection is into the tendon that attaches to the lateral epicondyle. if not the tendon it is a little closer to the muscle belly just below that tendon. it depends on where the symptoms are. this injection is VERY painful because he would be injecting a painful and inflammed area. with this injection, the way the research says it should be done, and the way we do it, it is not just a straight injection. we employ a "peppering" technique which consists of the doctor poking and redirecting the needle up to 20 times to create trauma to help "jump start" the healing process. many times the body will create scar tissue in a chronically inflamed area and the body will "call it good" and stop trying to heal the area. the peppering technique creates trauma to the area and the body's response is to begin the healing process there again.

this injection is something that my doctor will not repeat until 4 months after the prior injection, and will limit them to 3 injections per calander year. side effects such as tendon weakening with increased chance of rupture and thinning of the skin and fatty tissue at the injection site can happen with prolonged repeated exposure to cortisone. we will not inject more than that because the more you inject the more likely those complications can occur.

in our experience patients describe 2-3 days of pretty intense pain and then gradual reduction in pain. the key is to REST for 4-5 days after the injection. sometimes people feel so good afterward that they "overdo it" with too much activity too soon and the injection will have been wasted. we do not use a numbing injection before hand. instead we include marcaine, a local anesthetic, in the injection. just prior to the injection i numb the skin with a freezing spray called ethyl chloride and it lessens the pain of the procedure but it does not numb the deep tissues ebcause the spray does not penetrate.

all of that above said, there is some hope for you, if you can find someone in australia that can do these techniques...the reason we do not do many of these injections anymore is because we have found 2 treatment modalities that are very effective for treating tennis elbow, and all other tendinopathies.

they are called:

1. the ASTYM technique

2. the Graston technique

both are designed to break up fibrosis in the affected muscle group and the entire extremity. we recommend ASYTM more often because the tools they use are acrylic and it is a gentler technique, while the Graston uses metal tools and is a little more aggressive and we have some patients complain that it hurts. it usually takes at least 8 visits of physical therapy with ASTYM to get you over the worst of it. I have had DeQuervain's tenosynovitis and was facing cortisone injection as well. I chose the ASTYM route and got better in 5 visits. It does not help everyone, but it is worth a shot in your case. along with the ASTYM and the other modalities that have been recommended in thie thread, you must use strengthening exercises as well, specifically ECCENTRIC exercises. the current research suggests that eccentric exercise is the most important component of a rehab protocol relating to tendinopathies.

you should google ASTYM and graston techniques and see if there are providers in your area and then ask your doctor if it is something worth trying. it works for our patients, and the proof of that is in the significantly reduced number of tennis elbow injections we have done the last 2 years when compared to the 4 years before that. the 2 doctors i work with swear by those techniques, and if a physical therapy company does not have those techniques, we don't refer patients to them. as a result, every physical therapy location in a 30 mile radius of our office has gotten at least one ASTYM or Graston certified physical therapist. believe me, it is worth looking into. good luck with whatever course of treatment you take!

Wow! Thank you so much for all the info! Does ASTYM work forever? Did your problem recur after your 5 treatments?

Basically, I want to know if tennis elbow ever really goes away completely....or will I have this for the rest of my life?

norm

ZiggyStar wrote:

norm wrote:

sus have you tried icing it? 10-15 minutes every few hours combined with some anti-anflamatories might be better than cortisone

No, I haven't iced it. Strapping it works sometimes....makes it harder to bend.

I can't take anti-inflammatories because I'm trying to conceive.....dammit! :x

well you should try icing it for a few days...as far as i know, tennis elbow really never goes away but the info that gimmie provided should keep it under control