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ColinRossie
Joined: Wed, Apr 25 2007
Location: Sydney
Posts: 175
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RE: Cortisone
Tue, Feb 16 2010 3:26 PM
From the coal face of clinical experience, it appears that symptoms abate after a cortisone shot. Sometimes permanently, but a significant number represent with the same problem several months later and another shot then doesn't seem to work. Misdiagnosis in the first place, or just the collagen proliferation starting to tear if the movement habits don't change?
"One of the penalties for refusing to participate in politics is that you end up being governed by your inferiors" Plato
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Achilles
Joined: Sun, Dec 11 2005
Posts: 309
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RE: Cortisone
Fri, Jan 09 2009 1:04 PM
I am not necessarily suggesting it is a different material, however it's structure would relate to it's function one would think ie; Tensile load vs reduction of friction.
The tendon is thick collagen fibrils in a parallel fashion where as the sheath is generally more of a loose aeriolar type tissue - still made of collagen
Maybe the sheath has better capcity to get inflamed and the substance degenerate? Maybe that's why the injection is in the sheath? I don't think we conclusively know just yet
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imassage
Joined: Tue, Dec 2 2008
Posts: 41
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RE: Cortisone
Thu, Jan 08 2009 12:31 PM
Are you suggesting that the sheath is made of something other than collagen?
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Achilles
Joined: Sun, Dec 11 2005
Posts: 309
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RE: Cortisone
Thu, Jan 08 2009 7:32 AM
Good question i would have to think they bath the inflamed area with cortisone in the sheath rather than direct injection into the substance.
How would they know - imaging, History and duration of symptoms or cases where most other things have been tried.
Research into Cortisone is still going on. Very much a work in progress.
Definitely has it's advantages and disadvantages
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imassage
Joined: Tue, Dec 2 2008
Posts: 41
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RE: Cortisone
Fri, Jan 02 2009 2:51 PM
This drug confuses me. We were adamently told in school that it was a bad drug (but i'm gathering some of my teachers were tree huggers and not exactly at one with the modern world). Hence we didn't study it much at all. But now i read forums (other than this one) and see that it is mentioned everywhere.
It does seem quite confusing to when it is indicated. I'm gathering it is predomonently for inflammatory conditions? But you suggest it can be used for degrading scar? How do they know when scar needs to be degraded? Plus i see the mention of cortisone being injected over the achillis, not in it but on it, for inflammatory achillis. Why doesn't it degrade the collagen it sits on in an achillis injection?
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suspension
Joined: Tue, Jul 18 2006
Posts: 71
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RE: Cortisone
Tue, Dec 30 2008 2:10 PM
I have seen the same happening over here aswell. As i understand it, Cortisone has a degrading effect on Collagen (types I & III) from memory, therefore scars/fibrosis that are not fully formed have weaker x links and can be affected by such a practice
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Achilles
Joined: Sun, Dec 11 2005
Posts: 309
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RE: Cortisone
Tue, May 15 2007 12:40 PM
Interesting that cortisone is used in cases of neural tethering to deal with symptomatic stuff. Cortisone (Celsestone - usually down this end of world) is commonly injected down the length of the sciatic nerve i cases of tethering/fibrosis with chronic hanstring problems. Might there be other uses?? We are talking about an anti-inflammatory drug here.
In the cases i have seen and treated this usaully allows the condition to get to a point where STT cab have a significant effect on fibrosis (see Emag case study 3rd ed) for a case study of STT and eccentric muscle tarining and its effect on tethering and scar tissue formation.
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ThePhantom
Joined: Fri, Jul 28 2006
Posts: 89
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Cortisone
Fri, May 04 2007 10:19 PM
I thought Dr Judith May gave a wonderful expose and summary of Cortisone use, misuse, and abuse at the STT conference a couple of weeks ago. Her honest and frank representation was very refreshing. It was very interesting to hear that it's indications for use are still a work in progress - I thought much differently until the conference !
I love to doubt as well as know.
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suspension
Joined: Tue, Jul 18 2006
Posts: 71
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RE: Cortisone
Fri, Apr 27 2007 8:01 PM
Yes, good question; When does something become chronic.......3 months,.........6 months??? When a degenerative process of some sort has set in??? (Other than tendons of course)
I guess other than acute might be a start?
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inquisitive
Joined: Wed, May 24 2006
Location: Brisvegas
Posts: 379
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RE: Cortisone
Fri, Apr 27 2007 1:58 PM
Cortisone only after a time frame for the natural healing response to occur. You wonder when that time is? STill guessing i presume?
After the stt conference i'm amazed that we call this drug a science. Still handy drug to have but hey,...it's not science just yet.
keep it simple stupid
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