Question
my husband is on coumadin and needs a steriod shot in his shoulder for spurs. is it o.k. to mix coumadin with steriod shot one doctor says yes the other says no, coumadin has to be stopped prior to shot. but if he stops coumadin he clots really fast. this happened in the past and ended up back in hospital. any input or medical knowledge on mixing the two would be appreciated

Answer
Cindy,

The question you ask is a difficult one. I can not give you a definitive answer in a forum like this. There are so many factors that are involved such as amount of coumadin the patient is taking, what it is taken for, how well a particular patients blood clots while on coumadin and in this case the exact location of the bone spurs. So I will try and give you some background information about the subject and hopefully it will make a difference in the decision making process.

Generally it is not considered safe to take coumadin and oral steroids. Steroids can effect your bloods clotting ability when taking with coumadin.

A steroid shot does not have the same effect. This is because of the small amount of steroids that are shot directly into the effected joint. There is a much lower level of over all steroids that enter your system this way than when taking steroids orally.

On the flip side an injection into the joint comes with the risk of bleeding. When on coumadin your body has a harder time controlling bleeding. This usually is not a major risk but one to be considered.

The real problem is that there are not other options that are any safer. The only truly safe option is to live with the pain and limitations of the bone spurs. Depending on how bad the pain and limitation is this may not be an acceptable option either. I have a similar problem. I have s herniated disk in my neck that put pressure on the nerves in my right arm, causing much pain and limits the use of the arm. The treatment is surgery on my neck and fusing the vertebrae together. After 4 years the pain and limitations are getting to the point that the surgery is now becoming a more realistic option.

When it comes to bone spur in your shoulder there are several options.
1. Surgery
2. Anti-inflammatory drugs
3. Oral Steroids
4. Steroid injections.
5. Living with the pain and limitations.

If you can not stop taking your coumadin the surgery is not an option. 2 and 3 are not options. This leaves only 4 and 5,

There are some safe things that can make number 5 easier. Many people with bone spurs in their shoulder find that Physical therapy helps. Also many people find that massage therapy and acupuncture helps with the pain.

I know this is not the simple yes or no answer the question suggested but I hope the information is helpful.

Rusty
http://arthritis-symptom.com/bone-spur/