Prednisone injection into spine

[Normal]

I have spinal stenosis L2-L5 (severe L2-L3, L4-L5) and it was suggested that a epidural Prednisone spinal injection be done to decrease swelling and as a test to see if surgery would be benificial. What are the risks and side effects and is this an approved procedure? I thank you for your consideration.

[CCF-Neuro-M.D.-JT]

Epidural steroid injections for lower back pain due to spinal disease such as a herniated disc is a common, accepted procedure in the medical community usually done by anesthesiologists, rehab docs, or pain clinic specialists.  In the literature, 25-80% of patients report some relief with the injection. Those who are reported to have a higher chance of benefit are people who are younger than 50, have had no previous back surgery, shorter duration of pain, and have symptoms of a radiculopathy (nerve root irritation-in your case pain and weakness in your legs). Complications/risks include infection and bleeding at the top of the list, followed less commonly by transient low blood pressure, then spinal headache from accidental puncture into the dura (a little too far), and finally and very rarely paralysis and difficulty breathing if it's done too high up by the neck (not a problem for you). Make sure you go to a reputable pain clinic/hospital or experienced physician to have this done.  Also, a proper diagnostic workup should have been done such as an MRI of your lower spine and formal physical exam.  Good luck.

[guyinjax]

Just wondering how your injections went? I have a series of 3 scheduled and hoping they helped. Would like to warn you that there can be side affects.I had 6 lumbar blocks done 2 yrs ago and since that time my thighs have been killing me every day and know one from a neurosurgeon to orthopedic doctors can tell me why.

[Cosmie]

I had a prednisone injection into the spine last year as a last resort attempt to avoid lumbar fusion surgery.  The injection did not work and I had been warned that, in my case, it most likely would not.  But I would like your thoughts on what happened to me following the injection and, in summary here goes:  I was fine throughout the procedure, walking out to a room where I was supposed to be "observed" for about 20 minutes.  I felt fine, but the next thing I know they are telling me my blood pressure is quite low and that I need to be moved to the main recovery room for further observation.  I admit I was feeling a bit tired, but next thing I know is they hook me up to an I.V. and heart monitor, are giving me oxygen and telling me I'm not awake.  I WAS awake, just sleepy.  They then ask me if I had taken any drugs or medicines prior to the injection, and I said I had one attivan (given to me by the nurse prior to the procedure because I was nervous).  I don't know how much time had gone by, but by around 9PM they called me doctor to come back and then transferred me to the ICU as the regular recovery room was closing down.  There, I was given something through I.V. to bring up the blood pressure and, in the early morning, put into a regular room where I spent the next 2 days on oxygen, and unable to void on my own.  One week later when I returned for the "post-injection" visit to the doctor, he told me in an almost accusing tone that my blood pressure had gotten dangerously low and that everything, including my breathing, was depressed, and proceeded to imply that I must have been on some sort of drug (even though they took blood tests and nothing was found).  The doctor also informed me that surgery at that (well-known and highly respected NYC hospital) was not an option.  This was evidenced by my attempting to have a consultation with the head of the spine department who refused to see me after reading a fax I sent to the doctor on his staff who performed the procedure, with a copy to him, in which I basically said I was not out to accuse anyone of anything, but what happened to me was clearly not normal, and I felt I had been unjustly treated and wanted an explanation.  Since then, it has been explained to me that the doctors involved may have been afraid of dealing with potential legal claims and opted to dismiss me in any way possible, as fast as possible.  Later, I got more opinions on the surgery, all agreeing on the need for lumbar fusion and finally did have it done at the other excellent orthopedic facility in Manhattan.  I'm doing well following the surgery last summer, but the experience I had at the first hospital - which is world-renowned in orthopedics - was emotionally very hard on me.  I believe they were cowardly and cruel in their treatment of me and were only concerned with avoiding blame and showed no integrity or regard for me at all.  I don't think our system should allow doctors (or their lawyers) to get away with this kind of treatment.  Please tell me if I am wrong.

[Normal]

I had the injection, felt slightly worse for and it didn't help.

[Normal]

I did not have the severe reaction to the injection you exprienced, and neither did it help. As of now I have had two neurosurgeons confirm the need for surgery and one neurologist say there is no need for it. One surgeon said the need was immediate and the other said only if the quality of life deteriorates to unaccepatble levels. This business of taking MD's advice can be taxing on the patient.

[Margarettemarie]

I have been receiving "epidural blocks", steriod injections for many years.  It has been one thing that has helped me get by with chronic back pain.  I searched out a qualified pain management doctor who is very good at these type of procedures.  There is a series where you can have up to three injections.  The steriod type, depomedrol similair to prednhisone, is very helpful. Each person is different, and have different medical problems.  I have received pain reduction from these injections which I have periodically. The only difficulty I have ever experienced is 1) Sometimes I have increased pain in that area and others for a period of 2 to 4 days, which is common.  I also do not feel the final results of the steriod medication for 3 to 5 weeks.  This is a possible solution for pain reduction for some individuals.  I have never exerienced any problems.  I would suggest anyone having serious pain to seek out the possibility for them. I always tell everyone who asked about the pain of having the procedure, that I only feel pain for 60 to 120 seconds and that makes it worth it! I also ask personell at the hospital of their opinions of doctors and you find out a great deal as to who is good and who they would recommend.

[ambrgrl1]

A related discussion, Rebif & Epidural steroid injections was started.