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    Old 08-07-2006, 02:56 PM   #1
    jitteryme
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    Epidural Steroid Injection

    I have a couple of questions for anyone who has had an ESI. I had a cervical epidural steroid injection late in the day last Wednesday. The paperwork given to me by my doctor said that it could take up to seven to ten days for the steroid to provide relief. Today is day five and I've got nothing. I'm no worse, but I am also no better. I had really hoped to have noticed something beneficial by now. For those of you who have had this procedure, how long until you felt better? I am looking for just a tiny bit of hope that this will work. I know everyone is different, but I would like to hear what others have to say. Also, if you have had more than one of these injections (say the first one did nothing) did the second one provide any relief? I am not sure I want to do this again if it isn't likely that it will help.

    Thanks!

     
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    Old 08-07-2006, 05:26 PM   #2
    kera4
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    Re: Epidural Steroid Injection

    Hi! I have had ESI's in the lumber region, and it has taken a week to feel relief. So, I would wait a few more days to assess. Usually, you want to feel SOME relief to go forward with further injections, but every doctor has a different protocol. Do you have a follow up appointment a few weeks after the injection? If it is not better by then, let him or her know. If it does not work, sometimes they will inject another level, or the facet joints around the disc. It is a process of elimination as to where the pain is coming from. With me, we did 3 injections near my bulging disc, but the pain relief was short lived. Then my doctor injected my facet joints, and that really worked (more of the pain was coming from there). I still have to be careful with my bulging disc, if I sit too long or twist wrong I can get pain. But, the intense, burning, constant pain is gone. Good luck to you-I know how frustrating it can be! kera

     
    Old 08-07-2006, 06:00 PM   #3
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    Re: Epidural Steroid Injection

    I've had lumbar ESI's...the first one provided the most relief pretty much right away for me. It relieved my sciatica and herniated disc pain but didnt help my pain from stenosis. But still it was a big improvement over the pain I had before I got the shot. I had a 2nd shot 2 weeks later and still felt the same. I was also scheduled for a 3rd shot two weeks after that one....but after about 1 week I started feeling some pain come back but it was more of a stiffness and pressure-like pain in my lower spine. One month after the 3rd ESI it all wore off suddenly and I felt as if I was hit by a train with the most severe flu I'd ever had. My entire spine was sooo stiff, everything went into spasm. NOt only was my spine hurting, but every single joint in my body felt stiff and swollen.. I felt exactly like I do when I have a lupus flare. But since I take Plaquenil for lupus, the flare only lasted about 3-weeks. After that went away, I didnt really feel the sciatica pain anymore..but the stenosis pain (neurogenic claudication) is always there. However, I know a few people who had 1 or 2 ESI's and have been pain free for years

     
    Old 08-07-2006, 06:02 PM   #4
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    Re: Epidural Steroid Injection

    Hello Jitteryme-
    I have had 4 epi shots in my lumbar spine but I am about to have my first in the cervical area (C5-6). My lumbar shots were a real disappointment but I don't regret trying them. Also, the inside story is that many insurances will insist that they be tried prior to any more invasive Tx (like surgery). I actually had an increase in pain for 2 of my shots for about 2 days. At best, the shots lessened one or two of my symptoms for about 2 weeks. But 2 of the shots never did do a thing for me that I could tell.
    It is a real mixed bag and many, many people have great results with them. My epi doc really wanted me to commit to at least 2 shots before giving up on them. So I did. In my case, the problem was not one that was going to respond to the shots but we didn't know that when we decided to go ahead with them. Even if you agree to give the 2nd or even a 3rd shot a chance, I would be asking your doc what is the plan for if they don't work. You could be using the time to do some valuable research and it helps to pass the time - for sure. Best of luck - Suzy-Q

     
    Old 08-08-2006, 09:35 AM   #5
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    Re: Epidural Steroid Injection

    It is most likely not going to be a wake up and you don't feel pain scenario, more likely gradual improvement of symptoms over some weeks as the inflammation (hopefully) goes down. If you are staying very active during this time you may not relieve the inflammation.

    You might inquire about Selective Nerve Root Blocks for your case. I has much more success with those than with the ESI's.

     
    Old 08-08-2006, 10:41 PM   #6
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    Re: Epidural Steroid Injection

    After 3 years of chronic pain at L5S1 I finally saw a spine doctor (Hoyman Hong, san francisco) who told me my MRI shows my disc is about 25-30% of original size with a right protrusion that was hitting a branched nerve. After throwing out my back twice in one month and missing a week of work, I begged for the epidural.

    I noticed immediately the dull achy pain still existed, but the sharp pain from the protrusion touching the nerve subsided. I could feel it, but it was numb. I was still in pain for the first month, but the second month has been very nice. No sharp nerve pain. dull achy still exists and I started taking my pain meds about 7-10 days after the epidural because the dull achy pain was too much to bear.

    I'm into the beginning of the third month and the sharp pains are slowly beginning again. I'm gonna let it run its course for a couple more weeks before I contact my doctor.

    Some great relief from pain that has helped wonders is an orthopedic therapist. It's out of pocket, but it's only twice a week at $120 for 90 minutes (cheaper than the overpriced drx 9000). took me three tries of therapists to find the guy but Scott Schwartz at Psoas has really helped me extend the benefit of the epidural more than he knows.

    the muscle release techniques have loosened up the muscles in the lumbar area and relaxed my glutes to the point that I feel nearly pain free at times.

    I think my second month of sharp pain free experience was partially attributed to the muscle relaxation therapy.

    I have coworker who had three epidurals until he finally felt relief. I have also heard you only get three a year. This would make perfect sense because this is a steroid and could start to damage to your liver over the long run if you were to get a new shot every month. I know we're not all musclebound freaks using high dosages, but long term exposure might possibly be the reason they would limit the amount you could receive.

    Last edited by lowbackpain; 08-08-2006 at 10:45 PM.

     
    Old 08-09-2006, 08:10 AM   #7
    jitteryme
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    Re: Epidural Steroid Injection

    Okay, I'm not exactly sure why my post went from the Back Disorder board to the Spinal Cord Disorder board. I have DDD, three bulging disks, two bone spurs and a straightening of my cervical spine. There's absolutely nothing wrong with my spinal cord.

    Today will be day seven after my injection. I'm still not feeling anything. My pain, is and always has been, the dull achy kind, which goes up to the base of my skull. The doctor feels it is the disks causing the pain, as when I lay down, it goes away and only comes back when I am upright.

    Following my injection, I asked my doctor what the follow-up would be. He said that someone would call me in ten days to see how I was feeling. They didn't make me an appointment or anything, just that someone would call me. I have every faith in the world that my doctor is a very good physician, but I have to admit that I am not all that thrilled with the way his office is run. I guess I am not a very patient patient and want things to happen faster than the way they really work.

    I'm still holding a glimmer of hope that things will get better, but I am feeling more and more like a second injection is in my future and that's really not all that appealing to me right now.

    Thank you all for your replies. It is nice to hear from people who have gone through this and learn of their experiences.

     
    Old 08-09-2006, 09:18 AM   #8
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    Re: Epidural Steroid Injection

    I was told it's common not to see results with the first injection. If you tolerated this one well, it might make sense to try a second one rather than thinking surgery or thinking you have to live with the pain.

    A friend of mine said she was headed for lumbar disc surgery but went ahead with the 3rd injection and that one was the charm. Not only did it resolve her pain, but that's been about 3 years ago and it's never come back.

    When my cervical ESI's did't work I was recommended to see a neurosurgeon, but before doing that I took my films and ESI records to a different pain mgmt doc for review. I just wanted to see if the doses given and the levels injected seemed like an adequate trial before jumping into surgery. (They were)

    (My dad had serious complications from a lumbar fusion, so I was terrified of surgery and was hoping ESI's, PT, time, or even a miracle would be the cure w/o having to go thru the surgery and long recovery.)

    I agree, the "hurry up & wait" with a series of ESI's can be very frustrating, but since one or two more might be the ticket to relief, you might consider keepinig up with it.

    Hope you feel better soon.
    Lilacs

     
    Old 08-09-2006, 06:47 PM   #9
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    Re: Epidural Steroid Injection

    In the first series of epidural injections I had (neck), I felt relief after the 2nd injection in the series of 3 (one injection every two weeks - 3 total in 6 weeks). My PM doctor said the same course of treatment could be done twice a year (so a total of 6 injections). If it had worked I would have stuck with it as it was easier than the surgery. The first set of 3 worked well and I was fine for over a year. The second time (earlier this year) it only dulled the pain slightly and I ended up with C5-C7 fusion.

    Incidentally I did have L4-S1 fusion in 1993 but not for disc problems (for spondolytic spodylolysthesis).
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    Old 12-08-2006, 12:51 PM   #10
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    Re: Epidural Steroid Injection

    The first shot only made me about 40% better and it took up to 7 days for relief. The second one, 8 days later made me 80% better and I began PT and fully recovered. Unfortunately I lifted and moved things too soon (April and May were my shots and I started moving stuff in August) and I herneated again. Had 2 more shots and no relief and now am scheduled for surgery. But if you haven't continued the shots and done PT I suggest u do - it worked for me initially and I was 100% fine!

     
    Old 12-09-2006, 03:31 AM   #11
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    Re: Epidural Steroid Injection

    same here. i had 5 epidurals in my lumbar years ago. it actually took the 5th one to work but it did and thank God kept me out of surgery since '99. i am careful that i don't lift anything too heavy or the wrong way for fear of making matters worse. now i am faced with a really bad neck. 3 bulges, bone spurs indenting my spinal cord, stenosis and a pinched nerve at the C7. spine specialist has mentioned surgery twice which i will do anything to avoid and at my last visit said he is holding off on it for awhil. i injured 5 body parts when i hurt my neck and afte going to PT for 8 months not one would toudh my neck. worked on the other parts and have gotten some relief. but don't know if injections an dpT would help my neck since it keeps being held off. the lumbar ones never bothered me but i am petrified of having injections in my neck. can't imagine them not being extrememly painful.

     
    Old 12-09-2006, 06:58 AM   #12
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    Re: Epidural Steroid Injection

    ICC:
    I had epidurals in my neck and they put me under "conscious sedation" when i had them. I didnt feel any pain whatsoever. Zero. Every injection I have ever had in my neck was done this way, with different Drs. The only ones that have hurt me are "trigger point" injections, which are totally different and have been done in my Dr's office rather than a surgical center.

     
    Old 12-09-2006, 12:59 PM   #13
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    Re: Epidural Steroid Injection

    Like everyone else has said, I believe, your doc will determine your protocol. I've found in my own research that they'll usually try a 2nd shot, but if you don't feel anything from that, they usually won't proceed with the third and my opinion is that you should not allow them to. Your post was probably moved because the cervical spine is a different bear from the lumbar. If you have any stenosis (osteophytes, bone spurs), etc., or if you're considering surgery, you're going to be dealing with different issues than those are with lumbar issues. Although we get lumbar visitors here too.

    Cervical issues are tricky and serious. Hopefully you get some relief one way or another. I think someone here suggested selected nerve blocks, that may be something to consider.

    Good luck.
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