Question about Epidural Steroid injections (I had one Friday, and it seems to be wearing off already)

[davemmevad]

Hi All,
So the insurance wanted me to do an epi series before proceeding with deeper investigation on my lower back & sciatica.

Last Friday (today is thursday) I had one, and 2 days later just started feeling better and better, and yesterday felt great - until about 5 pm, when the old pain started to slowly show up. Today it is worse, and I'm just worried that 6 days is enough for my body to have started flushing the steroid, and that the fix is not gonna last. I know surgery is an up and down recovery, is an epidural also???

By the way, he used a CT scaner to guide the needle, and could see a protrusion on it right over the nerve....a part of me is thinking that any time you can see a disk issue on a CT scan with out IV contrast, that is one heck of a protrusion - am I right about that?

Sorry I have so many questions - my old doc left California, and this guy seems to be good, but far less communicative, and I'm feeling needy and wanting to know what to expect. Especially because I've got vacation planned starting next week....if it was just me I could cancel it, but there is no way I can do that to my wife and son, so if I've got to get ready to suck it up, I'd like to know.

Thanks!

Dave

PS -- the Cervical fusion I had in March is going GREAT!!!!!! Whew!

[Gilbert P]

Hi Dave

ESI can be used as a diagnostic tool to locate your pain. It can also reduce inflammation to reduce your symptoms.

Most Docs will do them in a series of three and some will have long lasting relief and others will have none. Sometimes one works, two or three

Not all spines are created equal

I personally have had plenty with no relief.

Great to hear your CSpine fusion is doing great

Gil

[davemmevad]

Hi Gil,
Thanks - and sorry your injections didnt' work out.

I did know that the epi's don't work for everyone, but I just thought it was weird that mine worked GREAT for 6 days, then seems to be stopping. What I don't know, is can the body flush the epi in 6 days (ie, is the benefit of the epi from the steroid hanging out for ever, or does it do it's thing and long term benefit is from the nerver having been relaxed and staying that way, but not because the steroid is still there). With vacation looming ... that would stink. I'm hoping I'm overreacting, and it is just another bump in the road, 'cause the flight to Hawaii is gonna really really stink if my sciatica comes back full on. seriously, I just need 2.5 more good weeks ! (yes, I know we don't always get to control that, but man, if I got to wish....)

Dave

[Cindylou]

Dave, it is highly possible you are only going to receive 6 days of relief. If your pain is coming back as the same pain you had before the ESI, it's not looking good. The local numbing medication, like Marcaine, can many times give you 3-5 hours of relief, then your old pain is back and you have to wait a few days, or up until about 7-10 days, for the steroid to kick in. However, if you received 6 straight days in a row (and we know the marcaine can't last that long), then I am going to guess it's wearing off already, unfortunately. Just my guess. I am no Dr. What I would do if I were in your circumstances, is make another appt. w/ the doc, tell him everything that just happened with your response to the ESI, let him know exactly when you leave for vacation and how long you will be gone, and see if he can schedule one more ESI real close to your departure time. That's just me. Good luck!!

[KBear]

Ditto what CL said

[KanRunMo]

Ditto, the two above. My 2nd injection has worked for 3 months. Always, no guarantee.

[davemmevad]

Actually, thanks all -- that is pretty much what I'd thought, but I had to make sure. I'm leaving on Tuesday, so unless we can get it figured out ASAP I may have to wait (actually when I'd asked if it was a evvery 2 week series he'd said they like to space them out more...but who knows).

Right now the pain is there, but mild, so I am going to take it really easy today, and see what gives. It is, for all I can tell the same pain, so if it is still bad in the AM I'll start calling. I'm going to hold my breath and close my eyes hoping I just lit it, slept funny etc ... hey, sometimes the Ostrich gets away!

Thanks again,
Dave

[KBear]

Actually, thanks all -- that is pretty much what I'd thought, but I had to make sure. I'm leaving on Tuesday, so unless we can get it figured out ASAP I may have to wait (actually when I'd asked if it was a evvery 2 week series he'd said they like to space them out more...but who knows).

Right now the pain is there, but mild, so I am going to take it really easy today, and see what gives. It is, for all I can tell the same pain, so if it is still bad in the AM I'll start calling. I'm going to hold my breath and close my eyes hoping I just lit it, slept funny etc ... hey, sometimes the Ostrich gets away!

Thanks again,
Dave

My husband had his first injection and it worked for 6 or so months and then the back pain was back full force. He had another one and has had complete relief for 3+ years (every now and then he will have a flare up from over activity; but only major activity, like laying tile- he is a manual laborer, mowing, weed eating and such all day). Me on the other hand never got even a little relief, so it just depends on the person. I would try really hard to get another injection before Hawaii (I'm sure that's not a cheap trip and it would suck to be laid up during it) Some doctors will do them in their office, you just don't get the sedation (I'm a sissy, so I always wanted the sedation ) Hope you have a great family trip and create lots of memories (take pictures for us, would love to live vicariously through you on this one :thumpup

[davemmevad]

You got Sedation?!? All I got was a local! -- Now I'm really jealous. And A+ for 3 years relief - I'm really hoping. Right now I'll take 3 weeks though.

Oh, the doc does do them via his office, but my referral is only via the hospital. Grrrrrr. I'll have to call them tomorrow. And fax my weekly Pain Diary at 6AM so we have talking points.

And yes, I'll take LOTS of pics ... I'm a bit of a nut that way anyway, so no worries

[Katie]

Dave, I hope you can get through this vacation with little pain.

I just wanted to chime in with my experience with the injections. All I received was local anesthetic as well, and I had a number of shots, all in a series of three. The first set worked a tiny bit for a few days then nothing, and the same with the others.

I stopped when we all decided that it wasn't working. However, my husband's relative in her 70s only had one shot and it has worked for several years now. I was so envious! Like we've said, everyone reacts differently.

A friend in the medical field was a bit uncomfortable with the number of injections I received. She had read of long term problems with that much steroid material being injected. It has been known to cause damage in animal medicine...having said that, most animals react to drugs much differently than humans...like with Tylenol killing cats, etc. even small doses.

While uncomfortable, I didn't find the injections too painful, and well worth it if only they worked