I have stage four metastatic breast cancer in my hip, T12, ribs and skull. I have “stable disease “ per oncologist. Ironic right? All us horse lovers have stable disease!
Anyway, only have pain in the hip and got the cortisone shot last week. Oncologist says since tumors are stable she doesn’t think pain is from them and orthopedist says he sees good cartilage and minimal arthritis.
No major noticeable relief yet. Anybody else been through this? Hoping I can walk better soon.
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IME,
If you haven’t gotten relief from the cortisone shot in a week, you probably won’t. Sorry.
I usually get relief immediately - no later than than 48 hours after the shot. The variable for me is how long the relief lasts. I’ve had knees, wrists, shoulders and lower back injected.
I think something else is causing your hip pain. 
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In November I had a cortisone injection into my left hip joint for advanced arthritis, and the relief was immediate, with full relief, as in zero pain, in that 48 hour window McGurk said. Unfortunately the pain started creeping back in around the 2 week mark, so I’ll be having a THR in March. All the other people I know who’ve had cortisone injections have also had pretty immediate relief
Have you had any MRI done to see what sort of soft tissue damage there might be?
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Chiming in to agree with McGurk and JB. I have had 3 injections over a 10 year span and the relief was almost immediate. I am sorry you aren’t feeling any relief. Hope your doctors can come up with a Plan B to treat your pain.
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It really depends on the steroid used. Longer acting steroids take longer to kick in. They’re also more likely to cause a painful inflammatory flare following injection.
If a longer acting steroids was used, it may be a couple weeks before you begin to feel effect, and the effect ramps up gradually. One of those things where in a couple few weeks, you realize “hey, my hip doesn’t hurt as much as it used to!” rather than a lightning bolt of immediate improvement.
Steroid injection often includes an anesthesic component. If you received anesthetic in the joint, you should’ve had great relief for the duration of the anesthesic (~1-4 hours post injection, depending on which one was used). If you got zero relief from anesthesic, that indicates your pain isn’t stemming from inside the joint itself. If that’s the case, more work to identify what’s causing your pain is warranted, and the steroid is not likely to be effective (because the hip joint isn’t the problem.)
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I hope you get some relief soon.
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I am so sorry you are dealing with metastatic breast cancer.
As for cortisone injections, I’ve had them in many joints and bursas. I haven’t had one into the hip joint, but I’ve had so many into hip bursas as my rheumatoid arthritis triggers hip bursitis. They work amazingly fast. One time I couldn’t walk at all, and my husband got me into the rheumatologist’s office in a wheelchair. I walked out after the injection.
I’ve done two rounds of knee injections, and they have been very helpful.
The problem with joint and bursa injections is it takes great skill to get them in the exact right place.
Rebecca
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I’m jingling for you. Not much help, I know.
I hope your entire body gets better.
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Just to provide some additional info:
Steroid joint injections never have immediate effect. The steroid always needs time to work. Depending on the steroid used, that can be days to weeks.
Steroid is often paired with an anesthesic. Not only does it make the injection itself more comfortable (pressurizing a pissed off joint with a load of fluid very often feels pretty crappy), the anesthesic does provide very immediate pain relief. This is diagnostic–is this joint actually the pain generator? Common anesthetics used in joints are lidocaine, bupivacaine, and ropivacaine, and these have a duration of action from 1-4 hours (ish.) Some people may have a more prolonged response to anesthesic. (I, sadly, am not one of those people. Sigh!)
Some people may also get relief just from the injection itself, regardless of what’s going into the joint. Degeneration can cause an excess of watery joint fluid–how many of us have seen a solid spurt when a horse gets hock injections?–and relieving that pressure may yield some relief. Or adding anything at all to the joint may provide some “lube” regardless of what the drug being injected is (although that would be pretty temporary.)
Doctors are notorious for not giving patients details on what exactly is going into the joint, how those different things act, or what to expect!
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there are orthopedic surgeons who specialize in oncology and deal w this stuff all the time. so sorry you have to deal w this.
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That was very interesting and informative. Thank you!
Rebecca
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No MRI yet.
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@HPFarmette, I’ve nothing to add medically. I’m sorry this is all happening to you; my hat is off th you regarding your sense of humor and “stable” disease. Well done.
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Thanks all for your kind responses. Had a pretty good week so far, actually.
@NaturallyHappy thank you too. I’ve had a good life, I’m 73, the 5 year survival rate is 30% and I want to be in that number!
This whole experience has made me savor every minute in the barn. As a kid (when I first realized I had "stable disease - the worship of horses) I would have lost my mind with happiness if I had known what great horses I have been able to have and take care of on the farmette.
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Keep seeking some relief for the pain. I like the orthopedic oncology suggestion. Healing prayers for you!
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Thanks, @Simkie, for the explanation.
I have usually had lidocaine injected along with the steroid, and that is what provides the immediate relief. Sometimes there’s a gap between the anesthetic wearing off and the steroid taking effect.
I have also found there to be varying degrees of effectiveness based on how the injection is placed.
Having good imaging and have the doctor place the injection precisely in the problem area makes a huge difference, especially with the spinal epidural shots.
Hope you see an orthopedic oncology specialist, and hope you get some relief soon.
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This may also be due to the steroid used–certain ones may just work better for you, for whatever reason.
Doctors are nearly never transparent about what’s going into the joint, but don’t be afraid to ask, so you can keep track of how it goes with different agents.
I also always request ropivacaine. It’s the longest acting anesthetic that’s commonly used in joints injections with a duration of about 4 hours. It’s also less toxic to the joint than the other options. Lido only lasts an hour, which often isn’t even enough time to get home for me…four hours makes a big difference!
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Thanks!
I am in a wonderful period right now where I’m not getting a lot of stuff injected, but that is good to know, because I am sure I will be again soon.
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You are an inspiration! Enjoy your horses!!
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That’s a good point. I have at least an hour’s drive from the rheumatologist to home, and it can be much longer. I have not really wanted to drive after knee injections anyway (the joint feels squishy), so I’ve been making my poor husband take me. That means he is sitting around for hours waiting for me, because my rheumatologist spends far more time with each patient than he’s supposed to, so he’s always running behind. Sometime he has surprised me by seeing me right on time, usually when someone cancels last minute.
After listening to be griping when we get caught in traffic, I’ve been thinking of just going by myself. I take a pretty zen approach to traffic, but he just can’t seem to. He even winds me up if I’m driving. It’s a good thing that he’s an overall good guy, or I’d be tempted to violence on a road trip some day.
Rebecca
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