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Update/Question pg. 3 - spine injections: to be "knocked out," or not?

Riders with Health Issues
#1

I have a long, boring history of low-back problems and sciatica, and am finally getting my back injected (L4/5, S2/3, like pretty much the rest of the world with low-back pain) later this week… So, the information I have from my doctor’s office says most people don’t need sedation and are fine with a local anesthetic. I’m generally not wimpy about such things… for those who’ve had injections, was the procedure fine without sedation, or am I likely to regret it if I don’t get it?

And, how long was your own stall rest afterwards? Again, the info. I got suggests taking it easy for a day, then just resuming normal activities. I’m assuming this means I should not sign up for the team sorting clinic I wanted to go to the day after my injections (chasing cows very probably not recommended) :wink: but I’m curious to know what others’ experiences were like after, realizing everyone and every spine is different, etc.

Thanks! I’m really hopeful that this will do the trick for me. I have a lot of riding I need to do!

#2

I have had several series of injections on both sides of the lumbar spine- culminating in RFA of the facets.

The doctor I use does a very light - I wouldn’t even call it sedation. I talk to the dr the whole time, joke with the nurses, even watch the images on the screen. It’s more like how you feel after a couple of glasses of wine.

He prefers that method because often the patients are very tense - patients suffering back pain may be suffering from muscle spasms. Makes the procedure more difficult as well as causing more bruising. So it’s not so much that the patient is weak or a wimp - and more than relaxed back muscles make it easier for both.

For the RFA - they want you totally awake and talking because they need your feedback before they cauterize a nerve. So again - it’s more like a couple of glasses of wine.

I think - since this is your first time - go for the sedation. If you require repeat injections, you may be more comfortable with just lidocaine.

I’m no wimp and I was grateful for the sedation - but I had “locked back” syndrome on the right- the muscles were spasming to the point that my right hip touched the bottom of my rib cage and I was barely able to walk.

Another risk with injections is that the pain gets WORSE before it gets better. Post injection flare. The day of the injections I take it easy, then slowly resume normal activities depending on how my back feels.

Injections can give you your life back - I hope you have the same outcome I did. I was being heavily pressured to have a multi level disc fusion - was told I could never ride again, one surgeon told me I’d have to sell the farm - all kinds of crap. With injections and RFA I got my life back - literally.

#3

I’ve never had spine injection, but am a big fan of “Better living through chemistry”. Heck, I took sedation dentistry when Ihad a wisdom tooth pulled. Woke up at home 4 hours later, no pain, no drama etc. etc. etc.

It’s a bit more expensive, makes it easier for the person at the fat end of the needle…why not?

#4

I have had numerous epidural and facet blocks and was not offered sedation. I obviously made it through every time without it but would have opted for it if that were an option. It wasn’t terribly painful but I too am all for better living through chemistry.

#5

Take the mild sedation. As JSwan said, it is like you are the “life of the party!”. At least that was the way I felt when I had pretty much what you are having done. Now…low-dose Valium doesn’t do a damn thing to me–so if you know that something works better than others, tell them that. My first injection, with Valium, was not fun–I was tense, wide “awake” and the doctor was not happy (nor was I!). The second time around, they gave me twice the dose of Valium and all was good!

Versed, which is IV sedation, is a wonderful, wonderful thing:lol:. Mr. CC calls it the “Whatever!” drug, as in they can do whatever and I’m happy.:wink:

These injections aren’t super painful–you’ll get lidocaine as a surface numbing agent probably, then when they do the actual injection, it will feel as if the area is filling up, and it will (for me it did) kind of ache, deep inside, then it stops. YMMV.

#6

Can’t I have two glasses of wine, instead? :slight_smile:

Partly, I don’t like having something done/taking something if I don’t need it, I guess. But you’ve made really good points about those low-back muscles tensing up – I’m very likely to do that. And also partly, I want to know what’s going on, which is a reason why I’d opt -not- to have the sedation. But if I go for the good drugs, lol, my husband will be there to drive me home after.

I just hope I have easy, fast stall rest, and no “joint flare.”

#7

I’ve been getting them @ C5/6/7-T1 for a few years now. I prefer the sedation, occasionally they can be quite painful and it is imperative that you hold still. Plus, I’m a bit of a backseat surgeon so if I’m not in control in the OR I get extremely nervous.
I’m usually back to near normal in a few days, and it gradually improves from there for the next 3 weeks or so, and I feel pretty good for 3/4 months then I repeat.

#8

Trust me - if you are tense the dr is going to have to use a lot of effort to get those needles in.

And they are big needles.

Even with the sedation (I’m going to guess they’ll give you a teeny smidgen of IV Versed), you will know what is going on. You just won’t care.

Ask the dr to let you know what he’s doing, or ask if you can watch the monitor. You’re in, you’re out, you go home, watch a movie or take a nap or get a severe case of the munchies.

If you google the subject, you’ll find animations of the procedure, which can be very helpful if you’re not quite sure what is going to happen.

There are some anonymous saints on this BB who PM’d me when I was first scheduled for them - and were all so very helpful.

Good luck and I hope you are feeling better very soon.

#9

JSwan, you’ve convinced me. :lol:

#10

FWIW Versed doesn’t work for everyone, me for instance. When I had my hand operated on I told the anaesthesiologist this and he took it as a challenge. He gave up after 8 doses

ETA:nitrous oxide doesn’t work either

#11

My gal pal has had her neck and spine injected lots.

She gets no sleepy/dreamy drugs. I tell her if she is going to be naughty she will have to be twitched. To date, she has been obedient and required no twitch, or bullet or whatever. That way she can go home asap.

She does have to lay flat for 12 hours. She gets all chores done before hand.

I have taken her frequently. Yes, I have a plastic pinch twitch and I ask her each time, are you going to be naughty or nice, I can bring my twitch if need be. She is always good.

She has had numerous injections. For her fused neck she did have outpatient, and they did put her under briefly.

#12

Go for the sedation. I had my back injected over the summer and it hurt like he!!.

As far as lay up time, I was stiff for the first 1/2 day and then the next day or two I had some of the worst back pain I had ever experienced. It was awful. Ice will be your friend. :yes:

#13

Now, see, my husband asked a nurse he works with, and she says they prefer patients not to have the sedation, so the patient can be awake to answer questions/tell them if something hurts, doesn’t hurt, etc., and she says (from her end of it, as a nurse) that it doesn’t really hurt.

UGH.

Well.

It’s tomorrow, anyway.

Thanks, COTHers…

And lol about the twitch! I’m usually good for the “vet,” so…

#14

Ok, I just asked hubby and he said his friends ( hes a trauma surgeon so hes got friends in just about every specialty) prefer pts be sedated. He also wants to know what department that nurse works in because he had a hard time elueving she has much experience in epidural steroid injections-they don’t put you totally out for gods sake- last time they had to give mean additional 2 x versed and fentanyl because it was a painful one. I am fully aware and able to say stop that gets like hell I need more drugs. I also am one of those people who don’t get the amnesia from midazolam. I’ve only had to stay very long after twice once was the first injection I ever had and the other time I developed a hematoma and severe migraine so they kept me to do pain mgmt.

#15

You guys are making me so envious! As I said above, it wasn’t even an option for me but I assure you I would have chosen it if it were. Not necessarily because it hurt SO bad but because I see no reason not to take a little relief where possible.

#16

I’ll find out what that nurse’s experience level is for you guys, out of curiosity…

ANYWAY! I went this morning, and decided as I walked in the door to go without the sedation (my husband drove me, just in case), and got the lumbar epidural, and it was not bad, not at all, really, truly almost nothing. I only had one second where I felt a weird pressure inside my back and thought to myself, “Eew, that’s weird,” as they put the needle all the way in, and then it was gone. Otherwise, I didn’t feel a thing.

And my butt tingles right now, lol.

I really hope this helps me! I’ve got riding to do, without burning legs, shooting pain, buckets of Advil, and Tylenol etc.! The doctor wants to see how I feel after this initial shot, and if I feel 100% better, yippee, and if I need a second injection, we’ll schedule that.

There was an older gentleman who had an epidural right before me, resting before they released him, and he joked that he always asks them for a Coke & Crown, but they never have it. He said he gets shots pretty often, and never has the sedation, but if they kept a well-stocked bar back there, that’d be different. :lol:

#17

[QUOTE=Trakehner;6069884]
I’ve never had spine injection, but am a big fan of “Better living through chemistry”. Heck, I took sedation dentistry when Ihad a wisdom tooth pulled. Woke up at home 4 hours later, no pain, no drama etc. etc. etc.

It’s a bit more expensive, makes it easier for the person at the fat end of the needle…why not?[/QUOTE]

I am all about this post. Give me the good stuff. :winkgrin:

#18

I’ve had cervical facet injections a bunch of times. My first doc years ago, knocked me out, the whole thing was an ordeal. I avoided it again b/c of that.

My current doc does it with out any local or sedation. Easy breezy. The lidocaine in the shot keeps it from hurting for the initial 10-20 minutes. It does hurt afterward, depending on how long I put it off. Sometimes the drive home stinks. Usually they will provide a lidocaine patch which helps quite a bit. I usually take the day off and usually sleep for at least 4 hours. When I get up it’s all better. I have gone on to work some days. It’s doable, but not pleasant.

I’ve had cortizone in my SI joints, that caused some “injection site discomfort” for about 2 weeks.

None of that compares to getting an injection in your foot. I will take a needle in the spine any day over that. I’ve had 2 in different parts of my foot and it was the most painful thing ever. They ought to offer twilight sleep for that.

ETA - I’m definitely part of the better living through Chemistry crowd, but being in & out of the office in 15 minutes, and still able to drive is priceless.

#19

I had this done three separate times but in my cervical spine. They don’t give their patient anything because they want to know if it worked and then they go back in and burn the nerves. This was the absolute worst pain I have ever experienced in my life and I have given birth to two children. I am sure that everyone is different but it was pure agony:no:

OP I am glad that it went well for you. I wouldn’t wish what I went through on my worst enemy!

#20

No way were they sticking that needle in my spine with me being awake! I’ve suffered enough! =) I was awake one minute and the next was waking back up. No problems and no problems afterwards although it took a week or so to really kick in. It had limited effectiveness for me so I probably won’t have it done again.

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