I think thats probably similar to the way my doc thinks - with the added limitation of no more than four short courses (injection or oral) per year.

thanks cemc

this is only the second time i've done a pred taper. did one back in aug 2009. so its been awhile. but will be asking about the ssz or humira instead. good to have pred as a backup, but it makes me feel so good, i realize that i need something besides just the ldn and supplements so i can feel like this all the time.

thanks, will call the doctors' office and tell them either no cortisone in the injections or will put the injections off a few months. thanks again.

Hi Sue,

I know most of my drs won't give out more than 4 cortisone shots per year. I am on 7 mgs of prednisone and I asked for half a dose of cortisone in my knee, it was so swollen I could not strighten it out for 4 days and it was waking me up.

I don't know if there is a rule about being on oral steroids and also getting cortisone injections. I thik if the oral dose is somewhat low like mine has been they will give a cortisone injection. I would pick one or the other. If your whole body hurts then go oral and if you just have severe pain in one joint then I guess go for a cortisone injection in that joint. I don't feel right when I get a cortisone shot I prefer oral prednisone, but I think that has to do with the amount again. Cortisone shots are a bigger dose, so that is why I feel so off when I have gotten them.
My rheumy wants me to get a bone scan because he thinks I might have osteopenia, I hope I don't, I eat really well, but all medications have side effects and since I have taken prednisone for over a year, even though a low dose, my bones might have paid a price for it. I have heard it can get better and it's not permanent, hopefully the scan will go well.

Hope you feel better.
Have you had lidocaine injection in the back/si joint? Does it work and for how long?

thanks!

i think you are probably right, i am on a low dose / short course too. and if it were a joint that needed it right now, like yours sounds like, i'd probably do it if my doctors gave me the go ahead.

but for me, these triggerpoints have been around for years now and besides i've had lots of successful triggerpoint injections by other doctors in the past with lidocaine only and they worked like a charm. so i'll give this new doctor a choice, just lidocaine / no cortisone, or wait a few months. but will also see what my rheumy says.

the thing about pred (like maybe most meds) is i hear so much both ways, from doctors, what i read, what patients say. some like an old rheumy really instill the fear into you, even for a short course. others like my new rheumy think a little every so often shouldn't be a problem. i'm sure like most things that the truth lies somewhere in between. so up to us to evaluate and make a decision we can live with; the more informed, the better. sometimes its evaluating who you trust more, and since i trust this rheumy more than the last, simply because he has been helping me and the other one never did (why i ultimately had to move on after 2.5 years of not getting anywhere); but this new rheumy has made me feel better in between flares, and sounds like he's motivated to help prevent the flares, whatever it takes. just the fact that he prescribed the prednisone and had faith in me to not over use it, i think shows faith and trust on both sides. hope your relationship with your doctor is as good.

thanks, yes, the pred has helped me feel a lot better. will be interesting to see what happens when i go back off the pred. hope you feel better as well.

as for the SI joint injection, that's always been with cortisone. first time was topically into the right SI joint. that one worked very very well. was good for an entire year before it flared again. the second time was deep into the joint, bilaterally, with fluoroscopy. that one worked ok for a few months. read something recently explaining why its actually better to inject where the first physiatrist did, vs the way the second physiatrist did. and the first way hurt far far less.

but since i didn't want to make a habit of getting the injections, at least not that second way, i decided to just wear a flector patch over the area 24/7. that works really well except the few times a year when i flare badly. then its no match. but the rest of the time, its a very good solution for me. and this is coming from someone who can't take oral nsaids. i've noticed no side effects with the flector patch, it just simply does what its supposed to do for me.

Sue,
Hey you've given it all you can sister. You are an AS kicker for sure. You've thrown everything you've know at it. I know you don't want to take anything else. None of us do. After 25 years of having this stuff I finally got on board the train and do the NSD,take the Medrol pak's (Prednisone tapers) to get out of a flare, take the sulphasalazine which really helps my elbows and knees and my Remicade and MTX and now the last piece of the puzzle was the Savella for my fibro. I have weaned off of the Percocet by 2/3 now. I am almost pain free having lived at a level 8 for years. I have blood test every 2 month's and just had my whole spine M.R.I. and all is well.

Just try one and see if it helps. They may be all you need. I used to worry myself sick over all of this but to have my body in no pain is awesome. If in the end it all catches up on me so be it. I want some quality of life now. I am not one of those that wants to live to 90. The more the inflammation goes on though, the worst it is on our hearts.

thanks pea

i agree with your sentiments; well put!