Cortisone-injection frequency up for debate

November 6, 2010 By

DEAR DR. GOTT: Could you tell me how often someone can have cortisone injections? My mother had some in her shoulders. They worked great, but now the pain and stiffness are back with a vengeance.

DEAR READER: Cortisone can be injected into joints such as the ankle, knee, shoulder and other areas to relieve pain and inflammation. They have been known to help osteoarthritis, gout, carpal-tunnel syndrome, bursitis, plantar fasciitis and a host of other conditions. About 30 years ago, corticosteroids were given with great regularity. Today, however, a different approach is taken. Some physicians restrict a person to three injections a year, others to three in a lifetime. [Read more...]

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Weightlifting can be a pain

November 5, 2010 By

DEAR DR. GOTT: I have osteoarthritis, bursitis and tendinitis in both shoulders and upper arms. I hurt both shoulders while lifting weights. What is the best treatment to reduce the inflammation? Is it ice or ultrasound? Would it help to immobilize my shoulder joints with arm slings? Lifting my arms away from my body and above my head causes the most pain.

Would it hurt to try and do light exercise? Is it better to wait until the inflammation and pain go away? With proper treatment, how long do you think it will take to heal?

Would an MRI test on both shoulders help to determine how much inflammation is present and whether there are any muscle tears in the shoulder joints? I would appreciate any insight and information you can provide.
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Polymyalgia is a pain

October 27, 2010 By

DEAR DR. GOTT: My doctor diagnosed me with polymyalgia. I have pain in the back of my head, shoulders and lower back that usually occurs at night and goes away when I get up in the morning. I’m 78 years old, in generally good health with no diabetes, heart or other problems. I go to physical therapy three times a week for my back problem and have traction treatment as well, which seems to be working. Is there any help for me?

DEAR READER: Polymyalgia rheumatica (PMR) is an inflammatory disorder that results in widespread muscle aches, pains and stiffness of the hips, shoulders, thighs, upper arms and neck, fatigue, anemia, malaise and unintentional weight loss. Symptoms experienced are the result of mild inflammation of the joints and surrounding tissue. Stiffness can worsen following periods of inactivity, such as after a night’s sleep or sitting for too long.
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Sarcoidosis treatment: Watch and wait

September 25, 2010 By

DEAR DR. GOTT: I was diagnosed with sarcoidosis after many bone-marrow tests, blood work, X-rays, pet scans and finally by removal of my spleen, which was greatly enlarged and filled with nodules. I requested a second opinion on the diagnosis, and the second doctor agreed with the first. It is inactive but in my lungs, and he tells me the normal treatment is 60 milligrams of prednisone daily for up to two years to reduce the scarring and inflammation. But, with that high dose, it will cause other major problems.

I am white, in my late 50s and have multiple other problems — asthma, fibromyalgia, high blood pressure, rosacea, borderline high cholesterol, osteoarthritis and low oxygen at night that isn’t sleep apnea. [Read more...]

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Warm skin may be caused by swelling

September 12, 2010 By

DEAR DR. GOTT: For three months, I have had warm skin. I have seen my primary doctor, a naturopath and a dermatologist. All three have told me that I have inflammation under my skin but none has been able to help me. Can you?

DEAR READER: Without knowing more, I cannot be certain, but the first thing that comes to mind is angioedema. This is an inflammation of the tissues just under the skin. There are two types — hereditary and acquired. Hereditary angioedema (HAE) is rare and genetic. Acquired angioedema is much more common and often the result of an allergic reaction, and it typically affects the skin around the eyes and lips. I urge you to speak to your physician about this possibility.

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