Home Forums Hunting & Shooting Hunter's Campfire Steroid injection question

I do not know everything so I am looking for some input from hopefully an expert- Medical Doctor well versed in giving steroid injections.

I have had pain in my left shoulder area for about 12 years after a slip and fall on ice in which I landed on my back. I braced the fall some with my left elbow which jammed my shoulder somewhat.

I have also had pain in my right hip/rump area for 19 years. I do not recall any specific injury but I was doing a lot of scouting and bear hunting in the mountains that spring. I am 55 years old now.

I had surgery on my left shoulder late June of this year. The MRI before the surgery revealed a torn rotator cuff, damaged biceps tendon and arthritis in my collar bone area so the surgeon fixed those 3 things. The area of pain that sent me to seek help had no obvious surgical fix, no damage in that area was indicated by the MRI.

I have had a lot of physical therapy this year for the shoulder and hip area and none of that has seemed to help the unresolved pain in those areas but it has of course helped me to recover from the shoulder surgery.

So 6 months after the surgery I was still having pain in that same area (basically where the Teres Minor muscle attaches to the humerus). Maybe a bit higher where the Infraspinatus attaches? I met with the surgeon and he suggested a steroid injection into that area as well as in my Piriformis. I told him that it has been a bit difficult to get the therapists to find the sore areas as they are kind of deep and that it requires digging in their with a thumb or elbow to really find the sweet spot. He said that I should share that with the other doctor in their practice who would be doing the injections at a later date.

So I went to get the shoulder injection and just before the doctor injected me he was pushing on my shoulder area to identify the location of the Teres Minor and I told him that I was not sure that he was actually on the really painful spot yet. He said that he did not care where I hurt most, he was just going to inject the spot that the shoulder surgeon told him to. What could I do but hope for the best? Hope that they both knew what they were doing? Well it did seem to help for about a week but the pain is coming back in that same area. I can't help but wonder if he had taken the time to inject the sweet spot it might have been more effective.

A week later (Monday of this week) the same doctor (not the shoulder surgeon but the injection doctor) injected my right Piriformis muscle. Again as he was starting I mentioned that he was setting up to inject an area that was removed from the most painful area and asked if the steroid would migrate through the whole muscle. He said yes. Still I can't help but wonder if it would be more effective to inject the sweet spot. The injection sight is 3" removed from the worst spot. So it is closer to the crack of my butt than where the muscle attaches to the leg bone.

I think the pain in my rump is less but it still hurts. Maybe it will improve? Anyway I wonder if this is standard practice for doctors to not care so much about injecting the exact worst area of pain. Does the steroid truly migrate adequately throughout the entire muscle so that it does not matter?

I have tried some dry needling in the shoulder and rump area this year as well as the physical therapy and that did not seem to help.

I am really frustrated. My sleep is negatively affected. I have had 75 therapy visits this year between my shoulder, hip/rump and thumb surgery repairs and still hurt in all areas. God help me!!!

Those steroid injections have effects, you're sure to have a Kim Kardashian azz and great breasts soon.

I have scar tissue and bone growth where he would normally inject.

So after talking about it with him i had it done.

The medicine took a few days it seems but it did make it bearable.

Sometimes it just takes some windage to get there.

Sometimes its the only way to get the swelling down so things can heal.

Give the shoulder time, it's only been 6 months.

My dad had his shoulder worked on almost 4 years ago, took almost a year for him to feel 100% pain free.

I’m curious how you knew it was the Teres Minor vs Infraspinatus.

DF

There’s that ole piriformis muscle mentioned.

My wife got about 6 months of repeated injections from some specialty chiropractor with a nurse practitioner.

Sometimes weekly.

Didn’t do a damn thing for her, she went to an MD, rheumatoid specialist, ruled it sciatica. Pretty much just sucked it up and walked it off after about a year.

As for the back I have 3 bulged discs. Most of my pain was in my left cheek, way down in there and felt like a hot coal, some numbness towards my left knee.

Doctor injected me right in the top of my crack, went back 6 months later and have been pain free for right around 7 years.

Supposedly my issue was a tensed up muscle pushing against the sciatic nerve. once the steroid took effect the muscle could relax and the pain was gone.

Have done the injections and my understanding is they need to be exact area at least speaking to an injection specialist.


Ive had a lot injuries and surgeries over the years so lots of aches and pains.Restricting carbs, some intermittent fasting has seemed to help with aches and pains ( less inflammation) and sleep better.

Daily stretching and exercises for shoulders, hips, lower back helps too. I take turmeric, boswelia, joint supplement too every day and of course moving every day. sucks getting older

18 months ago, I woke up one morning while on a camping trip and my right shoulder hurt like crazy. Whatever it was didn't go away. I finally went to a Dr. and they took x-rays and found nothing. He though it must be some kind of strain in the rotator cuff so he sent me to physical therapy. That accomplished nothing and I figured I'd just have to live with it. It wasn't nearly bad enough for surgery.
I work with our church's Trail Life troop. This summer we got the boys into archery. I hadn't shot my bow in years but I got it out of storage and figured I'd shoot until my shoulder couldn't stand it then quit. It turned out that the shooting (right handed) was exactly the physical therapy my right shoulder needed. I'd go out and shoot maybe 10 arrows several times a day. After a month, my shoulder felt better than it had for a year. I have almost nothing at all in it now.

I’ve had 5 injections in my back. Like some have stated it was a short term fix. I still hurt daily but have stayed off opioids, just take Aleve and Tylenol as needed which is 4 to 5 times a week. Someone mentioned turmeric, I’ve heard that before and am going to try it.

Dirt Farmer, none of us seem to really know. By pushing in the area and looking at anatomy the pain is in the teres minor or infraspinatus area. The therapist that was doing the dry needling thought it was the infraspinatus because of where she had the needle positioned when I told her she had hit the sweet spot.

I do not have any pain or numbness down my leg so it does not appear that my sciatic nerve is impinged. I had a low back MRI recently (before the injection) and I have some minor bulging but the doctor didn't think it was causing my piriformis pain.

I'm no expert. But I've had injections in the shoulder and ankle, and problems on and off with the hip that I've worked with a physical therapist on..

First, if you have a chronic condition like arthtritis, steroid injections only give temporary relief. It might be dofferent with soft tissue injuries. My doctor told me the maximum pain relief is about two weeks after the injection, then it gradually wears off which is about what I found.

Second, as far as the location for the injection vs. where the pain is, my understanding os that the two don't always coincide. For my ankle, my doctor told me that regarlesss of where the pain was, there was an ideal spot to place the injection so that it got into the center of the joint and I'd get the most benefit if it was injected into the center of the joint.

For my shoulder I had a torn supraspinatus and biceps tendon. The biceps tendon caused the most pain but the pain that I felt wasn't located in exactly the same spot as the damage, it's called "referred pain." I got two injections in the shoulder, same with the ankle they weren't placed where the pain was but where it was easiest to get the needle into the center of the joint. I had rotator cuff surgery, and they released the biceps tendon, I'm pain free on that side now. For the ankle, I had fusion surgery, pretty much pain freee there too.

For my hip and lower back, every now and then one or the other will get sore. I had a hip specialist look at it, he did an x-ray and saw that the hip bones were a little mis-aligned. So he had me work with a therapist to stretch some muscles including the piriformis, and do exercises to strengthen other hip muslces to bring the hip back into alignment. Seems to be working.

It’s a long acting steroid that is used. You do not need to inject exactly at the most painful sight, just be close as it will spread out and effect the whole region. So that shouldn’t matter much

Remember steroids are to reduce inflammation. Inflammation causes pain. Steroids can resolve pain completely, but most likely won’t.

piriformis syndrome and sciatica are btw caused by same root problem. MRI lumbar spine and pelvis would help to differentiate sciatic nerve impingement from other possible issues.

If not resolving physiatrist could do blocks and more precise injections to try to minimize pain. Keep doing PT

I would stay away from steroid injections.The negative effects can far outweigh any positive outcomes.My brother got severe osteoporosis from steroid injections for arthritis pain and was a major factor in his death.

Piriformis problems are a function of sacroiliac dysfunction. A master physical therapist is my choice. Physical medicine specialists can help.

Sciatica and Piriformis synd affect the same sciatic nerve but for different reasons and at different sites. You can have both, but generally one is the main pain generator. Finding which is the main actor is important. Treatment is different.

DF

this exercise has helped a lot with lower back, hip pain

https://youtu.be/DWmGArQBtFI

I’ve had steroid injections in the shoulders, spine, and hip. At the time, the prevailing shoulder issue was tendonitis, and injections really helped.

In the spine, the pain cause was an “impressive” [medical term that proves Docs are steeped in hubris] bulging disc + Osteoarthritis. Shots hurt like a bitch and did little good. Decompression surgery hurt very little and worked wonderfully.

In the hip, shots hurt like a bitch and did no good. Cause of pain is osteoarthritis. New hip scheduled for January.

My take is that if shots get you over an inflammation issue and the joint is sound, they are a net gain. Otherwise, they buy a little time at best, and come with their own downside.

Hope your recovery is complete.

Talus, best of luck on your new hip!