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L4-5 epidural steroid injections, any experiences? please share!
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L4-5 epidural steroid injections, any experiences? please share!

`I recently went to a orthopedic specialist for their opinion ( mainly on my neck) and they told me they wanted to do some of these injections. At first the nurse suggested injections at C 3-4 and L 4-5, then he left the room to discuss it with the doctor. He came back and they had decided to only do it on my L 4-5. I am personally more comfortable with the thought of thought of the lumbar injections but, this doesnt help my neck pain, or help my case for keeping my insurance. I am fighting to keep my insurance and needed new medical information for the evaluation person, the state needs recent medical records for neck treatment, but no one wants to treat my neck after I got vertigo, I dont want anyone touching my neck.

So any how, I am just curious about these injections. I have read about them but I would like some personal experiences with this procedure. I get flairs of back pain that leave me stuck to the couch for days, and constant aches and pains. So please, if you have had this or know anything important about it, please let me know.

Also I have chronic gastritis and I know that those steroids an nsaids cause stomach issues, is this going to make my stomach upset even if it is injected instead of ingested?    Thanks in advance for the replies! Stacey
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620923_tn?1416285879

Well Stacey...vent away : )
I know of someone else that lives up in ur corner of the world and is having a time of it getting the proper care too....seems drs r too into looking for horses when they got zebras...if they would only listen to their patients.....

I agree, that shot does sound scary....but I also get the lower back pain and attribute it to my TC issues....not sure if it is or isn't...but I know how u feel....ouch!

"selma"
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620923_tn?1416285879

  Hi Stacey...I wish I had info to share on this, but I do not : (

I am posting to bump this up and to offer u some support on these injections u r considering....

I also wanted to ask if u were tested for POTS or ne of the other related conditions?

Ur insurance issue is also something I am not familiar with....what type of coverage do u have?

  "selma"
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It is the state of Washington health care for the temporarily unemployable. I is like a temporary Medicare program, one of the programs that has been seeing cuts due to the budget shortfalls this year. I have community health plan of WA with Provider One as a secondary insurance. I am going through a fair hearing to keep my benefits due to my previous doctors lack of medical information (they refused me my rights to see specialists).

I have not been tested for POTS, I have a appointment coming up and I can ask but I think I am going to try for testing for connective tissue disorders. My new doctor is more receptive with my requests so I actually feel comfortable with asking him for these things where as before I couldnt ask my previous doctors for anything that they didn't suggest themselves.

The injection thing is a scary thought, they can accidentally puncture your dura! But my lower back gives me such grief at times that I have no other options. I started thinking back to last summer and most of it was spent on the couch due to my lower back pain and my doctor at the time wrote in my records that I was hyperailmentating and should see the in house psychologist.  *Enter hysterical laugh here*  My back was killing me last summer and it flairs up all the time now and NOW they are offering me a injection to ease the pain!?!
I first injured my L 4-5 in like 2007, my MRI's are from march of last year and they are just now coming up with some offer for pain relief?!?   I am just frustrated and venting I guess.
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620923_tn?1416285879

Well Stacey...vent away : )
I know of someone else that lives up in ur corner of the world and is having a time of it getting the proper care too....seems drs r too into looking for horses when they got zebras...if they would only listen to their patients.....

I agree, that shot does sound scary....but I also get the lower back pain and attribute it to my TC issues....not sure if it is or isn't...but I know how u feel....ouch!

"selma"
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759386_tn?1324565724
Stacey,

I have had the injections in my back as well as my neck:  The injections in my neck helped for about 30 minutes and that was it.

I had injections in my back in the upper area some place; I do not remember exactly where as I have had back surgery S1 L4 & L5.  I can almost still feel her knee in the middle of my back as they got to the place they needed to be with the needle and meds.
It felt like they were crushing through verterbres with the needle.  I was not impressed;
this has helped greatly people that I have talked to.  So,I figured that I had nothing to loose.
I was willing to try most anything at that point in my life.
NOT AGAIN IN MY LIFE TIME...  It seemed to me that it made things worse.  The pain doc told me to give it time.  It did not help me at all.  They had all the equipment they needed to make sure that they could see the needle go free they needed it to so I know that it went where they wanted it to.

I also had an ATTEMPTED mylo gram with my back as preperations for the back surgery; three sticks later and still not the right palce he put in the dye and hoped that it would go where they want it to. it is very uncomfortable.  But, nothing like the experiences with the injections in the back.  They did not work for me as I have said, I have also talked to people that 10 years later that there back feels great still.

Roy902
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Dear Stacey,
I am sorry to hear about your pain!! I can say that I know how you feel, since being there myself.

Before I forget, the brain fog is starting to set in(lol). If you or anyone else has a problem with your insurance(myself included) and you can't get any further, write a letter explaining the problem and include bills and orders from the doctor, if applicable, and then send it to the Insurance Commissioner of your state. He can force them to pay.

Back to the steroid injections. I had my first series done for the same discs as yours. It took being there 15 mins and was finished. They were performed by the anatheisiologist at the Pain Clinic at Suburban Hospital in Bethesda, MD. When I left I had a couple of hours of no pain due to the pain blocker in the injection. Then I had the worst pain and I said something to my neuro-surgeon that sent me there and my GYN and the doctor that did it. I went back several weeks later for the 2nd, again upon leaving I was pain free. The third again no pain upon leaving and at that point I could not stand up straight and kept telling the 3 specialists that it felt like someone was pulling my insides. I was sent for a ultra sound while crying from the pain and no answers. I finally figured it out and asked if the steroid could affect my adhessions from pelvic surgery a couple of years before and bingo-that was what it was.I was allowed more and had no pain following the next three and was then pain free for 1 year. One has to wait 6 months before you can have another series and I wasn't going to chance that horrific pain again. Mind you, it was due to the adhessions.  Several years later I went to another doctor because
the one at Suburban was no longer there and this one put you out and I had 4 for my cervical spine with no help at all. Oh, forgot to tell you. With the lumbar blocks, one time the doctor put the shot too close to the L5S1 and I could not hold my urine. After I told him, he placed the next one above it a little and  that worked. There was no pain at all during the procedure.

You did not mention if you were prescribed any pain meds or muscle relaxants. These help even to today for me. Also, for relief now, you can ice the area for 20 mins. per hour that you can, NO heat. Also, did your doctor tell you how to sleep? Never on your stomach and if you sleep on your side, bend the outer leg at the knee and place a pillow between your legs. If you sleep on your back, place a pillow behind your knees, this takes the pressure off your lower spine or you can use a wedge. You can also use an IF4000 Personal Interferrential Unit when awake, which is better than a TENS. It is like your own STEM machine and it helps with inflamation (inflammation) and also to help block the pain.You can use it with the ac adaptor or a 9 volt battery and it comes with 2 sets of leads, but I only use one because it is stronger that way when I am really hurting. Oh, do not lift anything heavier than a can of soda, I was told.

I hope this helps. I have been through almost every possible tactic to help, including in home traction (trying to avoid surgery). I slept for 6 months in a pelvic traction device with 40 lbs. pulling my spine open, I had no pain from those discs while in it. However, the doctor that prescribed that for me, was done after my first MRI that unfortunately, the radiologist did not note that I had ACM. If he had, I would not have been able to use the traction. After 6 months, it took the pain away from the sciatic nerve (no surgery). Two years later another MRI and that radiologist wrote that ACM was present in the prior one, but not noted, and I had already gone down hill to the point of being 100% disabled, it made my herniation worse (now 1.0-1.4 cm from 5-7 mm, I have one side longer than the other).FYI- my neuro-surgeon told me at the age of 44(I am now 56), I had the spine of a 94 yr. old and would be in a wheelchair within 5 yrs.-wrong. I am not in one and use a cane while out to help with my balance. I enjoy proving the docs wrong.

Again, I hope this is of some assistance. If you have any questions, please ask away. When I 1st was diagnosed, I saw the report before my doctor and was somewhat freaked out reading malformation of the brain. I have a genius IQ and was worried what this all meant to my brain, and I had worked 8 yrs. with adults with IQs of 20 or less and some were born normal, but due to childhood illnesses, were down to the above and worse (you can imagine why I was freaked some) . I waited in the hallway till my  doctor came out of the patients room at his office and asked, while holding the report from the MRI,  what that meant and he said, "oh you have Arnold Chiari Malformation of the brain with a 5-7 mm herniation" (I already read that)." We got maybe 15 mins. in med school on that because it is rare", that was it-great,uh. I was living on the Eastern Shore. The neuro and the steroid shots, I had to drive to the DC area, where I had grown up from the age of 12, to get assistance. I finally went to TCI in Long Island, NY to be totally evaluated. The use of MRI technology has made it possible for others to be properly DXed.

I wish you the best and for relief!!!! You may have to travel for the proper treatment and understanding.

Best in health!

verdenango
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Just typing to update on how things have been going. I had an incident on April 12 where I lifted something heavier than I should have. I am pretty sure I re-injured the L4-5 disk that I had the injection scheduled for on the 22nd so 10 days later.  It was pretty terrible pain so I went to the ER, and was sent home with pain killers, muscle relaxers and steroids. I usually would turn away the steroids, but this time I know it was really bad so I took them as prescribed.
I didnt pay much attention to how the predinsone was persribed, I just took it till it was gone.  The first day after they had ended, I started to feel this widespread muscle pain like I was bruised all over my body. I then looked into the steroids and I had takin.   3   20mg predinsone a day for 5 days, at first I figured  thats not a long drawn out taper pack and I wont have to take them as long.  Big mistake! That doctor put me through a very painful steroid withdrawal. I should have gotten the taper pack. I dont know why he would do something like that?  The plus side to the steroids  was they really helped get my back inflammation down to where it was before I had injured it so I suppose it was worth it, but I will pay more attention next time.I will never let that slide by me again knowing what I know now, I would tell them to re-write the script!
So, I went through with the epidural injection, it re-induced my pain and it hasn't gone away yet. I almost passed out after the injection from the amount of pain and discomfort it caused me and I have to go through another one before they will decide if it is working for me or not. My BP was 141 over something before the injection then they took it after, when I looked like I was gonna pass out and it dropped to 90 over something! I was shocked! I have never seen it change that fast. The nurse said they triggered my vagus nerve response, so this really is something I dont want to go through again  I am really uncomfortable with the whole thing and I have no choice but to go through with it, my insurance requires me to follow through with recommended treatments of they can cut off my benefits.
  I was lucky enough to get my medical extended thru june for these treatments so thats a bonus I suppose?!?   I have had a lot going on and stress seems to make me get little bouts of vertigo lately.  I have found myself just suddenly falling sideways and bumping into walls. After I hurt my back again this last time, my legs were so sore the following days, it was terrible like I had ran a mile. I think I was having muscle spasms. I was walking around looking drunk!

Also something new I noticed, was reading through my report from the neurologist and I noticed something that he noted, " visualized spontaneous venous pulsations" in the eyes. I did a little reading and found it linked to raised intra-cranial pressure. I also read in the bottom of the report that he would be happy to seem me for any future issues, so that means he is my neurologist, so I suppose I could call him and make another appointment to address my pressure headaches.  

The weather in my area has been very wet and cool, our city broke a record for the latest spring day to reach 60 degrees. It has been between freezing and 55ish so not much spring around here yet. Yesterday the mountain near our city got 3 feet of snow And we also broke rainfall records in the city. This bad weather never helps with health conditions, im sure most of you can agree.
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i had injections in that area.  from nerve blocks to epidurals.  the nerve blocks did nothing.  i had a really good pain management doctor who performed them.  i was very comfortable.  i had 3 epidurals, one each week for three weeks straight.  took the pain right away.  come to find out i had endometreosis.  the 3 epidurals stalled my period which left me pain free.  but from the moment i left the doctor's office, i felt a huge relief from the epidurals. highly recommend, but make sure you are with an experienced doctor.
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The injections aren't helping me yet, and I had my second on the 4th so It should be feeling better by know. I only feel like if I do too much, I will be in more pain than I am already in. If I simply bend or lift too much (not much) I seem to re injure it very easy. I was hopeful that these would help but. so far they leave me in pain and make me almost pass out. My BP was 74 over 52 after this most recent injections. They kept layed me down, I didnt feel well at all and was white as a ghost it sounds. They are very uncomfortable my description would be along the lines of being getting the worst piercing of your life, but no jewelry to show for it. The feeling of it going through the layers of ligaments and tendons is not pleasant at all  and neither is the pressure pain sensation from injection of the numbing stuff or steroids! I dont think they are numbing me enough, I can tell exactly what is going on and would rather be knocked out for it. The second wasnt as bad as the first time but I would be fine going the rest of my life without having to ever experience it ever again.  

I have to have one more, even though they are not helping me. I have read if the first one doesn't help, more will likely not either  but they are still doing them and then want to do my facet joints at L 4-5 also.  
I think these injections and the round of steroids i had before the shots started have messed with my hormones and moods. I might have endometreosis also but I will not let them scope me to diagnose it, no thanks not unless I try to get pregnant and can  not.

As for experienced doctor goes, I really hope he is but I dont really get to pick and choose with my insurance. He seems to have done many of these injections so in not uncomfortable with him,  just the injection itself.    
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1778452_tn?1314498178
I have been receiving these injections off and on for over 20 years now and only 2 times did I feel that I got any relief from them I always hoped that at least they were getting some diagnosing info. but not really. so my last round of injections ( I had 5 in about 5 or 6 months) I gained 25 pounds in 4-5 months and the only change was the injections. I have now been trying to lose the weight and I cannot get it off no matter what I try.
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620923_tn?1416285879

  Hi...may we ask for what pain or condition u were having the injections?

  I noticed u were not a member of the chiari forum, so I was not sure if u had chiari.....or a chiari related condition.


      "selma"
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1778452_tn?1314498178
Oh wow, sorry no I do not have chiarri? I don't know how I ended up here. I have spinal stenosis, degenerative disk disease, and failed back syndrome.
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620923_tn?1416285879
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Avatar_m_tn
had injections for almost 6 yrs now and no end in sight ,cervical and lumbar epiderals.
my pain is intense or I would not get them . i am not sure if my injuries
have created osteoarthritis or the injections ,but the choice of severe pain
offsets any fear of this development .I cannot go far without them every 10 to 14  days and feel they have saved my life. Consult several specialists and your own trusted doctor ,,,, good luck
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620923_tn?1416285879

  Hi and welcome to the Chiari forum.

May I ask do u have Chiari Malformation or Syringomyelia?

I am not sure what u r getting ur injections for.....what injury did u have, how long ago and what was ur dx?

  Not sure , but u may also want to check out the Spinal Cord C/D forum.

http://www.medhelp.org/forums/Spinal-Cord-Conditions-Disorders/show/1227?controller=forums&action=show&id=1227&camp=msc
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