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Epidural Steroid Injection... Legit, Scam, Safe?

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Naught-Nole-Buc

All-ACC
Oct 12, 2006
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Orlando
I was diagnosed a couple months back with degenerative disc with disc desiccation (dehydration) in my L5 S1 that's slightly herniating into my nerve down there (right side). I've been doing PT since then and about 3.5 - 4 weeks ago I started taking Lyrica to ease the nerve pain (which has been helpful but with some side effects).

Anyways, just got back from my consult with a pain management doctor (anesthesiologist) through Florida Hospital and I am scheduled for the first injection this Friday. I've been told several different opinions from my GP, my PT, my own research, and now this doc about the efficacy of the injection.

Anyone in here have it done? How was it... and did it help? Thanks in advance!
 
I had it done due to herniation of L4-5 and found the relief marginal.
Doctor was a masochist too as he said I didn't need any numbing of the area, and just stuck the needle in there.
 
Lots of my patients have had them. Some say they work great, others not so much. And they are using the same doctor so it isn't a technique issue. Most back problems and pain are different with each patient. Try it out, if it works at all, do the series of 3. If you have no relief from one, it is doubtful the other 2 will do anything either. Then its time to move on to the next step. Good luck!
 
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Had 3 done. Helped for a little while, ended up requiring a laminectomy and micro discectomy. I know eventually I will need a fusion.
 
ericram said:
Had 3 done. Helped for a little while, ended up requiring a laminectomy and micro discectomy. I know eventually I will need a fusion.
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Sounds like it's the right thing to go through. I had just read some stuff online while researching about the efficacy of it and how the steroid used still isn't FDA approved for this procedure and blah blah blah. Just wanted some first hand experience.

Eric, what part of your spine was your issue and what exactly was wrong? DDD?
 
Naught-Nole-Buc said:
Sounds like it's the right thing to go through. I had just read some stuff online while researching about the efficacy of it and how the steroid used still isn't FDA approved for this procedure and blah blah blah. Just wanted some first hand experience.

Eric, what part of your spine was your issue and what exactly was wrong? DDD?
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L5-S1, had a herniated disc on the left side and had radiating pain from my back down my leg. Also was experiencing serious weakness and atrophy of my leg.
 
If you have weakness and atrophy, surgery is where you will likely end up. If left untreated, you can have permanent damage. The steroid may help the inflammation and abate the symptoms. Then again, it may not. If you are against surgery, or if your insurance requires an epidural first, it is worth a try.
 
ericram said:
L5-S1, had a herniated disc on the left side and had radiating pain from my back down my leg. Also was experiencing serious weakness and atrophy of my leg.
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Well, that's a little scary now since mine is quite similar but on the right side. I did have weakness but it seemed that I was improving range of motion and strength during PT (according to my "progress report"). But, I'm not sure if the Lyrica and prednisone was an attributing factor to that as it reduced my pain allowing me to move better?

I'm not totally opposed to surgery... I just didn't think mine was that bad. None of the doctors have actually used the term "herniation"... they've said the "disc is abutting the extraforaminal right L5 nerve root"
 
Naught-Nole-Buc said:
Well, that's a little scary now since mine is quite similar but on the right side. I did have weakness but it seemed that I was improving range of motion and strength during PT (according to my "progress report"). But, I'm not sure if the Lyrica and prednisone was an attributing factor to that as it reduced my pain allowing me to move better?

I'm not totally opposed to surgery... I just didn't think mine was that bad. None of the doctors have actually used the term "herniation"... they've said the "disc is abutting the extraforaminal right L5 nerve root"
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That by definition is a herniation. I never thought I was going to need surgery. I did the PT and meds route. Just was miserable. Hope the best for you!
 
My exhusband had a L4-L5 laminectomy. He was in pain with numbness and tingling in his left shin. As soon as he woke up from surgery, the pain and radiculopathy were gone. That was in 2008. He still has no pain. At that time, he spent one night in the hospital and was sent home. 2 weeks later, he was back to normal. Well, his normal anyway. :D
 
Naught-Nole-Buc said:
Eric, how was the surgery for you? Recovery time and comfort and success?
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I immediately had less pain. I was in hospital overnight, and took 2 weeks off work. Weakness of my leg took a bit longer but after a few weeks it was noticeable better. Surgery was the right choice for me. I suffered for years trying to find something that helped.
 
ericram said:
I immediately had less pain. I was in hospital overnight, and took 2 weeks off work. Weakness of my leg took a bit longer but after a few weeks it was noticeable better. Surgery was the right choice for me. I suffered for years trying to find something that helped.
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How did you decide which surgeon to use? I have an L4-5 issue and I'm working through my options.
 
I used to work for TOC so know the docs pretty well. I would recommend Dr. Park there and Dr's. Lee and Rumana who are neurosurgeons at TMH.
 
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ericram said:
I immediately had less pain. I was in hospital overnight, and took 2 weeks off work. Weakness of my leg took a bit longer but after a few weeks it was noticeable better. Surgery was the right choice for me. I suffered for years trying to find something that helped.
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Thanks to both you and NoleFan for the great insight! Was there PT involved after the procedure?

Also, (sorry for all of the questions), how long after diagnosis (and your injections) did you have the surgery? I don't think you posted that in your earlier post.
 
Naught-Nole-Buc said:
Thanks to both you and NoleFan for the great insight! Was there PT involved after the procedure?

Also, (sorry for all of the questions), how long after diagnosis (and your injections) did you have the surgery? I don't think you posted that in your earlier post.
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Yes I did some PT after surgery to strengthen my core. Should probably do more of that.

The surgery was about a year and a half after my last injection.
 
Are you talk about caudal? http://arizonapain.com/pain-center/pain-treatments/caudal-steroid-injection/

I work for a PM MD. He does the caudal in-house and it almost never needs a PA from most insurances.

Got to have MRI's before anything happen though.

It's not permanent, surgery is permanent and completely different procedure/operation.

There is a variation of the caudal that uses a fluoroscope that's more complex and requires insurance approval.

BTW: Dr Rumama did my surgery, the man is gifted.
 
Well, couldn't do it yesterday and had to reschedule tonnext Friday... they knew I was taking Advil and failed to mention to stay off of it for 5 days prior. I'm hoping that was more of just a rare mistake on their part and not an indication of their competence.

I'm going to look up that caudal injection.
 
HerdOfNoles said:
Are you talk about caudal? http://arizonapain.com/pain-center/pain-treatments/caudal-steroid-injection/

I work for a PM MD. He does the caudal in-house and it almost never needs a PA from most insurances.

Got to have MRI's before anything happen though.

It's not permanent, surgery is permanent and completely different procedure/operation.

There is a variation of the caudal that uses a fluoroscope that's more complex and requires insurance approval.

BTW: Dr Rumama did my surgery, the man is gifted.
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Yep, that's it. They didn't call it that and it is with the guided fluoroscopy.
 
My ex had surgery 3 months after the injury. But, since I was his primary care doctor, I skipped a lot of the "stuff" others make you do and went straight to the MRI. After seeing the result, I knew he needed surgery but the insurance required at least on epidural injection.

If you have the nerve compressed by the herniation, surgery is usually the only option.
 
Had two of them. Thought I could leap off buildings in 15 minutes. They hold for awhile, until you do something stupid to aggravate the disc. Eventually, you learn what bending and twisting you can and cannot do, and the shots last longer.
 
Had two of them. Thought I could leap off buildings in 15 minutes. They hold for awhile, until you do something stupid to aggravate the disc. Eventually, you learn what bending and twisting you can and cannot do, and the shots last longer.
 
HerdOfNoles said:
?
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It went really smoothly and was much quicker and pain free than I expected... granted, I opted for the drug IV cocktail.

I'm still kinda sore from the injection but the nerve pain seems to have lessened a great deal... but I'm still on Lyrica so I don't know how much that's masking it. Doc didn't want me to stop Lyrica just yet and wants to possible wean me off later. He already scheduled the second injection I two weeks so I'll see how this works.

Last night I felt like Bruce Banner while trying to sleep... like I had a form of insomnia that made me feel like wanting to go run errands and yard work and stuff.
 
Naught-Nole-Buc said:
It went really smoothly and was much quicker and pain free than I expected... granted, I opted for the drug IV cocktail.

I'm still kinda sore from the injection but the nerve pain seems to have lessened a great deal... but I'm still on Lyrica so I don't know how much that's masking it. Doc didn't want me to stop Lyrica just yet and wants to possible wean me off later. He already scheduled the second injection I two weeks so I'll see how this works.

Last night I felt like Bruce Banner while trying to sleep... like I had a form of insomnia that made me feel like wanting to go run errands and yard work and stuff.
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Congrats, your results are typical, just remember don't overdo it.

Again congrats
 
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