Steroid injections

Question: I suffer from mouse-induced pain in the lower joint of my thumb. My GP has offered me steroid injections. Can anyone who’s already had this treatment offer any comments? (Sorry if this topic has already been done to death. I’m quite new to this list. If so, perhaps it would be best to reply to me privately?)

Answer 1: Several years ago my RSI began with severe pain in the bottom joint of my thumb on my right hand. At the time it was put down to clarinet playing but later it has proved to be closely related to mouse work. My GP tried various NSAIDs with little luck and refereed me for physio – mainly ultrasound to the affected area – still no joy. I then got referred to a specialist, Dr Pearson. He initially had me wear a solid plastic cast which totally immobilized my right thumb. This I wore for approximately 1 year. After about 1 month with the splint he decided to inject steroids into the thumb joint. Although it is more painful for several days (throbbing etc.), I got relief for about 6 weeks. However, soon afterwards the pain returned. When I saw the specialist again he offered another injection but told me that I could not have any more after that for fear of damaging the joint. I had this second injection. It was painful for several days like the previous time but this time I got very little relief from it – only at best a couple of weeks.

If I were you I’d see a physiotherapist with experience in RSI‘s rather than try the injections. Also, stop using the mouse you have. I eventually found out about the Computability Centre – and went to see them. They were able to let me try many different mice and tracker balls until I found one which I found comfortable. I now use the MouseTrak tracker ball which has almost totally relieved my pain in my thumb.

Answer 2: Steroids only help if you have tendinitis/tenosynovitis as far as I can tell, and not all mouse induced pain is due to this. Try sorting out your posture etc, and getting some proper treatment for your neck/shoulders first – the latter are frequently involved in mouse pain, unlikely as it seems, due to posture problems and lack of breaks. I did have this sort of RSI and found that a hand pain that was partly due to mousing was relieved instantly by trigger point massage on the pectoral muscle. For more info on this sort of thing, see my web site, URL below, and get the recovery bundle. Also have a look at the RSI-UK and Typing Injury sites, particularly the pointing devices FAQ.

Answer 3: I don’t want to be alarmist but do be aware that steroid injections can cause tissue damage in a small proportion of people. I had a steroid injection into my left elbow in 1990 which had no effect at all in reducing pain and left me with a hole in my arm the size of a fifty pence piece and a permanent and painful bruise. It is only recently that it has filled in sufficiently for me to be able to a) touch that part of my arm without being almost nauseated by the severe amount of neuralgia resulting b) feel confident enough to wear short sleeves again. This won’t necessarily happen to you but do ask your doctor about side effects. In fairness, I do know someone whose RSI problem was almost entirely ‘cured’ according to him by a steroid injection. If you can use a pen, I find a graphic digitizer pad a much more preferable alternative to a mouse.

Answer 4: Thanks for your mail. Pretty mixed response so far. Some people found they were cured, some found no (or only temporary) relief. But one important point appears to be to make sure the rheumatologist fully explains any possible side effects! I’ve not heard of the Computability Centre — can you explain? I’m a graphic designer, so I need to be able to make smooth, precision movements rather than just move the cursor around in a text document – Can you *draw* with a tracker ball? Thanks for your help.

Answer 5: Have you tried a graphics tablet? I had problems clicking with a mouse and now use Wacom ArtPad II which is excellent. Apparently many graphic designers /architects etc. use it. Costs about ?180.00

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