I have had five ESI's (epidural steroid injections) since 02.27.2007. The two most recent injections were last month, in December. Since then my muscles feel very weak...it's very hard to explain exactly how they feel, but it's almost like they are on fire...a mild fire...and are heavy...has anyone experienced this? If what I am feeling is due to an overload of steroids, what should I do? Will I have long-term medical issues b/c of this? My PM isn't the greatest dr in the world and I can't get in to see him until February 14th...I have 2 more injections scheduled with him before then but I'm going to call his office and cancel them first thing in the morning...none of the injections have provided any pain relief.
Im not a doctor, but I think (from what ive read) that having 2 in Dec and 2 more shortly seems like too much. I've read 2 different things about ESI's....the first that one should only have 3 injections in a 6 month time frame; and the other that it should only be 3 per a year. Unless you keep having these shots so much & close together, there probably wouldnt be long term effects. That usually happens when someone has to take high doses of say oral steroids for long periods of time (years or even for life). Since it never leaves your system, it can cause all sorts of havoc on your body. Though having alot of injections over small time frames can still cause weight gain, bloat, skin thinnig, easy bruising & bleeding, raise your blood pressure, and maybe even lessen your adrenal gland function. The steroids in injections usually dissipate over 2 to 3 weeks (again, from what I have read, anyway), and if you get no more, the effects will go away. I get one injection & i already get bloat & bruising. Now when it wears off for me, even just one shot, I get terrible flare-up of joint pains all over my body, rashes, hives, bad fatigue, sleepiness, lose my appetite, severe stiffness, all sorts of things. I do have to say it was suspected I might also have lupus or some other autoimmune disease...and all these same symptoms happen to me anyway when not taking any steroids. The only thing that stops all the symptoms is a steroid. I have had a severe flare and finally given oral prednisone and within one week every symptom I had was gone. But every time I tapered down to a lower dose, the flare comes back & lasts a week or 2 until the body gets used to the lower dose. My Rheumy had told me that was normal & would happen. So it seems the same thing happens to me when the epidural steroids wear off (even though the shots supposedly dont normally affect one systemically).
I am not sure if the steroids in the epidural would cause muscle weakness, but you never know. What you can do to find out is to ask your PHarmacist. He/she is the drug expert and should be able to tell you if that can happen. If it can, then it very well may be the cause of yours.
This is a tad off topic but it does pertain to steroid injections. I worked at a professional ballet company in the early 80s and it was common practice for the dancers to have steroid injections. If a dancer had a problem with an ankle, for example, she would get a shot right into that spot where it hurt. Then she could go right on dancing. These would sometimes take place during a performance even. They were given for immediate relief without any thought toward the dancer's future. The sad truth is that down the line there was permanent damage done to the joint. It helped at that particular moment but ten years down the road after the dancer had retired, the joint was broken down and pretty much beyond repair.
We were always told that you should not have more than 3 shots/year...that the body couldn't absorb any more than that and beyond that amount, there was too much potential for damage.
If I were you I would try to analyze what benefit you're getting from the shots and weigh it against what damage they might be causing. I think I would get another opinion as well. After I read up on arachnoiditis I do not think I will ever have another ESI.
As far as I knew you could get two sets of 3 every year, one set every 6 months. I sure think that you have gotten too much in that time frame. I think I would stop them and tell your PM how you feel.
I hope you feel better soon from them.
"Thru every dark corner is a door to a new light"
You can have no more than 3 shots a year and only if they realy help you.
I was lucky: during last 3 years I had 9 shots. Finaly I realized that something is not working even though my DR kept insisting that they still may help.
I changed my PM Dr and he told me that first of all it was the worse thing to do (so many) for people who is in a fuse stage (fusion may not work, but I was not aware of it. I guess my previous PM could not loose a chance to charge my insurance $2,000.00 for each treatment )
Second of all: if the first 3 shots did not work, in fact got the problem worse, more pain - to stop doing it and not to try again.
Some people may temporarily benifit from it (relieves the pain), some people have no relieve at all. I did not get any relieve from any of them, I was in agony for a week at least after each shot. You can ask why did I still go for more... I trusted my DR unfortunatelly. But thankfully I learned during this 3 years (my ordeal with spine problems) that you have to be your own DR and to trust your intuition only.
I'm going for my 6th shot tomorrow. I've been going every two weeks since November. The first three were the epidural shots. The next three are the facet shots. I think they are all steroid shots. I think after my 6th one that I can't have anymore. The last one helped a little. I do have the fire pain in my foot and leg. I keep getting horrible foot and leg cramps in that leg too. Don't know if that is related. I asked and they told me to take Quinine (I think that was it). I didn't. One cramp lasted three days. Does anyone have a reaction to temerature. I am cold all the time so I use and electric blanket on the couch. When it touches my leg and foot it sometimes feels like they are burning. It is very odd. Hard to believe it is just a tiny nerve.
I haven't seen you on here in a while, I'm sorry your still going thru so much. I hope the shots help you. I can't tolerate the cold at all where the nerve damage is. They consider mine permanent now, yippee!, but the colder it gets the worse my foot & leg feel. The pain is very bad if I'm outside for long periods in the cold. I don't understand how if the damage is there and it's numb a good part of the time how can it hurt like that ?
After my last set of injections I had horrible cramps in my bad foot mostly, some in that calf too. All at night or in the morning when I would start to get out of bed. I had that for like 4-6 weeks after the last injection. It did stop, thank goodness.
Again, I hope your injections help soon. I hope you don't get those cramps any longer too, they were horrible. Not sure if they told you how to make it go away. If the cramp is in your leg or foot, point your toe towards your head even if you have to use your other foot to do it. It will hurt very bad but hold it that way until the cramp stops, it usually goes away very quickly. I learned that when I was pregnant, I got them really bad then. It really does help.
"Thru every dark corner is a door to a new light"
I called my PM's office today and cancelled my two scheduled ESI's...I am not going to have anymore injections...I've had five and none of them have provided any pain relief...I'm not willing to jeopardize my health to please a doctor that doesn't have my best interest in mind. I am in the process of finding a new PM...I have always had a bad feeling about my current one and only wish I would have started searching for a new doctor sooner...we live and learn and I guess that's how we get older and wiser, right?
Marlosmom - Thank you for bringing arachnoiditis to my attention. Before I read your post I had never heard of this condition...I appreciate the information...I researched it a bit and think it should be required of PM's to inform their patients of this condition (among other side effects of steroids) before they make the decision to go forward with ESI's.
Moldova - I'm sorry to hear about your experience with your former PM...I think our PM's may either be blood relatives or medical school buddies...my story is in many ways similar to yours...I'm glad you were able to find a new doctor.
Dh had 7 series of shots in a year. None of them helped the pain because when he finally had surgery, the neuro found that the herniated disk had broken to pieces and had traveled upward to cling to the spinal cord. Personally, I think surgery was the only option he had but he had to try the injections, first.
Please read the fine print when you sign for the shots. One consequence is that it can lead to diabetes. Dh is now pre-diabetic with no history of it in his family.
Oh yeah....I am a living example of what too much steroids can do...
For a couple of years I was given oral prednisone for a problem other than my back...then when I fell...well, I was given epi's...for the cervical neck pain...then after I had the acdf...yikes....I had all of the symptoms of a heart attack about 2 months later...was hospitalized for several days...the blood tests indicated heart problems...but other than a-fib...they found a healthy heart. For a year and a half, I was having problems...then...my husband's endrochronologist took a look at me and said I had hypoglycemia...yup...but he also found out later that I had adrenal insuffiency...not a pretty thing either..so I am on steroids to keep that under control.... In the meantime, I am having more steroids in the forms of blocks/epis etc. for my lumbar pain, which brings me to the 40 pounds I have gained since the end of May...yup...40...and this is a woman who had to eat to keep weight on...The Doctor who did my last injection said that I was not getting any steroid in it...ha...he lied...he later said, oh there was just a LITTLE in the injection...(normally I would have stopped taking my daily cortef (steriod(...but he didn't tell me...so I had a little overdose. My body is not happy. The endro. Dr. says...oh it's not the steroids I give you...they are at a physiological dose...(no more than the body would make in a day.)...So it has to be the other injections. We tried to wean me off of the daily steroids...well, that was pretty bad...my poor husband...I was so cranky and nasty...so I am back on them. I was so achy/hurty...nasty....just had a mental feeling of being so tired and lost...which was corrected when I restarted my normal dose...
So, for your sake, please be careful..you do not want to go through what I have...adrenal insuffiency is not fun...and can be very very dangerous..
We all have to take responsiblility for what we put into our bodies...I keep telling the doctors that I can't have anymore epi's if they have steroids..they are not happy with me...and my PM Dr. says basically he can't do anything else for me. Oh well...please..just be mindful of the injections...ask what they will be injecting...and express your concern.
Hello Kadinka8. Welcome to the board. It seems to me that most Dr's and their staff are so slick when it comes to injections and other procedures...when I've had ESI's, the office girls had me sign the waiver releasing PM from any liability and saying they will be right back w/a copy for me, but I have honestly never received a copy of the waiver, which is admittedly, dumb on my part. I had no idea a possible side effect was diabetes...it makes sense though...on the post procedure sheet my dr gives after an injection, it says after an ESI your sugar can be low for a short time. Sadly, at this point in my back journey, I can't say anything surprises me anymore about dr's .
Sage - Last week I had mthly appt with PM...we discussed how the 2 ESI's I had in December did not provide any relief...for the first time PM became annoyed and basically told me he couldn't do anything else for me...he said he wanted to try 2 additional ESI's (the 2 I cancelled yesterday) in a different area of my back...if they didn't help he was going to send me back to my neuro...I think he was annoyed b/c he makes the big money off injections and if they don't help me, I'm not worth his time I guess...so, I scheduled the next 2 injections, b/c I was afraid he would cut off my meds if I didn't and I couldn't have that...after my appt last week I started to feel aweful, from what I believe to be too many steroids, so I decided to cancel the injections and find another dr...I hope to have another PM very soon...maybe I will not have to go back to my current one, we'll see. I do NOT plan to let any drs give me any more injections, I am done with them. It may be a different story if they provided any relief but they don't. Sage, I hope things work out with your dr, if not with your current one, I hope you are able to find another dr you can trust. I'll be thinking about you.