[truivia]

It was suggested I repost this here ( I had it posted over in chronic pain )


I am new here so will in brief explain my injury - All L disks are herniated - S1 S2 as well and then those "spacers" are messed up between the disks, and tons of nerve damage and pinched nerves, arthritis, scoliosis, stenosis, degenerative disk --- I think that cover the spine

So I went to a pain clinic for the first time today and they strongly suggested Lumbar Epidural Injections - which I would very much like you all to share me your thoughts on PLEASE

The Dr told me it is a type of steroid and will do wonders for my pain level???

I was on oral steroids 2 times and both times felt like a new person - I had almost zero pain for the first time in 6 yrs.

So of course this treatment sounds very tempting to me - but I want to check around and get thoughts/opinions on it -

I am set to get a series of 3 of these - 1 week apart and then they said I am not allowed to get any more for 6 months - but they also said I would not need any more for 6 months as this first set of 3 will last that long

Please tell me anything you know about this treatment - the good the bad and the ugly

Thanks !

[Bobbi]

Is the set of 3 based on the the idea that the latter 2 will only be done if the 1st is effective or if you find that there are benefits or there is a lessening of pain/symptoms?

I'd question any doc who pre-schedules a 3-round series of ESIs before learning (after the procedure) if the first will prove itself helpful (to the patient).

Before having any procedure a first time, it might be a good idea to get a second (and some times) even a third opinion.

I've had ESIs, along with a host of additional PM procedures. I'm no doc, that's for sure, and am only stating this based on my experience as a patient, yet I'd do as you're doing and await replies from others, too.

To me, something sounds "off" if the doc goes ahead with a pre-set schedule on ESIs, not knowing if the first will even help. The only way to find out is after the first, even if it doesn't fit with the doc's plans. If the first isn't effective or doesn't have felt benefits, it increases the chances that the next two in the series also will not help.

I'd definitely keep an open mind toward the ESI(s), only I'd question ones that are being pre-arranged in advance - set one week apart.

[rfei57]

I have had Lumbar Epidural Injections done the first one helped for about a month the 2nd one about a week and thrid one they had a hard time and hit a nerves two times due to tissue bulid up. I have also taken the pills and they do make you feel like a new person. but as soon as you are off of them the pain is right back

[truivia]

Thanks

Bobbie - I never even gave the pre set appts a thought ! Thank you SO much for bringing that to my attention.

rf - was it scar tissue issues?

[rfei57]

Yes it was scar tissue my back is in bad shape here is some of the problems I have with my low back

There is a grade 1 anterolisthesis of L4-L5 with a hemanioma in the L2 vertebral body, The conus medullaris terminates at the level of L1-L2 and shows normal signal. This is suggesttion or a small synovial cyst posterior to the bilateral L4-L5 facet articulation.Mild bone marrow edema adjacent to the facet articulations at L4-L5 and L5-S1 are likely related to sever degenerative/ arthritic changes. Mild T2 hyperintensity in the paravertebral soft tissues adjacent to the left L4-L5 facet articulation likely represents represents reactive change as well. At L1-L2 level no central canal or foraminal compromise.
At L2-L3 level no central canal or foraminal compromise
At the L-3-L4 level there is minmal bulge asmmetrically prominent to the right side. Central canal shows no significant compromise, Neural foramina show minimal narrowing bilaterally. There may be a right posterolateral annular tear.
At the L4-L5 level there is a diffuse disc bulge associated with bilateral facet and ligamentum flavum hypertrophy. There is mild central canal stenosis at this level. There is mild left neural foraminal narowing. The right neural foramen remains patent.
At the L-5-S1 level there is a mild diffuse disc bulge associated with a posterior annular tear. the central canal is not stenotic. There is a mild neural forminal narrowing. The right neural foramen remains patent.
1. Atthe L4-L5 level there in mild central canal stenosis secondary to disc bulge, ligamentum flavum hypertrophy as well as severe facet hypertrophic degeneraive change bilaterally
2. Grade 1 anterolisthesis of the L4 and L5 that was the mri in 2006.

Feb 3,2008 There is a grade 1 anterolisthesis of L4 on L5, less then 5mm. the rest of the lumbar spine is well aligned, Vertebral bodies are intact without destructive lesionsor compression fractures. Marrow signal is normal.
Conus medullaris termiunates at L1.
T12-L1, L1-L2, L2-L3, and L3-L4 have patent spinal canal and neural foramina
L4- L5 has a disc bulge. There are degenerative changes in the facet and ligamentum flavum. Spinal canal and neural foramina are patent. There is degeneratve sclerosis billaterally in the pars interarticularis without a clear spondylolysis.
l5-S1 has patent spinal canal and neural foramina. There are degenerative changes in thefacet and ligamentum flavum. Impression
1. No Spinal Canal or neural foraminal stenosis.
2. Multilevel degenerative changes, worse at L4-L5 with stable grade 1 spondylolisthesis

[Just Jo]

Originally Posted by truivia

It was suggested I repost this here ( I had it posted over in chronic pain )

I am new here so will in brief explain my injury - All L disks are herniated - S1 S2 as well and then those "spacers" are messed up between the disks, and tons of nerve damage and pinched nerves, arthritis, scoliosis, stenosis, degenerative disk --- I think that cover the spine

So I went to a pain clinic for the first time today and they strongly suggested Lumbar Epidural Injections - which I would very much like you all to share me your thoughts on PLEASE

The Dr told me it is a type of steroid and will do wonders for my pain level???

I was on oral steroids 2 times and both times felt like a new person - I had almost zero pain for the first time in 6 yrs.

So of course this treatment sounds very tempting to me - but I want to check around and get thoughts/opinions on it -

I am set to get a series of 3 of these - 1 week apart and then they said I am not allowed to get any more for 6 months - but they also said I would not need any more for 6 months as this first set of 3 will last that long

Please tell me anything you know about this treatment - the good the bad and the ugly

Thanks !

truivia,

It's been two months since your June post so I don't know what you decided to do. I just found this forum a few minutes ago and this topic which is of interest to me.

My intro:
My PCP has for years considered my back pain 'just sciatica' stating she was sure I had some OA in my lumbar spine but never ordered an xray nor MRI.

In 2005 I was unable to walk, went to ER where they did an xray, gave me IV 5mg Valium & a NSAID - Toradol to get me on my feet shuffling along and sent me home with more NSAIDs - Naprosyn & generic Valium.

I have a hx of CKDIII which was not dx'd in 2006 and cannot take NSAIDs for pain. I have adverse reactions to all opioids so cannot take those for pain. Also have 20 yr hx Chronic Fatigue Syndrome and Fibromyalgia, and 10 yr hx of COPD/chronic bronchitis.

So my PCP ordered PT twice in 10 years which was helpful but not healing. I keep my weight at normal BMI for my height, have no high B/P nor diabetes, am a 61yo female.

Since Nov '08 my PCP had essentially ignored my lumbar pain as 'just sciatica' and as in the past ordered no xrays or MRI. Memorial Day 5/26/09 I spent the day at the ER in agony.

They gave me IV Valium 5mg which barely helped but could not give me any IV NSAIDs due to CKDIII dx. They allowed me to leave with instructions for PCP to order an MRI the next day. PCP has computer access to these records but when I called for her to order the MRI, she again took a 'wait & see attitude' for ten days to see if 'things would resolve on their own'.

I was furious. Finally on 6/4/09 she ordered the MRI which was done on 6/11/09 showed degenerative disc disease from L1 thru L5 and S1-2. More calls, more time passed and I finally got a referral to the Univ/Mich Back and Pain Center where attendings and fellows are all anesthesia pain specialists.

I researched the facility, physicians and procedures prior to my appt and took their first available appt was 7/22/09, filled out alot of paperwork which they actually read.

At that 3 hour appt the attending, a fellow and a physical therapist examined me, had studied 5/26 xrays and 6/11 MRI, went over meds I take and the meds I cannot take and recommended a lumbar epidural at L5 which was scheduled for Wed. 8/5/09. My diagnosis is Spinal Stenosis.

All were calming, kind, knowledgeable and answered any questions I had. Twice I thought of more questions, called and was called back the same day with answers.

Just yesterday morning I had the corticosteroid, Kenalog, injected at L5. The nursing staff was excellent and calming, pre-injection was gowned, had B/P, etc. checked, they went over meds I take, anesthesiologist agreed to let me take 10mgs Valium rather than IV Versed. Was in procedure room, injected with lidocaine then epidural of Kenalog injection took 10 minutes with B/P, heart rate being monitored.

Post-inj I was instructed to walk around for 15 minutes, then saw anesthesiologist again and discharged. They did require that someone be there to drive me and to just rest yesterday. While Lidocaine'd had zero pain.

So far so good. Lidocaine wore off by 1pm Wed 8/5/09. Fibromyalgia pain started flaring somewhat in legs and upper back which was not unexpected.

Today there is mild tenderness at injection site which was expected. I'm moving around normally - I never bend at waist, i.e. I'm just always careful which is normal - with no pain at all in lumbar spine. I did twist awkwardly w/o thinking and got one little twinge in left buttock but that's all.

Every patient, diagnosis is different so outcome can be different. A Board Certified Anesthesiologist with pain management experience IMO is the best physician to handle these types of injections and/or medications.

You wanted the good, bad or ugly. My experience thus far has been very good, no bad nor ugly.

I have a follow up appt on 9/1/09. Depending on the success of this injection, it may be recommended that I have up to 4/yr if it continues to help. The possibility of additional epidurals were not discussed until after I'd had the first one.

Additional PT with the physical therapist I saw in '98 and '08 will be ordered at some point. She has 30 yrs experience, understands fibromyalgia and will help me get abs stronger.

Since my anesthesia/pain specialist is highly trained/skilled and welcomes my questions, I have no qualms regarding further treatment with him.

I've always had a good/warped sense of humor which I find essential in dealing with pain (with life!), and I've learned many ways to distract myself, from the antics of wildlife in my yard to those of my 7 indoor cats. Meditation, biofeedback and other stress/relaxation techniques provide calm which helps reduce pain and I'll take any reduction however sliight.

Maintaining cautious optimism and finding *JOY* & a good belly laugh daily especially with additional stressors (current domestic/foreign events) is key for me.

If you had the epidural, I hope you received some or all pain relief. Good luck!

HTH,

Just Jo

[firethightheater]

the bipuvacaine didn't help much but less than 24 hours later I am experiencing substantial pain relief in my left groin and anterior thigh pain problems that had been going on for 10 to 12 days....
kenalog injection in two locations....
this could be the answer for me

[shannon12]

Originally Posted by truivia

It was suggested I repost this here ( I had it posted over in chronic pain )


I am new here so will in brief explain my injury - All L disks are herniated - S1 S2 as well and then those "spacers" are messed up between the disks, and tons of nerve damage and pinched nerves, arthritis, scoliosis, stenosis, degenerative disk --- I think that cover the spine

So I went to a pain clinic for the first time today and they strongly suggested Lumbar Epidural Injections - which I would very much like you all to share me your thoughts on PLEASE

The Dr told me it is a type of steroid and will do wonders for my pain level???

I was on oral steroids 2 times and both times felt like a new person - I had almost zero pain for the first time in 6 yrs.

So of course this treatment sounds very tempting to me - but I want to check around and get thoughts/opinions on it -

I am set to get a series of 3 of these - 1 week apart and then they said I am not allowed to get any more for 6 months - but they also said I would not need any more for 6 months as this first set of 3 will last that long

Please tell me anything you know about this treatment - the good the bad and the ugly

Thanks !

I had a series of 3 (3 weeks apart). It helped the lumbar area, but did nothing for hip, pelvic, and leg pain. I think it is worth a try. I was sore for a couple of days after each treatment, but it wasn't too bad.

[jgianniny]

I realize my post is not current but i just registered today and read your question and the responses you received. Contrary to the concerns noted for having three epi's scheduled in advance it was explained to me that in some cases as severe as mine it may take several injections to yield measurable results. It was further explained that the LEI can be used as a diagnostic tool to better understand what problems I have with my spine. You see I spent a lifetime being mis-diagnosed so the doctor was interested to see if i responded well to the LEI or not. Based on zero relief or improvement I eventually had to resort to surgeries. I wish the epidurals were effective but I have far more damage than bulging discs or inflamation. good luck...hope this helps. I'd suggest asking your doctor the reason for sets of three so you know exactly why he is treating your specific condition in this manner. Even when we have the exact same issues often times we require very diffeent fixes. .

Originally Posted by truivia

It was suggested I repost this here ( I had it posted over in chronic pain )


I am new here so will in brief explain my injury - All L disks are herniated - S1 S2 as well and then those "spacers" are messed up between the disks, and tons of nerve damage and pinched nerves, arthritis, scoliosis, stenosis, degenerative disk --- I think that cover the spine

So I went to a pain clinic for the first time today and they strongly suggested Lumbar Epidural Injections - which I would very much like you all to share me your thoughts on PLEASE

The Dr told me it is a type of steroid and will do wonders for my pain level???

I was on oral steroids 2 times and both times felt like a new person - I had almost zero pain for the first time in 6 yrs.

So of course this treatment sounds very tempting to me - but I want to check around and get thoughts/opinions on it -

I am set to get a series of 3 of these - 1 week apart and then they said I am not allowed to get any more for 6 months - but they also said I would not need any more for 6 months as this first set of 3 will last that long

Please tell me anything you know about this treatment - the good the bad and the ugly

Thanks !

[ag1967]

Originally Posted by truivia

It was suggested I repost this here ( I had it posted over in chronic pain )


I am new here so will in brief explain my injury - All L disks are herniated - S1 S2 as well and then those "spacers" are messed up between the disks, and tons of nerve damage and pinched nerves, arthritis, scoliosis, stenosis, degenerative disk --- I think that cover the spine

So I went to a pain clinic for the first time today and they strongly suggested Lumbar Epidural Injections - which I would very much like you all to share me your thoughts on PLEASE

The Dr told me it is a type of steroid and will do wonders for my pain level???

I was on oral steroids 2 times and both times felt like a new person - I had almost zero pain for the first time in 6 yrs.

So of course this treatment sounds very tempting to me - but I want to check around and get thoughts/opinions on it -

I am set to get a series of 3 of these - 1 week apart and then they said I am not allowed to get any more for 6 months - but they also said I would not need any more for 6 months as this first set of 3 will last that long

Please tell me anything you know about this treatment - the good the bad and the ugly

Thanks !

Well I was just like you and just had cervical epidural done.I was left with a paralyzed left arm ,more sleepless nights then ever before,severe headaches.I had the procedure done,after trying ALL the therapy and ALL the meds first.They cant say or give me a percentage of any healing at all.I go to talk to otho surgeon friday.Dont know if I even want that done now.ANYONE have similar case please write me and let me know you thoughts....PLEASE

Signed,
Alot Of Pain