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.
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.
Epidural injections are often used to treat radicular pain, also called sciatica , which is pain that radiates from the site of a pinched nerve in the low back to the area of the body aligned with that nerve, such as the back of the leg or into the foot. Inflammatory chemicals (. substance P, PLA2, arachidonic acid, TNF-α, IL-1, and prostaglandin E2) and immunologic mediators can generate pain and are associated with common back problems such as lumbar disc herniation or facet joint arthritis . These conditions, as well as many others, provoke inflammation that in turn can cause significant nerve root irritation and swelling.