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Old 03-01-2012, 07:02 AM   #1
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Problems after Transforaminal ESI

Hello all....
Just happened to find this site, in searching for an answer for what happened.

Long story short... I have dealt with back pain for nearly 20 years now. My Dx has been, from what I remember, DDD with internal disc derangement at L4-L5 and lesser a L5-S1...

Current meds are Valium 3-4 a day, and Suboxone 2mg tablets, up to 10 a day. Got off the narcotics a few years ago, due to overuse, and abuse on my part. (was going through a month of meds in 2 weeks, then one day they refused to refill meds. Got to "experience" withdrawal symptoms for an entire weekend... yippee.. wouldn't wish it on my worst enemy, but now happy with suboxone, and doing better)

So, last weekend, I had the worse back pain I've had, since I can remember.. Woke up Sunday morning, and literally could barely walk to bathroom... (never had this happen before)... Later in day called my Pain management doc, who told me to come in the next day for a shot.

Found out on Monday, he was doing a Transforaminal ESI. I've had epidurals in the past, and always did well for awhile... anywhere from a few weeks, to a few months.... He does them under flourascopy and I do not use sedation. Well, when he started to inject the medicine, what I normally feel, is some pressure, than it is over. No biggy. This time it hurts VERY MUCH... Could feel pain all the way down my right leg. He finished the procedure, and I was feeling better. little sore, but nothing worse than what I've had before. he told me it hurt so bad because the nerve root was so inflamed, he ended up hitting the nerve. So, I make it thought the day, take it fairly easy... then the next day.... yikes!

So, Tuesday comes, I cannot walk to the bathroom without SEVERE pain in my right hip, all the way down my right leg. I found I had to bend over a bit, and support my weight to be comfortable. Walking around the house was a new form of torture... I've never had back pain this bad, EVER, not after any of the procedures I've had... (IDET, disc decompression, or ESIs)
Call doc, he says it is normal... I lay around the house with a bag of ice, getting very little relief. Taking Aleve and Mortrin like the were candy, along with my valium and suboxone. But, I figure, maybe the nerve was just that inflamed...

Wednesday comes around, still in the same amount of pain. I put up with it till about 11am, when I called my doc, to let him know how much pain I was really in... Let him know I literally could not walk across my house. I get a call back saying he's called in a script for neurontin, which seems to make sense, since I perceived this as nerve pain. Took my first dose at 3pm.. By 4pm I was already feeling better. The biggest problem still having numbness in my right leg... My big toe was completely numb.

I woke up today, and my pain is nearly gone... Except for being numb in right leg still..... At this time, as I write this... I have some mild discomfort in my right hip, numbness along right side of calf, and foot, mostly big toe still numb.

Has anyone ever had this happen to them? I starting to get worried this will be permanent. Tonight is bowling night.. My only night out of the house (I'm a stay at home dad, 4 kids 10 and under), so I very much look forward to bowling... But, right now, I don't think I could bowl, even if I wanted to... My right leg just feels so weird, I worry about tripping. I also worry about making things worse, if I try... although, I bowl right handed, so I slide on my left side, which doesn't hurt at all....

Any thoughts, ideas, or suggestions would be greatly appreciated... especially if it gets me bowling tonight... I was thinking of trying a heating pad today,since part of this now feels like tight muscles... But, don't want to risk getting the nerve inflamed more.

I should also mention one other thing... the back pain I was having prior to the injection, is gone.. I am only left with the weird right sided leg numbness.

Sorry this is so long... I tend to ramble... <grin>

Thanks,
Joe_Breezy

 
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Old 03-01-2012, 03:28 PM   #2
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Re: Problems after Transforaminal ESI

Hi there,

Kudos on taking care of the kids. Most folks don't realize that staying at home can be a rough job.

Your symptoms certainly match the doctor's assessment of having hit a nerve. My transforaminal ESIs were pretty benign (mostly unhelpful, though). (Your doctor's statement about your symptoms being "normal" is a little misleading, perhaps "not unexpected" is more accurate.)

Also, the slight delay in the crippling pain makes some sense, as the doctor would have injected a steroid to knock down the inflammation and sometimes a numbing medication, too. The numbing medication usually lasts for 12 hours, so waking up the next day with the increased symptoms makes sense.

I would recommend being a cheerleader this week for your bowling team. Between the back flexion and carrying a heavy ball and bending with it, etc., I think you see where this is going. Once the nerve is irritated, it can take a long time (years depending on the duration of the irritation) to recover. You also right now have the most steroid in the injection location, so any unwise activity could cause further damage to the nerve without you knowing it.

You might want to weigh out waiting a week to bowl versus re-experiencing the type of pain you've been in. But, by all means, join your friends. Keeping a positive outlook and some social life is necessary to recovering from any injury. I would just recommend enjoying the action from the sidelines.

Have you had any imaging recently? You mentioned that for 20 years you have had the same diagnosis, but it sounds like your symptoms have escalated with your most recent episode.

 
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Old 03-01-2012, 10:09 PM   #3
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Re: Problems after Transforaminal ESI

Howdy....

Thanks for the ideas....

Just wanted to mention, my increase in pain only happened last weekend. Up until then I have been doing well. The biggest problem I have at the moment is the 20lbs on put on during the summer. I'm at my highest, 240, but have found the less I weigh, the less pain I have... The best, when atkins diet was all the rage, I got down to 205, and was feeling very little pain. Normally, I have put on some weight during the summer, but normally, it comes right off in the fall, after I've stopped eating all the ice cream, and such. But, I turned 40 this year... and, I think someone flipped a switch to my metabolism, cause this year the weight didn't "fall" off like usual... (darn aging...<grin>)

So, the wife and I (and the kids) joined a gym. My biggest problem at the moment is, I need to lose 10 lbs before I can start working out. At my current weight, I have too much pain trying to work out. But, in the past, when I've been 225-230, I can do pretty much anything, without too much pain. So, not I'm trying to cut out all the junk food, and lose the 10 lbs, so I can get to the gym, and lose some more.

as for my last imaging... It has been quite a long time... I'm going to guess approx 5 years ago. Don't recall there being too many changes between that MRI and the others I've had in the past.

Bowling... hehe... I don't make a good cheerleader, so I tried it out. I figured if I started having pain, I'd quit... Well, I made it through all three games without any increase in pain. In fact, I have less pain now, then I usually do after a night of bowling. See, one of the things I always told myself, I was not going to let some back pain stop me from doing the things I enjoy. I still play golf, still bowl. I usually have to take some extra meds, but at the end of the month, I still have some left... I'm not running out like I used to.... (when I was on the vicodin and MS contin). I literally think the suboxone is my "miracle drug" as my pain has gone from 4-5 on a regular basis, down to 1, maybe 2, and many times I've had zero pain.

My doc explained to me, after being on the narcotics for so long, your body starts to confuse the meds for actual pain signals.... So, it ends up being the more meds you take, the more pain you end up in.... I was told suboxone works very differently, and the body doesn't confuse it for pain signals...

Today, I was pretty much pain free.... the thing that has me worried, is the bit of numbness in my calf, and toes. I find it a little difficult to move around the house too much. it also happens to be what caused me to bowl fairly poorly this evening... (I know... I should have skipped a week, you were absolutely correct) but, whenever I shift my weight to the right leg, I feel like I'm going to fall over... almost.

Anywho... I'm rambling on and on here... basically, I wanted to know if it was normal to have pain post Transformanal ESI. While waiting for a reply, I happen to find a small write up regarding epidurals... and it stated, while most people do have relief after the procedure, there is a small chance the pain will increase after the injection, and can take up to 7 days to fully work. But, also stated, the norm, for those who don't get immediate relief, was 1-3 days for the steroid to start working.

As of right now... I am 95% pain free. (although, I don't look forward to cleaning the house tomorrow, or working the fish fry at church with my girls, but I'll manage.)

Thanks again.
Take care,
Joe_Breezy

 
Old 03-01-2012, 11:32 PM   #4
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Re: Problems after Transforaminal ESI

My only relief from my lumbar epidurals was on days 2 and 3. Then all the pain came right back. I had stenosis, though, and the relief was likely from the mechanical effect of the injection pushing the disc off the nerve, rather than the anti-inflammatory itself.

Be careful! You might want to ask for some PT appts to stretch out the nerves and get them reacting again, rather than just numb. I do nerve glides every day, and they help by tugging on the nerve endings. It helps with my issue, which is mostly pain with a little bit of numbness.

I don't know if you have been forbidden from going to the gym by a medical provider, but don't let the weight keep you from being totally inactive. Your gym membership doesn't have to be an all-or-nothing, 100 mile an hour raquetball OR couch potato situation. I am stuck walking and slowly pedaling on a stationary bike, while two years ago I was swimming 2 miles 4 days a week and thinking about taking up par cours before it became an MTV sport. Though not as satisfying as a hard-core workout, a 20 minute walk has great cardio effects and can be really good for your back, to get you to where you want to be.

Glad your bowling turned out ok -- just remember to ice, 15 minutes per hour.

 
Old 03-02-2012, 03:27 AM   #5
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Re: Problems after Transforaminal ESI

Howdy...

No, i haven't been "banned" from the gym by my doc... It is more of a, "I know what will happen, self ban."

Basically, at my current 240, anytime I try to do some treadmill, or recumbent bike, I get pain.... That doesn't happen if I get down 10-15lbs... Just know this from previous experience. Once I lose those first few pounds, I can go to the gym, and not have to worry about pain.... Unless, of course, I overdo it, then, of course, I'm in pain....

Today, I've noticed, my numbness is a bit decreased... So, hopefullu.

Time to get the kids off to school....

Take care,
joe

 
Old 03-02-2012, 10:32 AM   #6
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Re: Problems after Transforaminal ESI

I'm just curious if you have had any diagnostic tests in the past couple years, or if you are just continuing treatment with a pain management doctor?

Chances are, you are just experiencing the aftermath of the nerve being glanced by the needle and it can take awhile for the symptoms to resolve.

But it could be that the sudden onset of pain is a disc that finally herniated after being under stress all these years....If the numbness doesn't go away in a week or two, please contact your doctor and ask whether you should have a MRI done.

 
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Old 03-05-2012, 05:59 AM   #7
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Re: Problems after Transforaminal ESI

So today is 1 week post procedure....
After getting a script for neurontin, my pain has subsided, actually stopped taking it this weekend, as I might be allergic... (had some itchy red blotches on forearms, and around ankles...)

But, today I still have numbness in right side of calf, and left side of right foot... To the point where I cannot walk comfortably without shoes on...

Everytime I think it is a little better, it seems like the numbness comes back... not that it ever goes away.

Do you all think it is still the side affect of the nerve being "poked" or, possibly just a side affect of the type of ESI I had?

At least now, with shoes on, I can force myself to walk normal, that is, not limp due to the numbness in my foot.

Just thinking out loud...

Joe_Breezy

 
Old 03-05-2012, 04:04 PM   #8
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Re: Problems after Transforaminal ESI

I think the fact that the numbness comes and goes is an indication that it will come around in due time. I think it is traumatized from the procedure.

 
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