It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Pain Management Message Board

  • Epiderul Steroid Injection....?

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 10-11-2004, 09:29 PM   #1
    AncientTowers
    Junior Member
     
    AncientTowers's Avatar
     
    Join Date: Sep 2003
    Location: hollywood, FL, USA
    Posts: 22
    AncientTowers HB User
    Epiderul Steroid Injection....?

    After being to the ER, after having a crap Dr. who didn't want to order an X-ray, I soon found out after an MRI that I have a hurniation L5-S1 (which I had last year, but got better...see I was thinking I was having Tailbone pain, which turns out to be Sciatic pains). So it was back to my orthopedic surgeon. He gives me percocet and Medrol to try (medrol=oral steroid). Well the pain meds work, shortly and little, but the Medrol didn't do a thing. So he's now setting up an appt. for ESI (epiderul steroid injection). I'm curious to hear if anyones had that procedure done. Was it painfull, did it help eleviate the pain, etc. I've read about it online, but havn't read if it's painfull, and from what I HAVE read...it's really a 50/50 chance of eliminating the pain. And if that doesn't work, my Dr. says surgury is an option. Which doesn't scare me, but I'd rather not do that I'm sure.
    Feedback is appreciated

    -James
    __________________
    A Utopian Society would have libras as a foundation!

     
    Sponsors Lightbulb
       
    Old 10-12-2004, 05:51 AM   #2
    rdunnit
    Newbie
     
    rdunnit's Avatar
     
    Join Date: Jan 2004
    Location: Wichita, Kansas
    Posts: 6
    rdunnit HB User
    Re: Epiderul Steroid Injection....?

    I just recently had 3 epidural steroid shots for bulging discs at L3-L4, L4-L5, and L5,S1. They did not in the least bit help with my pain one bit. In fact, my pain has increased. My PCP has had me on hydrocodone, oxycodone, MS Contin, and Oxycontin. I ran out of all pain meds Saturday night and paged my doctor this morning at 2:00 am. He told me to go to the ER and that I would just have to learn to live with the pain. I have heard that some people have had good luck with the injections but when the discs are bulged or herniatied enough to cause severe pain then surgery might be your best bet. I am having a microdiscectomy done on 10-19 and am hoping that it will relieve this excruciating pain, because my doctor refuses to help me any further.

     
    Old 10-12-2004, 06:13 AM   #3
    scotty12
    Veteran
    (male)
     
    scotty12's Avatar
     
    Join Date: Sep 2003
    Posts: 469
    scotty12 HB User
    Re: Epiderul Steroid Injection....?

    James,

    ESI's are pretty standard treatment.some do get relief from it.ive had 3 w/no relief.
    they may hurt when they inject the meds if you have minimal disc space.my first 2 were not bad ,but the last one i got did hurt.doc gave me a 2nd local and proceeded pain free.they do try and numb the area.

    if the first 2 dont help i would think twice before getting a 3rd.they are usually done in a series of 3.i was desperate so i went ahead and got the 3rd shot anyway.if you have leg pain it may do some good.max of 3 per year.


    good luck,scotty

     
    Old 10-12-2004, 10:47 AM   #4
    Shoreline
    Senior Veteran
    (male)
     
    Join Date: Jun 2003
    Posts: 3,519
    Shoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB User
    Re: Epiderul Steroid Injection....?

    Hi James, ESI help some folks and not others, it just depends on the problem they are trying to treat. Simple inflamation or stretching a nevre like whiplash may respond very well. My wife had an ESI done for a whiplash injury, It worked well and at the PM Clinic they actually put her out with profonol, a short acting anesthesia.The best I ever got was a couple mgsof versed if anything at all. You also want to be sure your doc use flouoscopy to guide the needle and doesn't do it blindly.

    Her first experience has been great, didn't feel or remeber the procedure, after a little increased pain from the increased pressure of putting the mix of steroid and lidocaine or marcaine in, she has gotten relief. I don't think it's a cure unless the injury would have healed without intervention. It may be a way to decrease the inflamation process and relieve pain and speed recovery but it doesn't remove dsc fragments, or un-impinge a compressed cord from a disc. Discs herniation is really a catch all phrase that doesn't acuretly describe anything. I imagine your using herniation to describe a bulge, but what's more mimportant is thewre any compression of nerves or the cord and to what degree.

    However there are risks aside from it not working. Scar tissue, arachnoiditis "when scaring occurs or squeezes the arachnoid or sub arachnoid layer of the spinal cord. Risk of nicking the dura and loosing spinal fluid will cause the most tremendous headache you have ever had. 2 out 6 nicked my dura and had to be repaired with a blood patch, which is just injecting your own blood dircetly into the area of the cord they nicked. Spinalk fluid has little to no clotting abilty and as the blood that's injected trickels out the 2 holes you now have, causes them to clot and seal. It's much better than waiting weeks flat on your back for the hole to close.

    My question is, If he's offering an ESI to relieve your pain, which in itself isn't going to really fix anything, why would he mention surgery.
    As soon as surgery came out of his mouth I would have said for what, and what kind. What is your DX other than sciatica which is a vague description of leg pain.

    If the MRI showd a definite comprssion of the cord or a nerve root, then surgery is likely the only way to correct it. Buldges that heal themself are just buldges. Did the disc rupture and spill out disc fragments that are causing impingmnets.

    Throwing out the posibilty of surgery withut an explanation of what surgery would do for you would upset me. Surgical odds are grossly over estimated and the posibility that your pain could be drastically increased beyond normal ways to manage this type of injury can't usually be undone. Once your back is sliced for open surgery, your back will never be the same.

    If you have definitve compresions and fragments that can be seen and can be addressed, It is lkely your neuro symptoms ca be resolved. All 3 of my surgeriies relived the neuro symptoms untill each set of hardware snapped and caused a shift of bone, disc or hardware.

    Having surgery to relive back pain has terrible oddds. Having surgery to decompress or relive a compresson has better odds of taking care of the nerve problems but could still leave you back a mess.

    I really don't have constant nerve/leg pain now, surgery did corect that. I'm numb from my groin to my knees but numb isn't painful.When the hardware shifts it does light my legs up but I can usually get it shifted back into a nuetral position. However my back is a bloody nightmare. After each surgery I had to rethink the whole 1-10 pain scale. What you think is unimaginable pain now "a 10", could be what you get to live with for the rest of your life.

    After the first fusion that failed and the hardware actually broke, what I had once thought unimagnable or pain that would make you pass out was what I was living with. Unfortuantely you don't pass out. Instead you crap your pants going over a speed bump and can't stand 5 minutes without your legs shaking and breaking a sweat.

    I would be worried about surgery by a doc that throws spine surgery out there like it would be elective surgery. I wouldn't elect to have any spine surgery. It either needs to be done or not. IMO Or your being denied other option due to a docs lack of knowldedge, experience abilities or beliefs.

    Or, we are in so much pain, the pain isn't being managed, we haven't been offered a solution so now we will rolll two 12 sidded dice hoping for a 3 or to grab for the carrot hanging out that that offers relief because the only thing being offered as a way to manage the pain is very iffy surgery.

    Have the ESI, If it doesn't help get another opninion. There are reasons to have surgery and reasons not to have surgery. If you don't correct a nerve impingement and then decide 4 years later it's time because the pain is now unbearable. The nerve could be so damaged that even the best surgeon couldn't relieve the nerve pain , let alone the additional back pain from having your back sliced open and having the spinous process clipped off to gain access to the problem.

    There is another failed back surgery syndrome called post laminectomy syndrome. A laminectomy is clipping the spinous process off. Those boney posterior protrusions. They interlock just as the facets on the side of each vertabrea interlock.
    However often the problem can't be reached without removing that part of the vertabrea. A safe procedure is calleda laminotomy, where they drill holes in the Lamina to gain access or site.

    When you remove one of the 3 joints that holds each vertabrea in place there is the possibility of slipage of the vertabrea from front to back or vice versa. This type of instabilty crushes nerves when vertabrea shift back or impinges the spinal cord and stretches the nerve roots when it shifts forward. Now you have the speed bump problem. So the next carrot becomes a fusion.

    The problem with not fixing a nevre impingement though is the whole gateway theory of pain.Pain signals open a gate allowing nerve transmission to your spine and up yto your brain. If pain signals are engrained into the nerve pathways the gates stay open and continue to send the same signal, by then decompression doesn't help. Your still left with the same pain. Hopefully the speed bump problem impoves and your back hurts more from instability from the lami and pain from the muscle damage as they cut through the thick muscle and fascia that protects the spine.

    I'm pretty much the worse case scenario for every surgery I had. The first two were before OxyContin was invented and when pain wasn't treated with opiates.PT ESI's, relaxation techniques and antidepressants were believed to manage all pain bythese docs that wouldn't prescribe a T-3 on a cancer ward.

    I wouldn't be cavelier about not being afraid of surgery. L5-S1 has more problems than L4-5. The odds of success are inflated and If your considering it, you want several opinions. Not every doc is going to use the most current and non invasive methods to operate. They normally use the method they were tought 10-20 or 30 years ago and keep on doing the procedure the same way, when another doc may use minimally invasive endoscopic to trim a disc.

    You could see 5 surgeons with a disc compression of the L4 nerve root and get 5 different aproaches to surgery. You have to shop surgeons untill one of the guys procedure makes sense. You have to ask why is this way better than the other 4. If you think your pain couldn't be worse, don't kid yourself. After my last fusion, 3rd surgery. My pain scale become more like a rictor scale where every number is 10X worse than the previous. It's the only way to expalin the pain of vertabrea grinding and crunching on vertabrea, and when the hardware shifts from broken and toggling screws onto a nerve root they could put you on the whithouse Xmas tree and be seen for miles.

    You have a virgin back and If I could go back I would. keep it that way unless there isn't an alternative. If you need surgery you need surgery, not a doc that sees it as an option to possibly relieve pain without a specific plan to corect X y or Z.

    The idea that back surgery is a choice or elective when your tired of the pain is like thinking being disabled is a choice.It may be for some that abuse the system and don't want to work. But personally, I didn't wake up one morning and say I hurt too much and I'm going to apply for disablity. I did it from a hospital bed in my den I had been bed ridden in for 9 months following the last attempt to redo and replace hardware and fusion. That failed too and that set of hardware is in worse shape then the first set I broke.

    Pain is relative to what you have experienced and docs don't talk about increasing pain. The act like it will either work or you will be left in the same condition with the same level of pain. However what you thought was a
    10 "unimaginable pain that sends you to the ER" prior to surgery is now a 4 on your new scale of what you think is unimaginable pain. Just because you can't imagine it being worse doesn't mean there isn't something beyond what you can presently imagine or are experiencing. It may be the worst pain you have ever felt, which is horrable regardless of how many times you reset your pain scale. This was never even mentioned as a posibility by any doc, but then you learn what intractable actually means.

    I'm not trying to deminish the pain you are in. If you said your pain was a 10 and couldn't be worse. I would believe your experiencng the worst pain you have imagined and should be on your way to the ER. But the unimaginable can become real and then you have to rethink the whole 1-10 scale.
    Good luck, Dave

    Last edited by Shoreline; 10-12-2004 at 12:02 PM.

     
    Old 10-12-2004, 05:13 PM   #5
    geifer
    Senior Member
    (female)
     
    geifer's Avatar
     
    Join Date: Apr 2004
    Posts: 135
    geifer HB User
    Re: Epiderul Steroid Injection....?

    Hi, I just finished my second caudol Epidurual this past week and I am going in for my third on the 22nd. So far so good I have had no complcations and the pain level is better. There has been an improvment of at least 50% and I hope this last. They are going in thru the tailbone and shooting the seroid in at L5 S1 area. They do it under xray and it is alittle painful like shoreline said just when they inject you but it quits right after. I can bend better and my leg pain has improved. I have arthritis in the area. It has hurt for over a year and they kept increaseing my morphine pump with little results. They say it last awhile and there is a limit on lifting. They say nothing over ten pounds for the series is done. I hope this helps and good luck to you geifer

     
    Old 10-12-2004, 07:21 PM   #6
    AncientTowers
    Junior Member
     
    AncientTowers's Avatar
     
    Join Date: Sep 2003
    Location: hollywood, FL, USA
    Posts: 22
    AncientTowers HB User
    Re: Epiderul Steroid Injection....?

    Thank you all for your responses. Shorline - bravo as usual, SO imfomative. OK, to clarify a few things. My Surgeon, though I don't know much about him, he seems very sharp and the 'firm' he works for "Broward Institute for Orthopedic Surgeons" is a sharp institute. But, if it does come down to surgury I WILL get some opinions. He didn't jump to surgery in the same breath as speaking of ESI's, but I did ask him and he said surgury could be an option, but he would like to see if less invasive techniques will prevail.
    -Now here is what my Radiologists report inside my MRI films say....
    [B]
    IMPRESSION: At the L5-S1 level there is a central and predominantly right paracentral disk protrusion which abuts the right S1 nerve root. This disk protursion extends posterior to the superior aspect of the S1 vertebral body.
    Honestly I get part of it, but maybe shorline you can clarify in Laymans what exactly that means.

    -James
    __________________
    A Utopian Society would have libras as a foundation!

     
    Old 10-13-2004, 06:12 AM   #7
    scotty12
    Veteran
    (male)
     
    scotty12's Avatar
     
    Join Date: Sep 2003
    Posts: 469
    scotty12 HB User
    Re: Epiderul Steroid Injection....?

    James,

    in all honesty i think you should get into phys therapy.

    if you have pain meds its alot easier to push yourself in the begining.
    stregnthening is key to avoiding surgery.even if you are in good shape,abs strengthenuing and DAILY stretching after about 2 months you will see a difference.

    I know what its like to be in pain constantly and say to yourself i cant take it anymore and think surgery is the right choice but shore is right about once your back is operated on youll never be the same.

    best of luck,scotty

     
    Old 10-14-2004, 08:44 AM   #8
    Shoreline
    Senior Veteran
    (male)
     
    Join Date: Jun 2003
    Posts: 3,519
    Shoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB User
    Re: Epiderul Steroid Injection....?

    Hey AT, It basically means you have abulge that does extend to the nerve root but they didn't note a compression, It doesn't mean that slightly touching the nerve dosesn''t cause pain or the problem is minimal. MRI don't really show soft tissue swelling or spasms that can clamp down on the nerve and cause leg pain, so conservatibve at this point sounds ideal.

    A bulge can receede, but it does take time, You need to be careful lifting as not to cause a greater degree of bulging or for the bulge to rupture,. Disc material is caustic to nerve tissue and can cause demylanization/damages the outer lay of nerve tissue, and once ruptured you would likely need something more invasive.

    How invasive, is up to the surgeon, He can do open surgery or can do endoscopic surgery, A laminectomy of L5-S1 wouldn't likely be needed to gain access to the site, You actually have quite a bit of room at that level, you would also have quite a bit of roonm to accept the steroids without the pressure it can creat when injected into a tighter joint. L5-S1 is more open because it's a segmental break in the different parts of your spine Meaning the lumbar spine and the sacrum which are composed of small fused vertabrea.

    It is a point where more movement can occur as the basic joint from spine to our hips so you do want to be careful lifting and twisting. Ideally the ESI will reduce local inflamation, the numbing agents will give relief and the disc bulge will recceede. But it is right at the point of touch but not quite impinging.

    I've always had the question of, does it look the same while standing or does the bulge recead while prone. There is no weight bearing while an MRI is performed so you may need to have a Meylogram where they do Xrays after injecting dye and roll you on a table into a standing position and even an inverted position and side to side. They have hand grips on the table so you don't do a face plant when they tilt you head down.

    Whith weight bearing and tilted in all directions they can and look for cord or root impingment by seeing blockages in the flow of dye. It's an old test but still can produce significant findings. It's also improved greatly with the development of absorbable dye. In the older days they used an oil based dye that had to be removed after the films were taken. Having it injected doesn't sound bad, But manipulating a needle around to suck up the oil based dye sounds rough.

    My last meylogram went very smooth, Having a lami from L1-S1 pretty much opened a great deal of space where I could easily except the standard amount of dye they inject in everyone. I felt no increase in pressue and the radiologist comented he could have used twice as much dye. If the area is tight, the increased pressure is more painful. My first meylo wasn't nearly as comfortable but that was when my spine was still intact and closed.

    Sounds like a normal corse of treatment and a conservative doc not trying to book every possible OR hour he can, which is a very good thing. A doc that's not worried about loosing a potential surgical candidate will have no problem and won't be insulted by asking to get a second opinion.

    Good luck and hopefully this will be a speedy recovery. Take care, Dave

    Last edited by Shoreline; 10-14-2004 at 08:51 AM.

     
    Closed Thread

    Related Topics
    Thread Thread Starter Board Replies Last Post
    bruising ater injection is it normal???? dinnon Hepatitis 3 04-19-2010 06:55 AM
    Triesence Steroid Injection Dancinboots Eye & Vision 6 09-29-2008 02:43 PM
    steroid injection for S1 area....please advise jacquelineforde Back Problems 12 02-03-2008 12:32 PM
    Steroid Injection shawley Back Problems 24 11-05-2006 07:12 AM
    Steroid Spinal injection and weight gain? bjpuyallup Open to All Other Health Topics 6 10-04-2006 05:45 AM
    Esacerbated Symptoms Post Steroid Injection findingmeg Foot & Ankle Problems 1 01-24-2006 06:46 AM
    Wasn't Someone Asking About Steroid Injections For RSD? Horsie Nutt Reflex Sympathetic Dystrophy (RSD) (CRPS) 1 04-06-2004 07:22 PM




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is On
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 02:38 AM.





    © 2020 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!