Primarily talk to us about it before choosing a treatment for your CTS. Try to find out as much as possible about the injection to which you reacted. These injections contain different steroids, varying or no local anaesthetic and other chemicals such as stabilisers and preservatives. For example, the commercial preparation 'Kenalog' used in this area contains not only the steroid (Triamcinolone acetate), but also sodium chloride, benzyl alcohol, carboxymethylcellulose sodium, polysorbate 80 and either sodium hydroxide or hydrochloric acid used to balance the pH (acidity). You may have had an allergic reaction to one of the other components of the injection or you may have reacted to one of the synthetic steroids which are not native to the human body. It does not necessarily follow that you would also react to a different preparation so knowing exactly which preparation you have had a reaction to is a vital piece of information.
A pooled quantitative literature search concerning the treatment of de Quervain’s tenosynovitis compared 7 studies (a total of 459 wrists) with identical diagnostic and success criteria. 4 Average follow-up was months (range, 1 week to 7 years). There were no control groups in the studies, and none of the studies were randomized. Of the 226 cases treated with steroid injection alone, 83% were cured, though 30 of these needed a second injection. Sixty-one percent of those treated with injection and splint were cured, while 14% treated with splint alone reported cure.
Sometimes steroids are used during the infusion of an RA biologic medicine in order to combat any potential reactions or side effects. This is most common with those given via infusion including Remicade, Rituxan , Orenica, and Actemra. Before I receive a Rituxan infusion, a rather large dose of 80-100 mgs of liquid methylprednisolone steroid is injected directly into the intravenous line. The nurse injects the steroid slowly over several minutes in order to avoid what she calls a “head rush” from the powerful medicine. This dose usually gets me quite hyped up for the next 24 hours and sleep is difficult.