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Mga Ineksyon ng Cortisone at Corticosteroid

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What cortisone injections do, when they help, how long the effect lasts, and the risks of repeated injections for shoulder, elbow, wrist and hand conditions.

Isang syringe na nagbibigay ng cortisone injection sa harap ng balikat.
Ang corticosteroid injection ay maaaring pampahupa ng pamamaga sa isang kasukasuan o tendon upang bawasan ang sakit at suportahan ang rehabilitasyon. Kieran Hirpara 4.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Ano ito

Ang cortisone injection ay isang suntok ng gamot na may anti-inflammatory na epekto na inilalagay nang direkta sa loob ng isang kasu-kasuan o malambot na tisyu. Ginagamit ng iyong doktor ang paggamot na ito upang bawasan ang pamamaga at mapawi ang sakit sa mga lugar tulad ng iyong balikat, bukong-bukong, hinlalaki, o balikat. Karaniwang itinuturing ito kapag mayroon kang arthritis na dulot ng pagkasira o paggamit (wear-and-tear arthritis) o mga kondisyon tulad ng trigger finger at carpal tunnel syndrome.

Gumagana ang gamot na ito sa pamamagitan ng pagbaba ng pamamaga sa pinagmulan ng iyong hindi komportableng pakiramdam. Para sa ilang kondisyon, tulad ng ankle arthritis, ang pagpagsama ng injection na ito sa isang lubricating fluid na tinatawag na hyaluronic acid ay nagbibigay ng mas mahusay na pagpapawi ng sakit kaysa sa paggamit ng steroid lamang. Sa mga kaso tulad ng heel spurs, madalas itong pinipiling opsyon dahil nagdudulot ito ng mas mataas na kasiyahan ng pasyente kumpara sa ibang mga konservatibong paggamot.

Maaaring pumili ang iyong doktor ng high-dose version para sa mga isyu sa kamay, dahil mas matagal itong tumatagal at binabawasan ang pangangailangan para sa paulit-ulit na suntok o operasyon. Kung kailangan mo ng operasyon sa hinaharap, tulad ng para sa rotator cuff tear, ang pagkakaroon ng injection loob ng isang taon bago ang operasyon ay hindi nagpapataas ng panganib ng pagkabigo o nakakaapekto sa iyong lakas at galaw. Ang paulit-ulit na mga injection para sa mga kondisyon tulad ng carpal tunnel syndrome ay itinuturing din na ligtas at hindi nagpapakabigat sa mga future release surgeries.

Gumagana ba ito?

Para sa maraming kondisyon, nagbibigay ang mga suntok ng corticosteroid ng epektibong pagpapagaan ng sakit at pagpapabuti ng kakayahan. Madalas itong pinipiling opsyon para sa mga heel spur dahil mas mataas ang kasiyahan ng mga pasyente kumpara sa ibang mga konservatibong paggamot. Sa arthritis ng buhos at pagkasira sa bukong-bukong, mas epektibo ang pagsasama ng steroid sa hyaluronic acid kaysa sa paggamit ng steroid mag-isa. Para sa mga isyu sa kamay, mas matagal ang epekto ng mga suntok na may mataas na dosis at binabawasan ang pangangailangan para sa paulit-ulit na suntok o operasyon kumpara sa mga opsyon na may mababang dosis.

Gayunpaman, nag-iiba ang mga resulta depende sa kondisyon. Para sa trigger finger, binabawasan ng pagdaragdag ng lidocaine sa steroid ang sakit sa panahon ng pag-suntok mismo, ngunit maaaring hindi nito baguhin ang iyong pangkalahatang paggaling. Sa pagkatigas ng balikat (adhesive capsulitis), mas mahusay ang pagpapagaan ng sakit at paggalaw ng balikat na ibinibigay ng mga nerve block sa 3-4, 6-7, at 12 linggo kaysa sa mga suntok ng steroid. Para sa mga isyu ng tendon (tendinopathy), mas superior ang pagpapagaan ng sakit at pagpapabuti ng kakayahan na ibinibigay ng platelet-rich plasma sa gitnang panahon kumpara sa mga steroid.

Mahalaga ang timing at ang nakaraang tugon para sa mga operasyon sa hinaharap. Kung may hip impingement ka, hindi nagpapahiwatig ang iyong tugon sa suntok ng steroid bago ang operasyon sa iyong pangmatagalang resulta o pangangailangan para sa ulit na operasyon. Para sa rotator cuff repair, hindi nakakaapekto ang timing ng isang suntok bago ang operasyon sa loob ng 1 taon sa mga rate ng pagkabigo o lakas. Kung may carpal tunnel syndrome ka, ligtas ang mga paulit-ulit na suntok at hindi nito pinapataas ang mga panganib para sa operasyon sa huli. Nakakagulat, ang mga pasyente na may kronikong sakit sa sakong na nakakaranas ng pansamantalang pagpapagaan mula sa mga steroid ay madalas na may mas magagandang resulta kung sila ay hihingi ng operasyon para sa plantar fascia release.

Ligtas ang mga ito sa pangkalahatan. Hindi pinapataas ng mga suntok bago ang operasyon ang panganib ng malalim na impeksyon pagkatapos ng carpal tunnel release o rotator cuff repair. Maaaring ligtas na gamitin ang mga suntok pagkatapos ng operasyon upang gamutin ang pagkatigas pagkatapos ng rotator cuff repair, lalo na para sa mga pasyente na may osteoporosis. Gayunpaman, may mga panganib ang mga suntok sa balakang tulad ng mabilis na pag-unlad ng arthritis, kamatayan ng buto (osteonecrosis), o fracture. Nag-iiba ang dalas ng mga panganib na ito ngunit seryoso ang mga ito.

Sa huli, hindi pantay ang access sa mga paggamot na ito. Mas mababa ang pagkakataon ng mga minoridad na makatanggap ng suntok ng steroid para sa arthritis sa kamay at mas mababa ang pagkakataon na makatanggap ng ito o makapagkaroon ng operasyon para sa sakit ng rotator cuff, kahit na magkapareho ang kasaysayan medikal.

Tama ba ito para sa iyo?

Ang mga suntok ng cortisone ay madalas nakakatulong kapag kailangan ng mabilisang pagpapagaan ng sakit. Ito ay isang paboritong opsyon para sa mga heel spurs dahil maraming pasyente ang mas nasisiyahan sa mga ito kumpara sa ibang mga gamot. Nakakatayo rin ito nang maayos para sa pansamantalang sakit sa kamay at hinlalaki. Kung mayroon kang arthritis sa bukong-bukong, ang paghahalo ng cortisone sa hyaluronic acid ay maaaring mas epektibong magpahinga ng sakit kaysa sa paggamit ng cortisone mag-isa. Para sa mga tear ng rotator cuff, ang pagtatakda ng suntok sa loob ng isang taon bago ang operasyon ay hindi nagbabago ng iyong paggaling o lakas. Ang mga suntok ay ligtas din para sa carpal tunnel syndrome at hindi nagpapataas ng panganib ng impeksyon bago ang release surgery.

Gayunpaman, ang paggamot na ito ay maaaring hindi angkop para sa lahat. Ang mga suntok ay hindi nagpapabuti ng pangmatagalang resulta para sa hip impingement surgery o hindi pinipigilan ang pillar pain pagkatapos ng carpal tunnel release. May mga seryosong panganib para sa mga suntok sa hip, kabilang ang mabilis na pag-unlad ng wear-and-tear arthritis, pagkamatay ng buto, at pagkabagsak ng buto. Ang mga pangyayaring ito ay bihira ngunit posibleng mangyari. Dapat mong malaman na ang mga minority group ay mas bihira natatanggap ang mga suntok na ito, kahit na ang kanilang pangangailangan sa kalusugan ay katulad ng iba. Ang mga suntok ng platelet-rich plasma ay mas hindi epektibo kaysa sa cortisone para sa pansamantalang sakit, kaya huwag mong inaasahan na gagana ito nang magkakatulad.

Ang iyong doktor ay magtimbang ng mga salik na ito kasama ka. Ang paulit-ulit na mga suntok ay ligtas para sa carpal tunnel syndrome at hindi nagpapahina sa hinaharap na operasyon. Ang stiffness pagkatapos ng operasyon ay maaaring gamutin din ng isang suntok, na maaaring mas ligtas kaysa sa karagdagang operasyon para sa mga high-risk na pasyente. Talakayin ang iyong partikular na kondisyon at mga layunin sa iyong doktor upang desisyunin kung ang shared path na ito ang pinakamainam na pagpipilian para sa iyo.

Ang pangunahing aral

Ang mga suntok ng cortisone ay madalas na nagbibigay ng epektibong pagpapagaan ng sakit, lalo na para sa mga heel spur at kondisyon sa kamay kung saan ang mas mataas na dosis ay maaaring tumagal nang mas matagal. Karaniwang ligtas ang mga ito at hindi nagpapataas ng panganib ng impeksyon bago ang operasyon o nagdudulot ng pinsala sa paulit-ulit na paggamit sa pulso. Gayunpaman, dapat mong maging mapagbantay sa mga bihirang ngunit seryosong panganib tulad ng pinsala sa buto ng balakang. Ang iyong doktor ang tumutulong sa iyo upang magdesisyon kung ang paggamit na ito ay angkop sa iyong partikular na pangangailangan at inaasahan.


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