Are Cortisone Injections Advisable for People with Post-Polio Syndrome?

Question: I am a 68-year-old paralytic polio survivor from the 1955 polio epidemic. I use two leg braces and a variety of assistive devices. My arms were also totally involved but recovered well. My main problem now is increased weakness and pain in my arms as I depend on them more for transfers. My primary care physician recommended using 600 mg. of ibuprofen three times a day to reduce inflammation and alternating ice and heat. A cortisone injection has also been suggested. Is a cortisone injection advisable for people with post-polio syndrome?

Answer: Cortisone injections are safe and often helpful for polio survivors who have developed inflammation problems in shoulder tendons (tendonitis), bursa (bursitis) or joints (arthritis). Their success in eliminating pain depends on an accurate diagnosis of inflammation in a structure and accurate localization of the injection into that structure. Many practitioners now use ultrasound to accurately guide the injection into the desired structure. Cortisone injections will not be helpful for pain in post-polio weakened muscles that are being overused. You may also find it helpful to read one of my previous Q&A’s about this subject. www.post-polio.org/edu/pphnews/PPH29-2spr13p4-5.pdf and www.post-polio.org/edu/pphnews/PPH29-2spr13p4-5.pdf. Note: SOS – Save Our Shoulders: A Guide for Polio Survivors from Moss Rehabilitation Research Institute (www.mossrehab.com/index.php?option=com_docman&task=doc_view&gid=67&Itemid) is a 34-page booklet compiled in 2003. It discusses shoulder problems of polio survivors and offers advice and exercise possibilities. The colorful booklet includes diagrams and photos. Also see www.polioplace.org/living-with-polio/living-polio (Scroll down to exercises.)

Post-Polio Health (Vol. 30, No. 2, Spring 2014)