Repeating steroid joint injections

[NJPAIN]

---

Members don't see this ad.

I don't do alot of joint injections but some. More IA hip injections that any others. I saw a post by a well respected academic pain doc recently indicating that he performs IA steroid injections of the hip in a series of three at two week intervals. I have always done one injection. If it lasts for a while - great. If it doesn't and it is > 3 months I will consider repeating but I will also tell you to get the joint replaced. Am I missing something?

 

[lobelsteve]

I don't do alot of joint injections but some. More IA hip injections that any others. I saw a post by a well respected academic pain doc recently indicating that he performs IA steroid injections of the hip in a series of three at two week intervals. I have always done one injection. If it lasts for a while - great. If it doesn't and it is > 3 months I will consider repeating but I will also tell you to get the joint replaced. Am I missing something?

Yes, the a$$hat is described as well respected. Call him for what he is. Series of nonsense.

 

[willabeast]

I don't do alot of joint injections but some. More IA hip injections that any others. I saw a post by a well respected academic pain doc recently indicating that he performs IA steroid injections of the hip in a series of three at two week intervals. I have always done one injection. If it lasts for a while - great. If it doesn't and it is > 3 months I will consider repeating but I will also tell you to get the joint replaced. Am I missing something?

You are not missing something , but this fellow takes three visits to get the needle in the correct place, so he is missing 2 out of 3 times. He probably does not do them with imaging. On the + side, less radiation with no imaging. Might be a good fellow to refer to if you have a pregnant patient who needs a hip IA injection.

 

[emd123]

I don't do alot of joint injections but some. More IA hip injections that any others. I saw a post by a well respected academic pain doc recently indicating that he performs IA steroid injections of the hip in a series of three at two week intervals. I have always done one injection. If it lasts for a while - great. If it doesn't and it is > 3 months I will consider repeating but I will also tell you to get the joint replaced. Am I missing something?

I do it the way you do it. Some people might go a year between injections. More often 3-4 months. If I have to inject more than once or twice, I'm referring them to ortho, for consideration of surgical options and further investigation.
Exception = knee, where I'll try a visco injection after steroids, then refer to ortho, if fails.

 

[pastafan]

I avoid re-injection at less than 6 months. If they don't get that length of relief I recommend RFA.

 

[painfree23]

I avoid re-injection at less than 6 months. If they don't get that length of relief I recommend RFA.

Hip rfa? Cooled or regular?

 

[pastafan]

Hip rfa? Cooled or regular?

Read thread quickly, missed hip only reference. Recommend arthroplasty, if surgical candidate, for hip.