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Ask the Expert: Questions regarding cortisone injections
Ask the Expert Questions regarding cortisone injections
By Anna Towers, MD
Q I have moderate lymphedema in my left arm, with some flare ups last year, due to a lymph node dissection for breast cancer staging back in 1990. Now I’m developing painful arthritis in both my wrists. Are there newer developments regarding the question of getting cortisone injections in the affected arm to relieve the discomfort?
A One thing that will make lymphedema worse in an affected limb is being unable to move it or to use it normally. Movement is essential for lymphatic drainage. Therefore, if you have arthritis, tendinitis or other inflammatory problem that is preventing you from using the limb normally, and if conservative measures like rest, braces and anti-inflammatory medication have not helped, then a cortisone injection would be reasonable and helpful. The same applies to people who need orthopaedic surgery to joints in an affected limb. It is important to maintain mobility, range of motion, and function.
Q Thank you kindly for your reply. In response, I am very active, fit and use my lymphedema arm normally. I use a mild compression sleeve when necessary. But here’s my concern: If I get a cortisone injection in my wrist to alleviate arthritic discomfort, should I (and perhaps my physician) take any precautions against a possible lymphedema flare up? Would it be wise for the physician to administer a preventative antibiotic injection, or should I take antibiotics by mouth? This concern is driven by the reality that I’ve had two flare ups last year that were intense – requiring intense bandaging as well as urgent care injections of antibiotics. I’d really like to avoid that if possible! Please let me know your thoughts on preventing a flare-up.
A The involved physician would judge if a prophylactic antibiotic would be required, however this is usually not necessary when receiving an injection, but might be considered if having orthopaedic surgery. LP
