Thanks for saying this because that’s my understanding of steroid injections. Well maybe not 2 in your lifetime but I’d definitely heard (several family members) that once you’ve had one it will be years before they’ll do another. I’ve had family who have had immediate relief from them but quite short term hits and they are gagging for a second but Docs won’t let it happen. I’m pretty sure they spell that out to you when you have your first because it’s a bit of a last chance saloon procedure before surgery
Rheumatology at Guy's is pretty forthright about their opinions on multiple steroid joint injections - I've seen it put in my notes that I can't have any further ankle or foot injections and they're holding off on the shoulder and hip because of the only two in a lifetime policy; they're not particularly keen on having to perform reconstructive surgery for people with spontaneous complete ruptures of tendons in the fortnight after one shot too many, according to the consultant. PsA and EDS combine to become a right bastard, don't they? I did half jokingly ask what about just giving the anaesthetic and leaving the steroid out - the answer was that the act of injecting the joint itself was also a risk of infection and they're already worried that the ims I've had in the past had contributed to the tendinosis around my hip.
I've never put weight on from injectable steroids (did have a bloated face and developed a fat pad on the back of my neck when on a three month course of oral ones, but didn't actually get heavier) - I've actually lost weight afterwards because I've actually been able to be more active and able to shop/cook/eat more healthily with the increase in mobility. The only thing I'm careful with is taking time to go back to the gym and sticking strictly to range of movement on the affected joints/no weight on them for three weeks afterwards.
However, I've not gone to Venice and eaten my bodyweight in gelato afterwards, which might have something to do with it. And I've always gone back to work either that day or the day after, rather than being able to flump around a bungalow with three freezers and free money to spend on shite for months
years on end.
ETA: I used to get dexamethasone but Guy's stepped it down to methylprednisolone because the risk profile is slightly better.
Cortisone is the 'weakest'/shortest acting one.
Relative Potencies of Systemic Glucocorticoids
Corticosteroid | Activity | Relative potency | Equivalent dose (mg) |
---|
Dexamethasone | Long-acting | 25 | 0.75 |
Prednisone | Intermediate-acting | 4 | 5.0 |
Methylprednisolone | Intermediate-acting | 5 | 4.0 |
Hydrocortisone | Short-acting | 1.0 | 20.0 |