On Thursday I had a cortisone shot for a shoulder injury. The nurse warned me about high BG but my physical therapist felt that I couldn’t do the exercises I needed to do because of the pain so she recommended I go ahead. When I got home I did a bit of research and wished I had read Jenny’s blog before I decided. As it happened, I think I was really lucky. After 2 days of BG in the 160s, I seem to be completely back to normal, with fasting in the 80s and PP numbers under 100. I doubled my insulin and went really low carb for a few days but this gave me a new appreciation for what everyone else goes through on a daily basis. I am still so new to LADA and eat so low carb that I rarely go far outside normal limits. Anyone else have experience with cortisone shots?
I was diagnosed with diabetes because I went to the doctor with a frozen shoulder. The doctor gave me a shot of cortizone and then said by the way let me check your blood. I got a call from the doctor the next morning letting me know I had to come in and come in now. My BGs was 310. I went to a physical therapist and he told me it was normal for my BGs to go way up on any steroids. I have found the more level I keep my BGs then the less shoulder pain I have.
Diabetics are prone to frozen joints and steriods make the blood sugar rise.
I have had two cortisone shots, for my trigger finger. Both were administered by a physician’s assistant who himself was tyoe 1. He said that treatment for fingers was a relatively small amount of drug and probably would have no effect. It didn’t.
But, for larger injections, such as knees, etc (and I’m assuming shoulder), it might increase the need for insulin.
What type of injury did you have? Was it a frozen shoulder (adhesive capsulitis)?
They don’t really know. They think it is a small tear, or some scar tissue, instability, and just the beginning of frozen shoulder. But the adhesive capsulitis is, they believe, secondary to an injury, due to not being able to move with the pain, rather than the cause of the pain. They think this because I have more mobility and more strength in my other muscles than is usual for a straight forward frozen shoulder. I’m giving it another month to see if I can get some improvement with therapy and if not, I will have some imaging done. It is really, really painful in certain positions and I can’t seem to avoid hurting it at least once a day. It’s a bit discouraging.
Hi Libby,
I too have had a cortisone injection in my shoulder for rotators cuff injury, (three weeks ago). I too am a T1 D. (34 yrs). I had an increase in my BS for almost 1 week. I also knew what to expect with the injection of cortisone. It did not work as well this time so I shall see what the next step will be in treatment of my shoulder. I am glad that you were able to prevent the high BS from the injection and things are back to normal for you after a few days. Linda
Not to get too off topic here, but like you Kathy, I have had a cortisone shot for trigger finger. I bowl 3 times a week (in leagues) and the ball just started to drop out of my right hand when i would swing it down to throw it at the pins. It really hurt my average (and my teams win/loss ratio). I’ve only had one cortisone shot last April (2007) and luckily my trigger finger hasn’t returned. Also, I didn’t get much of a spike in my BS after I had the shot, just as you said Kathy, it was probably such a small amount it didn’t have much of an effect on my system.
Thanks for starting this discussion Libby, because the doc that gave me the cortisone shot didn’t mention that it could effect my blood sugar at all. it’s good to know. I hope that therapy will alleviate the pain in your shoulder Libby, and I hope everyone who has issues with frozen joints will feel better soon. All the best.
-Bill
Libby,
Ask your therapist about doing steroid treatment on your shoulder during physical therapy. I am recovering from surgery from a rotator cuff repair and my therapist has been doing topical steroid treatments on my shoulder. They do not affect my blood sugar near as much since it is mainly surface, but it has helped the pain a lot.
Libby,
If the highest you saw was 160s you’re doing great!
Did the shot do anything for your shoulder pain? I hope it did!
I saw the PT today and she thought my range of motion was improved so I think the shot helped. I feel like I dodged a bullet since my BG only went high for a day and a half. In fact, I’m seeing some of my best fasting numbers in a while. So far so good…
Lindsay,
I had a total rotator cuff repair on Jan 2. I had one steriod shot prior to starting physical therapy. I did 2 months of pt with no change in pain or rotation so they scheduled me for surgery. My MRI showed that I had bone spurs only. So they were going to go in and remove the bone spurs but they got in there and the rotator cuff was tore in 2. It took them 3 hours to fix it. I am barely 3 months out of surgery and I already have 100% range of motion back in all directions but behind my back. They are now working on building up the strenght. After surgery I was in so much pain they gave me phentanyl, morphine, and demoryl in IV. They sent me home on lortab 10’s and Mepergan rotating the 2 ever 2 hours for 3 days.
This is actually my second rotator cuff repair and yes I would do it again. I have had both of them tore. Shoulder joint surgery is the most painful joint surgery there is. It is even worse then hip replacement. My first one they kept me in the hospital on a morphine drip with PCA pump for pain management. The first one was also when my blood sugars were still out of control and they were afraid the added stress of the pain would make them worse, but since I have gotten the diabetes under control the second one was outpatient. Pain wise it was pretty bad after, but the key is to let them do what they have to do to get the pain under control before you go home and make sure you do not chase the pain. They had me waking up every 2 hours regardless if I was in pain or not for 72 hours to take the pain killers. I am now able to get by on 2 lortab 10’s a day. One thing I would definetly recommend is spend as much time in physical therapy before surgery to have the muscles built up in your shoulder, it will make a huge difference on rehab. My therapist told me I am actually 3-4 months ahead of where I should be. Normally rehab for total rotator cuff repair is 6 months, they are recomending I be released already. Another thing I did and I do not condone this if you think you will move your arm. 2 weeks after my surgery, I started laying around without my arm in the immobilizer if I was not doing anything. This kept my muscles from seizing up and I only moved it from the elbow down. Now if I was sleeping, up walking around or I was going out I put my arm back in the immobilizer just to protect it. My physical therapist knew I did this and said it was ok as long as I was aware of not moving it. (My therapist knows me all to well, I have rehabbed both knees and both shoulders with them after surgery). As soon as the doctor released me from the immobilzer after 4 weeks I started using my arm a little bit more, not pushing to the point of pain, but I did use it more. The best physical therapy is just plain using the arm in your day to day activities and not babying it, but not pushing it. I also recommend a tens unit. I have my own and it cuts down on the pain a lot.
I have had one for 3 years since my first shoulder surgery. When the muscles are tight it works wonders to help loosen them. A lot of times I will get up in the morning attach mine and leave it on all day. And yes it is safe to leave them on and running all day. I also take a lot of road trips and I will put it on when I leave and then use it over pain pills. With all the surgeries I have had, I have used my tens unit after all of them to help manage the pain. It basically short circuits the pain receptors with the electrical pulses. Oh another trick I use are lidoderm patches. Originally my neurologist gave them to me for the neuropathy in my feet, but they work wonders on all parts of the body. It is an adhesive patch soaked in lidocaine. They are available by prescription only. You can put one on the area for 12 hours and use 3 at a time to cover if needed. But you have to leave them off for 12 hours after. At night if my feet are really bad I will slap a couple on and then I can rest, I have used them also on my knees and shoulders as well. At my age they are trying to get away from long term narcotics use for pain management which is fine by me.
I just saw the orthopedic surgeon and he confirmed that I have frozen shoulder, said the PT rehab process can take 12-18 months and did NOT recommend surgery. He said that even after surgery, you still have to do exercises to regain ROM. Unfortunately, he said that the cortisone shot given by his nurse was in the wrong place- into my rotator cuff muscle instead of into the joint- so I am a little upset about that. After all I went through with my BG I am reluctant to get another one. I just need to keep on doing the exercises several times a day. I have a pulley at school as well as at home and keep my thera-band in my pocket so I can whip it out at odd moments.
In doing some research I came across this website and your entry. I was told that after much pain that I had a torn rotator cuff. I am a type 1 and should have done far more research before agreeing to surgery. I had my surgery on Dec 18, 2008 and am not making progress as my doctor or PT had hoped. My PT suggested last Thursday that we try a steroid patch and explained how it would stay isolated to a small area in my arm being treated and that it would not spread. He put one patch on my shoulder (which had the steroid applied to it) and another near my elbow. He then hooked me up to an electrode machine for 20 minutes, removed the patch near my elbow and told be to leave the one on my shoulder for 2 hours, then remove it and discard it. He explained that I probably would not notice a difference in the pain until we repeated the process once or twice more times this week during my visits. Within 30 minutes of leaving his office the level of pain in my arm had gone from a 3-4 (upon arrival to his office) to a 7-8 and my blood sugars had spike to 385 in that time as well. I took a correction in my pump and waited. Within another hour and a half my chest was tight and radiating in heat, I had tingling in my left jaw bone and pain between my shoulder blades. This went on (coming and going) for 6 hours. I COULD NOT get my sugars down. I finally went to the ER at 11:30 that night and was admitted into ICU for DKA (BS 518). I do not recommend rotator cuff sugery (not sure if it started with frozen shoulder or not) and I definetly do not recommend steroid patches for type 1’s. Shortly before I was admitted into ICU there was another young lady (19) admitted for DKA (BS 700) - steroid patch applied that same day by a dermatologist. I am still struggling with my BS - taking shots in addition to pump.
Lynnie