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Last Minute feedback on Lumbar L3/L4 ESI injection

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Old 03-26-2012, 07:09 PM   #1
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Question Last Minute feedback on Lumbar L3/L4 ESI injection

I'm getting and ESI (epidural steroid injection) on Wednesday. I am going into this knowing that only 50% percent of people get pain relief from this. I have spinal stenosis at L3/L4 and SEVERE facet arthritis in my entire lumbar spine. I know this won't help my facet arthritis much but I'm hopeful that it will help the leg/calf/foot pain and weirdness I've had for the past 4 years (due to the L3/L4 spinal stenosis). (I was told that a laminectomy is in my near future...getting 2nd and 3rd opinions on that...and trying to avoid that surgery till November).

They advise to stay away from work after getting the injection. Has anyone gone back to a sit down job immediately after getting the injection? Any feedback on this ESI process would be greatly appreciated!


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Old 03-26-2012, 09:20 PM   #2
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Re: Last Minute feedback on Lumbar L3/L4 ESI injection

Many doctors will tell you to take the rest of the day off and that you may resume "normal" activity the following day, if you feel up to it. However, if you can stay home and be a couch potato for 48 hours post injection, it may increase the ability of the steroid to have some effect.

I first was told this by a chiropractor whose husband had terrible brain and back problems and received many ESIs. She explained to me that these ESIs are different from other steroid injections in that instead of going directly into a joint or muscle or tendon as is done when someone has an injection into a knee or hand, etc., in the spine, the steroid is floated in around a nerve or facet, and there is nothing to hold the medication in place. If the person is on his feet, walking around, moving, working, the heart pumps harder and the medication gets used up faster.

If the person can take it easy and rest for at least 24 hours or longer, (preferably at least 48 hours) the pulse is lowered, the blood is flowing more slowly and the medication stays in the immediate area longer. I asked two of my PMs about this and they thought it was not necessary, but the last doctor I went to for injections (and the only one who ever gave my ESIs that did any good) insisted that ALL his patients stay off their feet for 48 hours at the minimum. He was very strict about this rule and patients were reminded of it several times before we left the procedure room, and then the office.

So, I throw this out for your consideration. As I mentioned, I don't know too many PM docs that will direct you to do this...but if you can do it, I think it is worth it. You can only have a couple of these injections, so you might as well maximize the chances of it working.

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