# How long before steroid injections work for SI joint pain?



## Hotshot (18 August 2012)

Hi,

I have read through a lot of the threads on SI on the forum and they have been really helpful (if  somewhat depressing). I had a horse injected with steroid 5 weeks ago,following a diagnosis from Newmarket vets that horse has SI problem (after a bone scan). He showed 100% improvement to the nerve block in this joint .

I have him in a professional yard where he is ridden 7 days a week and he is walking and trotting under saddle. He is sound in straight lines but still unlevel around the corners.

I dont know know whether this is normal , or whether he should be showing signs of greater improvement - any experiences welcome.
He is also seen by a physio every two weeks and has had his feet re balanced. He is also on one bute per day as he works more comfortably with it .
Its costing a fortune and I feel I need to make a decision in the next month as to what to do with him . It would really help if I could get a view from other readers what their journeys have been. 

The horse is an eventer and needs to be able to go back to that level. If he cant then I will have to pts as I already have 4 other geriatrics at home and just cant afford another one.

I will carry on if there is hope, but like everyone right now - cash is limited!

How long have people found it takes the steroids  to work ? Should they be working by now and should he be sound ?


----------



## KentOsteo (18 August 2012)

Hi! I would have thought that they should have worked pretty much instantly - if indeed where they were injected was the seat of the problem.  Trouble is - steroids are pretty much a 'pain mask' - will reduce local inflammation but not really deal with the underlying cause of the problem i.e. why is it inflamed in the first place.  

It is a common finding in my line of work that SI joint pain is secondary to an underlying primary issue.  Sounds like the vets need to dig a bit deeper, or alternatively is there any possibility you could turn him away for a rest, and then start a rehab type program - maybe less drastic than pts at this stage!


----------



## Nothing Original (18 August 2012)

Hi. I am 3 months down the road after SI injections and when I look back the difference is huge!!! however we have not long introduced canter work and we are still working in straight lines (physio guidance).

From what I know with mine, once the joint is medicated it is then about building strength both by ridden work and ground exercises being carefull not to rush things and getting the rehab right.

Mine was almost 100% sound (odd 1/10th lame step on lunge only Newmarket vet could see) after about 6 weeks.

I think it also depends what original symptoms were. If problem had been there a while you could have compensatory muscle build up which could be affecting recovery as horse in effect has to learn how to carry itself properly again.

Mine had secondary hock pain too - vet initially thought SI was as a result of compensation from hock pain but has turned out to be other way round.

Wish you all the best for a good outcome.


----------



## Hotshot (18 August 2012)

Hi,

He had  full bone scintography and had all his feet and hocks x rayed too. The area in the SI region was very sore  on nerve block , he was 100% sound afterwards- so I thinks its as conclusive as I could get really .

He is on a rehab programme - started with walking at 10 mins per day and has built up in the past five weeks to now trotting , but keeping it large in the school. I know what you mean about a  pain block - I think the bute is having more effect than the injection tbh . The vet wants to try Tildren . I  am happy to go this route, but it is another £1500 for the three injections and I am really not sure that it can help.

I dont have anywhere to turn out long term as I am short of grazing as well at home ( four horses - all not in work ), and the vets advised that this is the worst thing to do as he needs to build muscle. Its so hard to know what to do  for the best .  

I do half wonder whether its a muscle tear in the sacro iliac region  which is compounding the problem though .

Thanks


----------



## Hotshot (18 August 2012)

Nothing Original,

Thanks - thats really interesting , Might well have bee the same vet by the sound of it.

I havent lunged mine yet, but the physio is keen that we start.


Did you need bute at the start or not ?


----------



## monikirk (18 August 2012)

We have also been to Newmarket - after unspecific lameness for 6 weeks and bute my Friesian was sent to Newmarket, he had scans and radio active isotope. His chest was asymetrical due to muscle wastage. They carried out more nerve blocks, higher than our vet felt comfortable about doing herself and found a possible problem with his elbow. He had a steroid injection followed by 2 weeks restricted turnout, 1 week long reining and now riding in mostly straight lines short hacks to be built up to 40 min over the next few weeks. He's also fed some Myoplast granules to build muscle. He is sound and happy and gradually building up again and turnout area is being increased.


----------



## Nothing Original (18 August 2012)

Hi Hotshot

We had bute for 10 days and 2 weeks of muscle relaxant.

I am not lunging still - vet just did to see lameness as was so slight.

Mine is 17hh so physio said circles are more difficult so wants muscle built really well before putting too much strain on area with circles to avoid re-injury/going back to compensating.

As still light in evenings making most of still being able to hack although we are now schooling on our hacks.

I go in the school occasionally when get back from hack - maybe for 5/10 mins and have to say I can feel difference in balance and ability to carry/hold himself, especially if I compare now to say 6 weeks ago. Had my 1st canter in ménage other night and was actually better than before treatment so very pleased.

Have to say I fed mine Comfrey for 3 weeks after conventional meds too.


----------



## loopylucifer (18 August 2012)

Im 5 weeks down the line from injections in to SI we had bute for first 3 weeks and have slowly increased work since had them we have a deffinate improvement. our main issue was inablitiy to canter and generally crabby behaviour. we can now canter although its not great it is canter and she is generally much less crabby. She hasnt yet had physio or any other treatment she is going to have tildren in two weeks to help aid the good progression.


----------



## Nothing Original (18 August 2012)

Cannot recommend the physio side of things enough - really don't think we would be where we are without her.


----------

