Epidural Injections - more pain!

I have a herniated disc @ L4 and have done every therapy known to man to try and alleviate the pain and sciatica. I have been at my wits end because my horse is working so wonderfully and I have been too uncomfortable to ride. So my doctor felt an epidural injection might help. I had one last Wednesday (now Sunday - so five days ago) and I am in more pain than I was before. Has anyone else experienced this? I am so bummed!

I have had several cervical epidurals and most were very painful for a few days but then I could feel them working and got some relief.

The last one I had was much more painful for much longer so I haven’t had another but since I took a bad fall on the ice in December, I can see one in the very near future! :frowning:

I am going through this right now. I have had 4 back surgeries since 2002 (3 fusions and a laminectomy) . I am fused from L3 to S1. My last surgery was in Nov. 2008, but I still experience constant, chronic back pain which continues to get worse.

My surgeon recently sent me for a series of epidural injections (3 injections, each 3 weeks apart), as I have also tried every therapy, pill and treatment available in order to avoid yet another surgery. I have had two performed already, and go in for the third and final one tomorrow morning. The first provided a very small amount of relief from my symptoms (sciatica, back pain, swelling), and the actual pain from the procedure lasted about a week. Three weeks later I had the second injection. Much more pain from the injection, no relief of symptoms, and I swear I feel worse now than I did before the second attempt.

I am hoping that the injection tomorrow will help, or at least not make things worse. My surgeon has said that these type of injections can vary from person to person, and from occurrence to occurrence. At least in my case, he thinks the reason the second injection didn’t work and was more painful than the first is that the doctor performing it (not my surgeon) may have nicked a nerve during the procedure.

It’s very frustrating when all you want is a little relief from the pain and the ability to do the things you enjoy. I have probably sat on my horse less than a dozen times in the last 3 years. Have you tried accupuncture? I know it works for some people and not others, but it’s worth checking into if you haven’t tried it yet. I actually got relief for about 4 months with this, but then it stopped being effective. I hope you find some relief soon, and please feel free to PM me if you ever just want to bitch about how awful these back problems are :slight_smile:

this is a timely post

I am going in for a consult next wee about getting an epidural. I have 4 bulging discs resulting from getting rear-ended on the freeway in Aug. I am doing better, sooo slowly, but have had numerous setbacks mostly my fault i.e. falling, sitting in bouncy truck too long, riding too long (months ago, haven’t ridden since.) The other drag is it seems that sex (sorry if TMI) sets my nerves off big time, much to my SO’s dismay. Each setback takes at least 10 days to get back to where I was. I’m not on major meds, just naproxin2x day and 100mgs of gabopentin at nite.
My doc says LUMBAR EPIDURAL but all the reading I’ve done on them doesn’t convince me. 45-50% success rate, doesn’t really cure you, etc etc. I do know a few people for whom a LE was the magic ticket. I look forward to hearing from others…

I had both nerve root blocks and epidural shots in my back for major herniations l3, l4, l5, along with degenerative disc disease, and lovely bone chips floating around.

The nerve root block was a joke, but the epidural did help, and I did these in order to avoid surgery.

HOWEVER…

I wound up having surgery, got tired of the pain, numbness and tingling in my hip nad legs and you know what, I wish I had done the surgery a year earlier.

I only had to take one pain pill post op (was given 50 to go home with) and was so much better with the herniations taken care of.

While I dont suggest anyone have surgery because of the risks, I would suggest looking at it. I have perm. nerve and muscle damage from putting off the back surgery with injections and pain meds.

I’ve got herniated discs in the lumbar/sacral area too, diagnosed when I was only 18. I couldn’t stand on my heels anymore (lift toes - exercise docs get you to do when examening you), my feet would slap down, had no pushing power in my right leg and I was limping on that leg. I had several epidurals between the ages of 18 to 24. Which helped for sometimes 6+ months, but often less.
I saw an osteopath regularly, helped a little too.
Then I saw a different surgeon and I had 2 cordal infiltrations at the age of 26.
Today 10 years later, I still have some days where my back hurts and I can’t properly straighten myself immediately, but for the majority of the time I’m doing quite well (touch wood).

I started riding again at the age of 27 and if anything it helped strengthen my back & stomach muscles.

I don’t know why this surgeon preferred a cordal infiltration over epidurals, but it sure worked much better for me.
I have no idea what I was injected with however.

[QUOTE=Lieslot;4708871]
I’ve got herniated discs in the lumbar/sacral area too, diagnosed when I was only 18. I couldn’t stand on my heels anymore (lift toes - exercise docs get you to do when examening you), my feet would slap down, had no pushing power in my right leg and I was limping on that leg. I had several epidurals between the ages of 18 to 24. Which helped for sometimes 6+ months, but often less.
I saw an osteopath regularly, helped a little too.
Then I saw a different surgeon and I had 2 cordal infiltrations at the age of 26.
Today 10 years later, I still have some days where my back hurts and I can’t properly straighten myself immediately, but for the majority of the time I’m doing quite well (touch wood).

I started riding again at the age of 27 and if anything it helped strengthen my back & stomach muscles.

I don’t know why this surgeon preferred a cordal infiltration over epidurals, but it sure worked much better for me.
I have no idea what I was injected with however.[/QUOTE]

I have been in Pain Management 13 years and I have never heard of cordal infiltration. Perhaps you mean Caudal Epidural? A caudal epidural is an epidural that is done at the lowest point which is right between the cheeks of the buttocks. Steriod is injected there just like in a regular epidural.

Bearhunter, do every in your power to keep from having surgery. One surgery just leads to another and another, and before you know it, your whole lower back is fused.

Pain after an epidural can be caused by nerve root irritation. It sometimes happens, but just because it happened with one epidural, doesn’t mean it will happen with the next one.

Also, make sure your doctor performing an epidural is an Interventional Pain Specialist. Many hospitals have their anesthesiologists perform an epidural steriod injection, but you want the doc that does epidural injection therapy FULL time and has had extra training and certification for Interventional pain injections.

It is now a month later, and for the most part, I do feel so much better. I am able to ride and not have crippling pain the next day. If I do have some minor pain, Alleve helps manage it unlike before. I am back with the rolfer once a week which I think is helping as well.

I dread the day however when the injection wears off. I am so happy not to have that crazy aching anymore!!

I know I’m repeating myself, but I had the surgery on L5/S1 (twice) and I wish to God I’d had it done earlier. When the pain returned, it was facet joint pain that nobody picked up on, and a procedure for that has taken care of enough of the additional pain that I’m riding again, going to work, going to yoga. I am SO pissed that nobody would do the surgery sooner, as I feel that my healing was set back so far by being in pain and contorting my body to deal with the pain for so long. I lost so much muscle mass and so much of my life to it before these procedures. Get someone to check facet joints and do diagnostic injections there as well.

Lindac, you are right it must have been called ‘caudal’ infiltration. Never saw it written out, just repeated what I was told back then.
Yes, it was infiltrated from the last vetebrae between the buttocks.

John Sarno books

I’ve had lower back pain most of my life. I’ve got mild stenosis and an extra vertebra. During my first hip replacement in '06, I woke up from anethesia with burning pain down my leg. It took weeks for me to find out that I had herniated L4-L5 during the surgery. Made for poor hip replacement physical therapy. Out of desperation, I read John Sarno’s book “Healing Back Pain”. I went into it thinking it was a load of $#)^. But when I closed the back cover, I realized my back pain was much less. I said the heck with it, cleaned out a couple of closets and felt very nearly all better. Coincidence? Perhaps. I guess I’ll never really know. But it was a cheap experiment.
His theory is that the back is the very strongest body part. There is no reason for it to fail on us. That we carry our emotions in our back, rather than deal with the pain of the emotion. Accept the pain of your emotion and your back pain will go away. (Or something like that). I’m a huge skeptic. And just writing this is making me think it was pretty hokey. But every now and then when a smidge of back pain starts to hit, I ask myself what emotional pain I’m denying. The back pain often goes away.

Misocksgal

Emotions can play a huge role in our physical feelings-why do you think stress can make you sick??
I have found that Nikken Magnets really help my back-and they’re worth a try! I won’t promote what doesn’t work.
If anyones’ interested, try my site please:
mynikken.com/thebunch
if that doesn’t work, you can look at my other site:
www.midwestnha.net

[QUOTE=lindac;4708914]
Bearhunter, do every in your power to keep from having surgery. One surgery just leads to another and another, and before you know it, your whole lower back is fused.[/QUOTE]

I will second, third and fourth this statement. My first surgery, which was supposed to fix everything (I have degenerative disc disease, spinal stenosis, radicular neuropathy, and floating bone chips) only led to my second, then third, then fourth surgery. Now I’m looking at a fifth this summer. I certainly wish the first surgeon had suggested epidurals, nerve root blocks, PT, anything prior to going right into surgery.

I recently finished my third series of lumbar epidurals (two through pain management doctor, one with my new ortho surgeon), none of which helped. Just this week, they tried hip injections, I think because they are running out of ideas. If those happen to help, surgeon will perform a rhizotomy, which burns the nerves causing the pain. While this may work for the shooting pain and numbness in my legs, it won’t do much for my back.

I can’t stress enough pursuing all avenues available to you before going into surgery, unless it is life-threatening and obviously required. Also, make sure you do plenty of research on your doctor/surgeon. My first surgeon (a neurosurgeon) actually caused more problems than he solved, which set in motion 8 years worth of surgeries that have provided very little relief. Good luck, and I hope your injections are successful for a very long time!

I had 3 epidural injections about 2 years ago for facet disease in L3, L4 and L5 and bad SI issues. They were done by a wonderful pain manage Dr in Philadelphia under sedation. Mine were done a little differently than most described in this thread, they were space farther apart which in my Dr’s opinion gave the steroids more time to reduce inflammation! The first one was done in March, 2nd May, 3rd July. with each injection the pain got progressively better after about a week of agony from the injection itself! To this day the injections have held and only after a strenuous activity do I have pain in my SI (back pain is completely gone). The one thing my Dr stressed was to build up the muscles in my back through riding and working out. He said the additional muscle mass would help the injection last much longer and he was right!

Bearhunter: hang in there! Hopefully you will be like me in respect to the injections lasting a really long time :slight_smile: Now if only there was an injection to fix my broken tibia and fibula from a stupid fall 10 days ago :frowning:

Good Luck and heal well

[QUOTE=JA;4720828]
I had 3 epidural injections about 2 years ago for facet disease in L3, L4 and L5 and bad SI issues. They were done by a wonderful pain manage Dr in Philadelphia under sedation. Mine were done a little differently than most described in this thread, they were space farther apart which in my Dr’s opinion gave the steroids more time to reduce inflammation! The first one was done in March, 2nd May, 3rd July. with each injection the pain got progressively better after about a week of agony from the injection itself! To this day the injections have held and only after a strenuous activity do I have pain in my SI (back pain is completely gone). The one thing my Dr stressed was to build up the muscles in my back through riding and working out. He said the additional muscle mass would help the injection last much longer and he was right!

Bearhunter: hang in there! Hopefully you will be like me in respect to the injections lasting a really long time :slight_smile: Now if only there was an injection to fix my broken tibia and fibula from a stupid fall 10 days ago :frowning:

Good Luck and heal well[/QUOTE]

Wow, some of us are really on parallel paths…Well, the epidural I had last week doesn’t seem to be working, my L4 nerve pain is back just as if the epidural had never happened. I hope it doesn’t get worse at least…I am so missing riding. BTW last year’s booboo was breaking the tib/fib. At least that one healed all the way…

Just finished with the 3/3 cervical epidurals for C5 & C6 pressing in on spinal cord. Makes my left arm feel like it’s getting tased if I turn my head a certain way. Neck sounds like bubble wrap - nice huh? No relief from the CE’s and now they want to do surgery. I can’t be out of commission for that long so I don’t know if I have any other options.

Nurse weighs in here!!

My heart goes out to all of you. Been there, done that too. There are no guarantees for ANY treatments.

First you gotta remember you have a serious, permanent injury. Your back will never be normal or the same again. BUT!!..almost all herniated discs re-absorb or “heal” by themselves in 6-12 months. What is left is the problem. Re-occurences happen often as that point in your spine is no longer “normal”. Scar tissue forms at the site. Mal-alignment causes pressure on the nerve. The spinal canal can narrow or “stenosis” occurs. Epidurals are meant to be a bridge kind of treatment…to buy time…to make you somewhat more comfortable; until you heal on your own or have a surgical fix. They are not curative!! Adjust your expectations everyone! They just help!! Some more than others!!

I agree that pain doctors that do more of them are largely better and get better results. But it’s what you do afterwards that really, really matters. For ex: you HAVE do back exercises, strengthen your core & abdomen, and LOSE WEIGHT, wear abdominal supports, learn and practice good body mechanics, avoiding heavy lifting etc. I always recommend you find a physical therapist that rides to work with you. If you aren’t committed to these recommendations then you WILL re-injure or continue to have nagging pain. There’s no getting around it.

From my own experience too…some things thatt help. (I’m a 4 disc survivor btw.)

  1. stop sitting trots for the rest of your life. Avoid jarring gaits that jar your spine. Concussion is NOT your friend. Avoid concussion anyway youcan.
  2. Wear comfortable shock absorbing shoes when standing,walking. Live in your sneakers!
  3. Get good shock absorbing gel or dense foam cushions for under your saddle to absorb shock (horsie loves them too!)
  4. When riding; wear tightish abdominal support. Tight jeans, a panty girdle or tummy minimizer undie works. A bouncing or swaying abdomen pulls on the weak part of your back and causes pain.
  5. Take nsaids before/during and after you ride. To PREVENT or minimize inflamation which causes the nerve to hurt.
    6…Ice your disc after a heavy workout.
  6. Avoid heavy lifting. feed bags and full water buckets are out! permanently!! Use good body mechanics everywhere & all the time!
  7. Exercise regularly. Start slow and take your time and …
  8. IF IT HURTS, DON’T DO IT!!! :yes::smiley:

I agree with Wateryglen! The injections reduced the inflammation in my back and SI, relieving enough of the pain which allowed me to build my core strength. Being stronger and maintaining that strength and fitness is what has allowed me to be virtually pain free for 2 years and counting!

The body does heal itself in amazing ways! My graduate degrees are in osteology and paleopathology and I cannot tell you how many ancient skeletons I have seen with MAJOR back problems that people lived with for years. The hardest thing is enduring the pain until the bones can remodel and heal and muscles build around the injured area to better protect and support it!