Aa
lumber epidural steroid injection
Hi. Female 28. dx ddd with anulear tear l4-l5. severe low back buttocks and leg pain numbness and weakness.. so , i had my first bilateral lesi yesterday. no sedition. everything felt just fine until the medication was actually injected..left was first and sent what i would say a7/10 pain shooting down my hip and leg with tingling..the right side produced the most insanely 10/10 pain down and i almost jumped off the table. i had experienced this one other time when a student Dr did my lp in er years ago..i am just wondering why it hurt so bad? no one else i know had any more than a sensation of pressure. It took almost an hour for the pain to start calming down..my bp was 152/86! and now today my leg and back pain is very intense and none of my meds or ice seem to help..i take gabapentin 300mg tid and meloxicam 7.5 bid(not sure if these even work..plusa new rx for norco 7.5/325 and 10mg cyclopenzaprine tid..is the pain i experienced normal? and if the injection don't work what's next? This is going on 6 years of chronic pain..and my kids miss their mommy!
Hi Megs!
So very very sorry for the late reply back to you. I have been working a lot on the weekends lately and I sincerely apologize.
Your symptoms sound horrific!!! I would think trying something other than injections should be the way to go as well. I have had periods where it hurts to lay on my left side as my right side is suspended in the air somewhat and has to bear the weight. You poor thing! And then falling off the jungle gym and twisting your ankle! That's just awful! :(
You really deserve some relief and soon! Did they make any changes to your medications? How are feeling today since it is now 10 days since your post?
I recommend at least getting a quote and info on the type of laser procedure they may be able to perform on you. I plan to schedule my laser surgery in March after we finish buying our home. It is going to cost me $10,000 out of pocket; however, the total cost is $70,000 but Anthem BCBS is paying the difference. The remainder I plan to finance through their financing company. You just fax over your MRI Scans and they will have a surgeon review it and get back with you on treatment options. There are some other laser/endoscopic spine facilities to look into such as the Bonati Institute and North American Spine. I consider it an investment towards getting my life back. If I can buy a brand new car, I can certaintly invest in my spine.
I will send a personal note for you to read my post. Let me know how you are doing and keep in touch.
Sending soft (((hugs))).
femmy :)
So very very sorry for the late reply back to you. I have been working a lot on the weekends lately and I sincerely apologize.
Your symptoms sound horrific!!! I would think trying something other than injections should be the way to go as well. I have had periods where it hurts to lay on my left side as my right side is suspended in the air somewhat and has to bear the weight. You poor thing! And then falling off the jungle gym and twisting your ankle! That's just awful! :(
You really deserve some relief and soon! Did they make any changes to your medications? How are feeling today since it is now 10 days since your post?
I recommend at least getting a quote and info on the type of laser procedure they may be able to perform on you. I plan to schedule my laser surgery in March after we finish buying our home. It is going to cost me $10,000 out of pocket; however, the total cost is $70,000 but Anthem BCBS is paying the difference. The remainder I plan to finance through their financing company. You just fax over your MRI Scans and they will have a surgeon review it and get back with you on treatment options. There are some other laser/endoscopic spine facilities to look into such as the Bonati Institute and North American Spine. I consider it an investment towards getting my life back. If I can buy a brand new car, I can certaintly invest in my spine.
I will send a personal note for you to read my post. Let me know how you are doing and keep in touch.
Sending soft (((hugs))).
femmy :)
Well talked to pm drs nurse as a follow up today..after hearing my symptoms she said he will be wanting me to come in to discuss other options instead of going on to the third injection on the 2nd..also because yesterday in enjoy an attempt to enjoy some time with my kids, i fell off the jungle gym to a loud snap in my ankle! initial x-ray at ER showed no fracture but suspected ligaments tears! lol seriously i should be wrapped in bubble wrap! So now i am in an aircast and on crutches for a while..not sure how this will effect my back...but i have faith in my Dr..so crossing fingers for something good to happen!
Thank you for your post! i just had round two this Monday. The injections themselves were not as painful this time..but 3 hours after the pain was excruciating again. Yesterday i had a throbbing pain from injection site to my toes all day and could not get any relief from ice or medications..I try to stretch and do light activity at least a few minutes every hour. This morning tho i work up screaming from a intense stabbing pain that ran from mid buttock down to my 3 toes starting at the pinky..i can't touch that side, lay on it or even sit on the toilet(sorry if tmi) without putting my weight on the other side..which is also painful. also since first injection a new symptom of weakness going Down stairs and inclines arose..and since this one i now have a buzzing type sensation in bother feet and calves instead of the normally experienced pins and needles. i will be calling my Dr today, as i can barely function and can't afford to be curled up crying when i haven two kids to care for!
Hi Megs,
I also go in for lumbar epidural steroid injections as well. I have had 7 rounds thus far and scheduled to go back in Aug. I have on several occassions experienced intense shooting pains down my legs when the steroid is injected. This is typically normal. I unfortunately experience that type of pain periodically at home or at work so for me, the sensation is very familiar. The sensation is caused by the medication rushing up against the nerve roots to "bathe" them. Did they use fluroscopy or X-ray when they performed your injection?
Not everyone gets meaningful relief from epidural injections. The injections for me, help a lot with the low back pain but only help the sciatica for a couple of days to a week and the sciatica slowly starts to build back up.
I truly believe I am getting beneficial results from these injections because of the other medications that I am taking for pain: long-acting/short-acting opioid medications, cyclobenzaprine, valium, gabapentin, 4-5 OTC naproxen sodium tablets, and an anti-depressant. I most certainly believe the medications you are taking are helping you and also helping the injections work more effectively. The Gabapentin and the meloxicam are medications that significantly help reduce sciatica. As when a nerve is compressed in the low back, the resultant sciatica is due to nerve inflammation and the meloxicam directly helps reduces that inflammation. Gabapentin works by increasing a chemical in the brain, called Gaba. This helps block the pain signals sent by the inflammed/pinched nerve from reaching the brain. Gabapentin is much more helpful at relieving nerve pain than the most strongest opioid pain killers. Cymbalta is also good for this type of pain as well and it is a SNRI anti-depressant.
So in summary, you are on a good mix of medications. Asking your doctor for an increase in Gabapentin would be a good step to take if you are still experiencing severe sciatica. Doses of Gabapentin go up to 3600 mg per day so you are on the very low end of dosing. You are maxed out on the cyclobenzoprine. An increase in the meloxicam would be the other recommendation if your stomach can tolerate the higher dosage.
The epidural steroid injections take 1-2 weeks to become effective and before this takes effect, increased pain is normal. However, if you see pus or swelling at the injection site, get to a local ER asap as this is a sign of a serious infection. The ESIs are generally effective for 6-8 weeks. So the effectiveness is not very long lived.
I experience my worse leg pain in the morning when I wake up so upon waking I take 600 mg of Gabapentin, 2 Aleve (naproxen), and 10 mg of oxycodone IR. This combo helps me to be able to at least get dressed in the morning but the pain begins creeping back after 2-3 hours. I am also on the Fentanyl patch which as you probably know is the strongest opioid medication on the market and it still leaves me with a large amount of nerve pain. So take my word as bond when I tell you opioids are not very effective on nerve pain.
My diagnosis is discussed in detail on my profile page. In short, I have a ruptured disc at L4-L5 that is pressing on the spinal cord and right/left nerve roots. At L4-L5 there are bone spurs, osteoarthritis, spinal stenosis, and thickening of the ligamentum flavum. I also have problems at the L5-S1 level. Been told I need a 2 level lumbar fusion but I would never agree to it as it is only 50% successful at relieving pain and many times makes it worse...much worse. I have contacted the Laser Spine Institute and hopefully will get a minimally evasive discectomy soon. I recommend looking into laser spine surgery. They can fix issue with the discs, nerve roots, and bone by making a very small incision and using a laser. Typically, general anesthesia is not needed and there is no hospital stay and you can go home the next day.
Good luck to you. I am a mom of a 6 year old son so I know what you are talking about when you say that your kids need you. I haven't been mommy for awhile and I am ready to be mommy again too. I hope this helps. Take care.
femmy
I also go in for lumbar epidural steroid injections as well. I have had 7 rounds thus far and scheduled to go back in Aug. I have on several occassions experienced intense shooting pains down my legs when the steroid is injected. This is typically normal. I unfortunately experience that type of pain periodically at home or at work so for me, the sensation is very familiar. The sensation is caused by the medication rushing up against the nerve roots to "bathe" them. Did they use fluroscopy or X-ray when they performed your injection?
Not everyone gets meaningful relief from epidural injections. The injections for me, help a lot with the low back pain but only help the sciatica for a couple of days to a week and the sciatica slowly starts to build back up.
I truly believe I am getting beneficial results from these injections because of the other medications that I am taking for pain: long-acting/short-acting opioid medications, cyclobenzaprine, valium, gabapentin, 4-5 OTC naproxen sodium tablets, and an anti-depressant. I most certainly believe the medications you are taking are helping you and also helping the injections work more effectively. The Gabapentin and the meloxicam are medications that significantly help reduce sciatica. As when a nerve is compressed in the low back, the resultant sciatica is due to nerve inflammation and the meloxicam directly helps reduces that inflammation. Gabapentin works by increasing a chemical in the brain, called Gaba. This helps block the pain signals sent by the inflammed/pinched nerve from reaching the brain. Gabapentin is much more helpful at relieving nerve pain than the most strongest opioid pain killers. Cymbalta is also good for this type of pain as well and it is a SNRI anti-depressant.
So in summary, you are on a good mix of medications. Asking your doctor for an increase in Gabapentin would be a good step to take if you are still experiencing severe sciatica. Doses of Gabapentin go up to 3600 mg per day so you are on the very low end of dosing. You are maxed out on the cyclobenzoprine. An increase in the meloxicam would be the other recommendation if your stomach can tolerate the higher dosage.
The epidural steroid injections take 1-2 weeks to become effective and before this takes effect, increased pain is normal. However, if you see pus or swelling at the injection site, get to a local ER asap as this is a sign of a serious infection. The ESIs are generally effective for 6-8 weeks. So the effectiveness is not very long lived.
I experience my worse leg pain in the morning when I wake up so upon waking I take 600 mg of Gabapentin, 2 Aleve (naproxen), and 10 mg of oxycodone IR. This combo helps me to be able to at least get dressed in the morning but the pain begins creeping back after 2-3 hours. I am also on the Fentanyl patch which as you probably know is the strongest opioid medication on the market and it still leaves me with a large amount of nerve pain. So take my word as bond when I tell you opioids are not very effective on nerve pain.
My diagnosis is discussed in detail on my profile page. In short, I have a ruptured disc at L4-L5 that is pressing on the spinal cord and right/left nerve roots. At L4-L5 there are bone spurs, osteoarthritis, spinal stenosis, and thickening of the ligamentum flavum. I also have problems at the L5-S1 level. Been told I need a 2 level lumbar fusion but I would never agree to it as it is only 50% successful at relieving pain and many times makes it worse...much worse. I have contacted the Laser Spine Institute and hopefully will get a minimally evasive discectomy soon. I recommend looking into laser spine surgery. They can fix issue with the discs, nerve roots, and bone by making a very small incision and using a laser. Typically, general anesthesia is not needed and there is no hospital stay and you can go home the next day.
Good luck to you. I am a mom of a 6 year old son so I know what you are talking about when you say that your kids need you. I haven't been mommy for awhile and I am ready to be mommy again too. I hope this helps. Take care.
femmy
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