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-   -   Anyone with more pain after a transforaminal epidural steroid injection? (https://www.neurotalk.org/spinal-disorders-and-back-pain/158997-pain-transforaminal-epidural-steroid-injection.html)

ava704 10-13-2011 01:07 AM

Anyone with more pain after a transforaminal epidural steroid injection?
 
In March 2011 by MRI I had learned that I have an annular tear, bulging disk, and facet degeneration. For the past 10 yrs I've avoided lying on my back to avoid low back pain and burning in hips and legs. That was the only time that I had pain. April 2011 I had the first injection. Six days after the injection I could not stand or walk with out help. I decided to do the second injection even though I was terrified and had serious doubts. From April until July I was in so much pain that I could not get out of bed most days. In July my pain just mysteriously started easing off. About 1 month ago (September) my pain has returned. Not as intense. I am mobile, but in constant pain whether lying on my back, sitting, standing, etc .Lower back ( L4,L5,S1) ache then burning in hips and down through legs. Also, aching pains; Ache in center of my lower back and at same time in thigh or leg. My new ortho or any doctor doesn't think that it has anything to do with the injections. I completely disagree. All I want is some relief. I also have Fibromyalgia, but that seems to be the least of my problems these days. I am terrified of anymore injections, but I have become discouraged and beat down and I am considering letting him do the facet blocks. I am 29, in college, and have three children, and I am scared that this could actually be the bright side. If things were worse I don't know what I would do. Has anyone else had bad experiences with these injections??? What has become the initial outcome and how did you deal with the pain and stress and especially the doctors not wanting to admit that something went wrong? Any suggestions for me? I go back to the doctor soon for another MRI :)

Leesa 10-15-2011 05:18 AM

Hi ~ I've not heard of injections doing this, but that doesn't mean it can't happen! I would certainly steer clear of ANY type of injections after that. I know you want relief -- you'd be better served to get a referral to a pain management doctor. They can give you more options for pain.

Has your doctor put you on any medications for the pain? There are meds specifically for the burning/nerve-type pain that you're experiencing. These meds work quite well. I've had nerve damage for over 25 years, and the medications help alot with the burning/tingling. Also, I'm on the Fentanyl patch & Methadone for pain. Nothing else worked -- I've tried everything. :eek:

See if you can get a referral -- I hate to think of you in so much pain. Best of luck & God bless. Hugs, Lee

Dubious 10-15-2011 03:33 PM

Quote:

Originally Posted by ava704 (Post 814392)
In March 2011 by MRI I had learned that I have an annular tear, bulging disk, and facet degeneration. For the past 10 yrs I've avoided lying on my back to avoid low back pain and burning in hips and legs. That was the only time that I had pain. April 2011 I had the first injection. Six days after the injection I could not stand or walk with out help. I decided to do the second injection even though I was terrified and had serious doubts. From April until July I was in so much pain that I could not get out of bed most days. In July my pain just mysteriously started easing off. About 1 month ago (September) my pain has returned. Not as intense. I am mobile, but in constant pain whether lying on my back, sitting, standing, etc .Lower back ( L4,L5,S1) ache then burning in hips and down through legs. Also, aching pains; Ache in center of my lower back and at same time in thigh or leg. My new ortho or any doctor doesn't think that it has anything to do with the injections. I completely disagree. All I want is some relief. I also have Fibromyalgia, but that seems to be the least of my problems these days. I am terrified of anymore injections, but I have become discouraged and beat down and I am considering letting him do the facet blocks. I am 29, in college, and have three children, and I am scared that this could actually be the bright side. If things were worse I don't know what I would do. Has anyone else had bad experiences with these injections??? What has become the initial outcome and how did you deal with the pain and stress and especially the doctors not wanting to admit that something went wrong? Any suggestions for me? I go back to the doctor soon for another MRI :)

Sorry to hear of your condition. Transforaminal ESI is somewhat of a blind procedure that can go way wrong. Injuries to the exiting nerve root, adjacent vascular structures and cord can and do happen. It is much more risky in the cervical spine however because of the close proximity to the vertebral artery.

One other thought that you may want to research is reflex sympathetic dystrophy or complex regional pain syndrome. Some of your complaints seem to fit that pattern. Google "RSD" or CRPS" and browse around. Maybe look at rsds.org for some additional thoughts. May not apply to you but you will know after you compare your problems with what is written.

K9Mom 01-17-2014 02:57 PM

Had transforaminal CESI
 
I had a TCESI at C5 done bilaterally. It's been a week and I'm still in pain. My right side- the affected side feels good. The left side- non affected side aches. I can't sleep, sit, stand or walk without neck, shoulder, back and arm pain on the left side. My doctor says to give it two weeks, but I'm tired of it already!

rlee 02-04-2014 02:36 PM

Pain after Trans Foraminal Epidural Steroid Injection
 
I am a Nurse Practitioner and though I work with many different patients in my job, I also suffer from Significant back problems., that are most like going to require surgery. My Orthopedic doctor recommended a trans-foraminal steroid injection as a means to possible help decrease the pain I was having as a result of my disease.

Trans foraminal Epidural Injections are done for primarily one reason and that is to see if an inflammatory process within the spine or area of the problem is responsible for the pain. If the patient receives pain relief then surgery or other invasive treatments may be avoided for quite some time as some patients get pain relief from these injections for a year or more at a time.

If the pain did not go away following the procedure then, most likely the problem is "mechanical" meaning inflammation is not the cause, the cause is usually then related to the nerve or nerves being compressed or squeezed between bones in the spine. At this time, many doctors will proceed to surgery or another treatment to relieve the pain.

I just want to mention to make sure your procedure was either performed by your own physician or a reputable clinic familiar with these procedures for they may additionally fail it they are not performed correctly.

Hope this helps some. have a great day!

rlee 02-04-2014 05:58 PM

Quote:

Originally Posted by Dubious (Post 815172)
Sorry to hear of your condition. Transforaminal ESI is somewhat of a blind procedure that can go way wrong. Injuries to the exiting nerve root, adjacent vascular structures and cord can and do happen. It is much more risky in the cervical spine however because of the close proximity to the vertebral artery.

One other thought that you may want to research is reflex sympathetic dystrophy or complex regional pain syndrome. Some of your complaints seem to fit that pattern. Google "RSD" or CRPS" and browse around. Maybe look at rsds.org for some additional thoughts. May not apply to you but you will know after you compare your problems with what is written.

Actually, a TFESI should not be a "blind" procedure. If done correctly it should be done by a Physician who uses C-arm Radiology techniques, where the spine and foramen can be visualized throughout the procedure. If a Physician or clinic said they did not! perform these procedures in this manner, I would have it done elsewhere as a "Blind" Epidural injection of any sort, but especially foraminal would certainly have a high failure rate...So, PLEASE, ellow members, if considering this procedure, be sure to ask "HOW" they plan on performing.. Have a Great Day...Rita

Dubious 02-04-2014 08:30 PM

Quote:

Originally Posted by rlee (Post 1048928)
Actually, a TFESI should not be a "blind" procedure. If done correctly it should be done by a Physician who uses C-arm Radiology techniques, where the spine and foramen can be visualized throughout the procedure. If a Physician or clinic said they did not! perform these procedures in this manner, I would have it done elsewhere as a "Blind" Epidural injection of any sort, but especially foraminal would certainly have a high failure rate...So, PLEASE, ellow members, if considering this procedure, be sure to ask "HOW" they plan on performing.. Have a Great Day...Rita

Correct...I don't think I know anyone in their right mind who doesn't use fluoro (c-arm) for transforaminals. While it is not entirely a blind procedure (the bones are well visualized), my reference to that is due to the soft tissues (muscles, nerves, blood vessels, etc.) being almost entirely not visualized with fluoro (it is an x-ray generator initially producing the beam and subject to the same non-visualization of soft tissues as conventional x-ray). Before my injuries, I was a primary provider with an x-ray and fluoroscopic supervisor permit in my state, owned a c-arm and so I know a thing or two about x-ray and fluoroscopic technique! There are adverse events in the literature regarding cervical transforaminals (12% from what I recall) where in worst case scenarios medications were injected into the vertebral artery or even events of puncturing the cord or exiting nerve root, causing a host of catastrophic events, including paralysis, stroke and death. I am not an alarmist, just a realist and fortunately these outcomes are uncommon! PM docs that I know are much more comfortable performing interlaminar ESI's in the cervical region.


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