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Lumbar epidural steroid injections
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Lumbar epidural steroid injections

I'm so glad I finally found an active forum for pain management! I've been dealing with my pain for over a year, but was not diagnosed until early this year. My first doctor was horrible so I switched. I have facet joint arthritis, a herniated disk at L5/S1, stenosis from the herniated disk, and an extra vertebrae (L6) so basically my lower back is a big mess. And to top it all off I'm only 26! When my doctor said I had arthritis my jaw nearly hit the floor.

I've been in psychical therapy which made it worse, I've seen a neurosurgeon who said I was not a surgical candidate and was just all around a jerk. Finally after trying 3 different NAISD's (which all did nothing and hurt my stomach so bad) my primary doctor put me in pain management. Now my primary doctor had me on 10/325 Norco. I was taking about 6-8 a day for the pain. I also take Soma when my leg muscle spasms get really bad. The first thing the PM doctor said to me was that I was taking too many Norco. I told her why I was taking so many and she said she didn't want me to take that many anymore. So she cut me down to 3 a day. She also told me to keep taking the Mobic that my primary prescribed and prescribed me a prescription for ulcer medicine so it wouldn't hurt my stomach. Which ***** because the Mobic does nothing and I don't want to risk an ulcer for useless medicine. I also had to sign a narcotics contract, which made me feel like a scum bag.

Anyway, I had a steroid injection on Friday. It felt ok this weekend but now my pain is back. Of course I have no more pain medicine because I need to take more than 3 a day to be able to work and function. The second thing she told me after she cut my Norco was that she does not do refills. I have to come in once a month, take a drug test and then get a refill if I'm clean. So my first question is, can they tell if you've been taking your medicine as prescribed? There is just no way that I can live on 3 a day and I'm scared to talk to her about this because it seems like she wont hesitate to kick me out if I ask for a higher dose or more per month. The injections are my last chance and I want to stick it out for all 3.

Which brings me to my last question. Have any of you had the steroid lumbar injections? If so did it help right away or did it take 2 or 3 shots to start working? I'm at the end of my rope.I need these injections to work for me. I can't live like this for the rest of my life. But I've heard so many different things about the injections. Some people say after 3 their pain is gone forever. But for some it works for a few days - weeks and stops. I don't really know what else to do if these don't work and it seems like if they don't work, my PM doctor will give up on me.

Any advice or anything would be appreciated. Thanks!
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Hi runitskat,

First let me welcome you to the Pain Forum. We're very glad that you  have found us!! I'm VERY sorry that you are having so much pain and at such a young age. My arthritis in my hip was found at age 28 and they think that I'd had it since I was around 15 year old. We are all CP (Chronic Pain ) Patients on here. There are NO Doctors on this forum. We share the different things that have worked for us and try to help in anyway that we can. We hope that you will be an active member on here and share your experiences with us also!

A lot of us on here have PM (Pain Management) Dr.'s and the majority have had to sign a Pain Contract. They have you do that to protect them from the DEA and all of the crackdowns that it is doing on the PM Dr.'s all over the U.S. Don't feel like a scum bag!! If you want to be able to get the meds that will help you, you have to play by the rules.
They will definitely know if you are taking the meds like you are supposed to. If you take too many they will be able to tell. If you don't have any left at the end of the month they will also be able to tell that you don't have any in you. You truly need to talk with her about it at your next appt. If you fail a drug test they WILL NOT hesitate to kick you out.   If that happens you will have a VERY difficult time getting back into see another PM Dr. In the meantime you NEED to play by the rules until you can get in to see her.

One of the reasons that your Neurosurgeon is hesitant to operate on you is because of your age. One of the side effects of back surgery is even more arthritis in your back. I had a herniated disk removed when I was 48 years old and developed severe DDD. He had warned me that it was what would happen and he was correct!! At your age you don't want to face that yet. You have too many years left to enjoy your life without adding that to your problems

That is a lot of Norco's to be taking and it might benefit you you talk to her about taking a long-acting pain med with something like your Norco's for the  BT (Break Thru) Pain med for in between. This is only the type of meds that have benefited so many of us. Just remember we ARE NOT Dr.'s. We are just giving you our experiences that we have had.

I, too, have Facet Arthritis of the lower back.  I haven't had the injections, I've had the RFA (Radio Ablation Frequency) which kills the nerves back there and if you get the results that you hope too, will keep you ALMOST pain free for anywhere from 3 mo. to 18 mo. (once in awhile it will last for 2 years). I VERY happy to say that mine has worked and has really helped a lot. I still have severe pain from the DDD thru out the rest of my back.

There will be other people along on here later tonight or tomorrow that will have had experience with the steroid injections that can be more helpful to you!

Again, I'm very happy that you have found us on here and hope that you will be an active member. I hope that you can get some needed relief from your pain...Sherry

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Avatar_f_tn
Thanks for the reply. I know the reasons for signing the contract. I've research my conditions so much that I can give a speech about them haha. I know why they are doing what they are doing, but it still does not make me feel any better.

I've read that vicodin stays in your system for up to 5 days. I'm having my next shot 3 days before my appointment. So the fentanyl will still be in my system. I'm hoping that that will be enough to get me through the drug test. The ulcer medicine I'm on can also give a false positive for THC so I'm kind of worried about that as well. I'm not a drug seeker by any means. I've never had a problem with drugs and I don't even drink, I just cant get by on 3 a day. And I'm worried that running out a week before my appointment will be a bad sign for her.

I know that I can't keep taking this many Norco's. I don't want to be on pain meds forever. That's why I'm hoping the injections will work. I just get frustrated sometimes because it seems like doctors don't care about patients anymore. They never seem to listen to what I have to say.

I've even gone on anti depressants because I heart it can help with back pain. I'm on 9 different medications and I just feel that at my age this is not the life I'm meant to live. I used to be a very active person. I ride road and mountain bikes (not anymore) work out, go for long walks. But I can't do any of that anymore and it's just one big cycle of depression and pain.

I plan to stick around. This place seems like a good place with lots of friendly people that have similar problems to mine. It helps to talk about it and read others stories.
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Avatar_f_tn
Also I'm not sure what breakthrough pain is. This is really the first time I've been to the doctor and I was kind of forced to go. I'm not sure about the terms and so forth. My PM doctor seems to hate prescribing pain meds and she even told me so. So I'm sure she wont give me something that long lasting.
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Avatar_f_tn
I definitely feel for you and what you're going through.  Its so difficult to live your life everyday in pain. We've all done it and it's terrible.  I hope that you will get some much needed relief, you're so young to be feeling this depressed but I'm glad that you found us.  You'll find out that we really care and want to support you in everything that you do.  

Please keep posting and let us know how you're doing.  Welcome!

Karen
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Avatar_f_tn
Thanks! You guys seem really awesome. I don't talk with anyone in my life about this because I feel like they don't understand. Pain is very personal and hard for anyone to understand because they can't feel your pain.
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I totally understand and agree with what you are saying.  I have an older brother and sister and they could care less with what's happening to me so I don't talk to them anymore about it.  They call and tell me what's happening in their lives but once I start telling them what's happening with me they tend to change the subject or have to unexpectedly leave the phone to do something else.  I agree pain is very personal and I never thought I would talk with people over the internet, but I've only been on here a short time, and I've been able to stand up to my pain doctor, talked to a psychiatrist today for the first time and was told that I have PTSD, amoung other things.  I definitely would not have been able to do this without my friends on this board.  I think the more you read, and post about your condition the better you will feel.  

So, we understand what you are going through and we are definitely here to share anything that we can, tell you what we've been through and generally here for your support.  I'm glad you found us!

And you'll see that Sherry will adopt you quickly and take you under her wing.  She, Jamie, Tuckamore, Bree, and a few others that I haven't mentioned have really walked with me down this path.  

So, welcome and keep posting.  We're here for you!

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Hi Runitskat:  I am so sorry you find yourself in such pain at your young age.   I get injections in my neck and they are fabulous.  One does the trick for me.  Hopefully your injections will work for you as well.

Sherry gave you some really good advice. (Isn't she wonderful!  Our local sweetie!!)  I would let my doctor know that 3 pills a day leaves me in too much pain.  She may or may not up your dosage.  That is her privilege.  Not fair but that's how it is.  We chronic pain patients get thrown in the same pot with the drug seekers.  I hate it but must accept that reality.  

Break through pain is pain that is not eased by your regular medications.  Sometimes it does seem that it's all break through pain.  Nothing is working.  Have you tried heating pads or ThermaCare patches?  They feel pretty good on an aching body.  Physical therapy just increased my neck pain as well.  It did great on my knees after surgery but not the neck.  Also, there is a numbing patch called Lidoderm patches.  These really help my neck and might help your back.  As they are Rx, call your doctor if you're interested.

I'm sorry that you're in pain but I'm glad you found us.  There are many knowledgeable and sympathetic people on our forum.  Welcome.

Sara
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Bless your heart you have so much on your plate right now!! Long-term meds are meant to last for about 12 hrs. but you can get surges of pain through out the day and that is called BT pain. That is what the BT meds are for. The Norco 10/325 that you have been on are considered short-term meds as they are meant to last around 8 hours. There are a lot of PM Dr.'s that WON'T even consider giving pain meds at all. A lot of them require you to try EVERY procedure that they suggest or they won't treat you at all. You need to read your  Pain Management Contract very carefully.

As I stated before your age is ALSO going to give you problems in getting narcotic meds prescribed to you. As you probably already have found out about since you've been doing your homework on all of this (and by the way congratulations to you for doing that) you will become intolerant of your meds and the dosages!!.  With you being so young you could run out of meds that can help you quite early on in your lifetime. That's why they are very reluctant to give the strong meds to young people. There was one person on here who said that their PM Dr. wouldn't even see a patient younger thatn 25 or 26, somewhere in the mi-20's. So unfortunately your age may work against you.  The big problem is that your pain is very real and very painful and you need relief for it just like we older PM Patients. If your PM Dr. gives you too many problems then you may need to consider having your PCP refer you to a different PM Dr.

As I said before I'm so very sorry for all that you are having to endure right now. It'sso very unfair to have to deal with all of this!!

You need to be sure that you carry with you any documented information about your Ulcer meds and the possibility of False Positives on a drug test. Like I said if you fail it you will be out the door and your chart will be Red Flagged. This is where, once again, your age may make it harder to get in with another PM Dr. after a failed drug test.

Just so you know every one of us are concerned about our drug tests because sooo many variables can come into play. All you can do is hope and pray that you have a very compassionate PM Dr.

Please stay in touch and keep us updated as we are concerned about the pain you are in....Sherry
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And our Sara is just as wonderful.  What a great post!
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Avatar_m_tn
I have a procedure every other month  and have done so for about 3 yrs now.It may take a while to find the right combination but will reccomend this vs surgery.
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Thanks guys. I know my age plays a huge role in this. I don't really look like someone who is in this for drugs but I do have a giant tattoo on my forearm that probably states otherwise. I know that that should not play a part in it but some people are quick to judge. I'm actually a fairly boring person who would rather stay home than go out to a bar. Which is not typical for my age at all. But like I said, I'm not into drugs or alcohol. In fact I put off going to the doctor for so long to avoid having to take medication.

I use a heating pad when I can't fall asleep. It relaxes my muscles. I also take hot baths and that helps a lot. I'm just starting to do yoga again to strengthen my back and core muscles. Day to day life I can handle right now it's only when I have to walk around for a while or sit for a while that my pain flares up. My boyfriend and I have passes to Disneyland and go every month. I swear sometimes I want to get a wheelchair. I lean over on the railing while waiting in line. It's a sad sight haha.

So I'm going to stick out the injections and go from there. I have a positive attitude with all of this so if I believe it will work, it's that much more likely to work!
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Sorry you are going thru so much pain. I really feel for you and you have come to the right place for advice. My friends on this board has helped me any times. I hope once your done with these injections it will take your pain away forever. That is all we can hope for right? As for the meds yes you will be dropped if she finds out you are taking more then you should be. Is there another pain dr in your area that you can try? It don't sound like this one is very nice and is only hoping for the injections to work for you. but don't go looking for another dr when you are in contract with this one, that can mean big trouble and if you go to another dr while you are in contract you can get dropped fast. Say you had to go to the Er cause the pain got so bad, you would have to tell them you see a pain dr and they will call her. That is just the way pain drs work.  Is there anyway you can call your family dr and see what he/she thinks? Your pain is not being controled and it should be.
Best of luck to you,
Jamie
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Avatar_n_tn
Hi. I just found this PM forum and read your post of June 2010. That was almost 2 yrs. ago and I can't help but wonder how you are today and if you found any pain relief with the steroid lumber injections. I am going through something simular with my 29 yrs old daughter. I hope you are still out there and will respond to this post.
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I recently had an injection, I thought the process was barbaric. Am I the only one who feels this way ? Oh by the way, no relief yet. I've not been on pain meds at all
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Avatar_m_tn
I now have have 2 epidhurals. 1st one worked maybe 2 -3 days.  2nd one seems to be doing better.

Can you tell me if any over the counter drugs can show up like any other drugs??  I've had the flue and have tried almost everthing there is to get rid of this crud.  Somone said cold meds can come up like Tramadol.  Is this true?  Whick one will do that, so I can tell my Dr.
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Read your post and some of what you have had done, sounds familiar to me. I have had multiple surgeries on my back but was warned by the doctor that scar tissue could (and did) develop. I have had physical therapy sessions which only created more pain. I have had steroid injections, nerve blocks and more procedures. I have degenerative joint/disk disease the surgeries helped along with the nerve blocks but recently I had a Botox injection to the piriformis muscle which has been bothering me for years and finally got a doctor to do something about it. It seems the shot of Botox to the pain area I have been complaining about worked and now I am walking again. Unfortunately my legs muscles are very sore from lack of use but at least I am walking again and off all the pain medication. Recently I went off my neurontin medication because I did not think I needed it but I WAS VERY WRONG to stop that medication. The neurontin medication helps the nerves calm down and helps with sleeping at night.
Ask about Gabapentin or Neurontin medication. Ask your pain management doctor about what areas that are being affected. Get a better understanding of what is happening to your body.
I have had to go through MANY pain management doctors to get answers. A lot of these doctors treat with medications and won't prescribe surgery. Their famous words that physical therapy will help but how can you do pt when you are in so much pain before and after pt? Ask you pain management team about Botox injections to the affected area. I know this last Botox injection I got in November helped me walk again for the first time in years BUT I had to fight with my pm doctor to get this injection. I am tired of fighting with my pm doctor and will get another team after I do research on what I need. So far so good with the recent injection of Botox to the piriformis muscle that has been bothering me for years.
I know pain is constantly annoying and all the pm doctors wanted to do is give me morphine. Now no more morphine or pain medication just walking and using the muscles that I have not used in years is my latest complaint but make sure you get a better understanding of what areas of your body are being affected. Then get a doctor that can work on those pain areas and hopefully that will help. Good luck and wish you well.
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