Any advice or information on epidural injections for back pain relief?
I have a herniated disc between my L5 and S1 vertebrae, and sciatica...my Dr. wants to give me a series of epidural injections for pain relief. Anyone know if this works, or have any experience with it?
I'm looking for alternatives to surgery...it looks like epidurals, or a lifetime supply of Lortabs...none of it is fun in my book...
I never had back pian, except for during "that time of the month", I'm not a small girl, I'm 5'11 and weigh almost 200 pounds, my BF and I went swimming, and decided it would be fun to do some cannonball dives into the pool...sounds fun right, The pool was only 5 feet deep, and I had a running start, jumped, and smacked my butt on the bottom of the pool hard!!!
I was in extreme pain at the time of impact, then it faded, but came back with a vengance the very next day...I went to urgent care, the did an x-ray, found nothing, and tried to tell me it was just a muscle spasm...the pain grew & continues to grow more severe on a daily basis, I kept going to Drs, the kept telling me there was nothing really wrong with me & sent to me tio physical therapy...that did not work...One day, at work, I nearly collapsed because the pain got so bad...I went to the ER, and they gave me a pelvic exam! (DUH). Nothing wrong there!!! It took a year for me to save up for an MRI, and voila! There it was!
I manage a women's clothing store, and my work is very physically demanding, wich has only made the injury worse!!! I am in constant pain & I'm getting soooo sick of having to take pain meds, when half the time, they don't help anyway....
Public Comments
1. The only advice I'd give on epidurals is don't let a medical student do it, even if your local hospital is a teaching hospital.I usually let student doctors practice on me (they have to practice on someone), but I let one do my epidural and it took half-an-hour, was agonisingly painful, and left me with numb legs for six weeks. Never again!
2. I dont have any experience with it, but I would do some research before you let him! This could end up giving you major headaches.. research all the side effects and ask him what other options you have! be careful..
good luck
3. ive had 1 but it didnt do me any good, i have spinal stenosies in 3 spots on my back, really it was a waste of time.
4. That's a million dollar loaded question! I suppose you could get pros and cons up the yingyang also! But here's my experience:
We have to first take into consideration that insurance companies have decided among themselves to re-invent the medical system in this country! To date, they have failed miserably! They will (how should I say this with kindness?) pay-off your doctor to recommend anything but surgery! Yes, they're just like the "Pharmaceutical" companies! ( Your doctor gets "kick back" for prescribing certain medications). I suppose our elected officals whom are entrusted to legislating under our constitution are so busy collecting their "kick backs" these days- someone else has to pick up the slack!
Now that we are all on the same page my experience was a work related injury in which I totally obliterated my L3-4 disc,
got the usual workers comp jerk around for a year and a half, and then they decided to treat me! Not as human with kindness but as a "monetary" issue that doesn't feel pain!
Next step- Epidural Blocks! I don't know, maybe they work for some folks but they did absolutely nothing for me other than complicate my situation when the administering anesthesiologist
punctured my spinal fluid sac requiring more medical treatment!
Oh yes, I did the physical therapy routine, drugs, you name it I did it!
As an answer to your question, my neurosurgeon was totally against me getting anything other than surgery as the only proper means of repairing the damage. Who knows, maybe his motivation was dollars and cents too! But as for his advice that the only way to repair a herniated disc is surgery and the longer you go untreated, the more you will experience irreversible damage from the scarring effects created on the involved nerve plexes, sounded like the most reasonable explaination I had received! The epidural block in my opinion, is a band aid approach to a major problem!
Now that the insurance carrier realized their brainstorm would now cost them double, I was left with a life time of pain! This may be attributed to the one last maneuver by the insurance carrier to decide they would tell my neurosurgeon how to perform the surgery! So instead of getting a herniated disc surgically repaired, a bone fusion to secure the vertebrae, I got a vacuum quicky that has plagued me for life with back pain!!
Hope this helps you in your decision making process! I'm sure you'll be flooded with various pro and con stories!
Best of luck with your endeavor!!!!!!!!!!!!!!!!
PS: For all that read this- Write your elected officals and inform them "social medicine" is the answer to the dilemna destroying this country! We are the ONLY industrialized nation in the world without it! ( Could it possibly be the "kick backs" might be obliterated?) We presently have 40 MILLION people in this country without health insurance! I would say that tops the list of "things to do" in Washington! How about you?? Oops! Just got new top priority committee meeting memo: The dingle berry bush in Bunfunct Eygpt will now become extict without immediate intervention!
5. i had it done but it didnt help,some people say its worksgreat for them
6. I am a Neuromuscular Therapist.
The L5/S1 disc is the most operated on disc in the body. When I see this type of condition in my practice, I don't approach a solution to the pain by focusing on the herniated disc but, rather, I ask, "what caused the disc to migrate in the first place?". Often the cause of the condition is dysfunctional postural issues which are generally simple to correct.
Let me explain postural distortions. Our skeleton is designed like a building or machine. When the bones are aligned properly the joints fit optimally with no abnormal or uneven wear. When joint alignment is off, especially in the spine, the result is that two or more vertebrae will literally "wedge" the disc, exerting more force on one side of the disc than the other. Instead of distributing pressure evenly across the surface of the disc, the wedging forces the disc out between the two vertebrae, sometimes into the nerve roots.
I recently treated someone with exactly your condition-herniation at the L5/S1. After taking a few measurements I determined his right leg is about 1/4" shorter than his left. The significance of a leg length inequality (LLI) is that whenever he's standing his pelvis tilts toward the low side, the side with the short leg. Since his nervous system's Righting Reflexes will not allow him to go through life leaning to one side, it starts a process of muscular compensations in order to keep his head up and eyes level. The result is not only chronically tight (and sore) muscles, but more profoundly, uneven pressure on the vertebral discs which have resulted in the L5/S1 disc migrating to one side.
The solution to his problem, and I'm sure yours if you have an LLI, is to simply raise his short leg 1/4" by wearing a foot lift in his right shoe. This levels the pelvis, aligns the spine, and eliminates the body's need to compensate by keeping some muscles permanently locked down and chronically contracted. Wearing the foot lift, combined with some deep muscle massage and stretching to release his chronically tight muscles, will allow his body to return to proper alignment and the disc will return to its normal position. It has to because the abnormal forces that moved it out of position in the first place are no longer there.
A qualified Neuromuscular Therapist will be able to help you with this. They are highly trained in postural analysis and can determine if you have bone length discrepencies like an LLI or small hemipelvis causing the problem. Your problem may also stem solely from muscular imbalances/chronic hypertonicity (overly tight) resulting from past injuries, accidents, poor posture or other factors, that have been exerting uneven forces on your spine. Incidentally, the condition diagnosed as "Sciatica" is almost always caused by overly tight muscles in your low back and hips. An NMT can clear that up with some specific muscle work and stretching.
Remember, there's a reason why your disc has herniated and you have sciatica-type pain. It would be a mistake to focus on the symptoms without looking for the cause. In my experience, the cause is often quite obvious to a practitioner trained to look for it, like an NMT. Doctors, surgeons and physical therapists are not trained in postural analysis and, therefore, are not looking for this as a cause of pain; they tend to focus on the symptoms and quick "fixes". Be warned: If you have an LLI that's causing the disc herniation, doctors will probably dismiss it as insignificant. Many studies, and my own experience, show that small differences are often very significant, as my real example above illustrates.
You may be interested in reading the book, "Pain Free For Life", by Al Skrobisch. Al is a Neuromuscular Therapist like myself trained in the St. John Method of NMT. This book simply, but clearly, describes postural distortions and muscular compensations and how these lead to pain and other serious conditions. He also shows with real life examples how the solution is often ridiculously simple once the cause is discovered.
Hope this helps.
Good Luck.
I am confident you can be helped without pain meds, physical therapy or surgery.
7. I have been having the injections and have found that they tend to be very helpful at first and now are starting to have less of an affect. I have a L5/S1 herniation and recently moved from Vegas to Florida and now I have sciatica as a symptom. I'm not sure if the weather has given me more trouble but it would appear that way. As for the injections, last time my anesthesiologist gave me too much medication and I woke up very sick and vomiting. I have one more in this series and then I'm stopping. I have to say that I at least tried since I am active duty.
8. i am a chiropractor and specialize in spine related injuries. the disc acts as both a cushion and a spacer between each vertebrae. if a disc is bulging, that bulge can put pressure on the nerves exiting between each vertebra which causes a "pinched nerve." also if the disc is wearing out (getting thinner) you lose the space between the vertebra, which leaves less room for those nerves to exit--and again can "pinch" a nerve. those nerves in your low back form the sciaitc nerve which runs all the way down your leg. if any are "pinched" they can cause severe pains from your low back to the foot.
as a chiropractor i see this type of scenario on a daily basis. for those who have degenerative disc disease, disc herniation, disc bulging, etc.--normal chiropractic care can usually help with those problems. but there are also many people out there that have had this problem for many years and can't find relief with anything they try--including chiropractic.
but now there is a treatment that is perfect for your situation and the best part is: it's non-surgical and non-invasive. if you haven't heard of it yet there is a newer treatment out there called spinal decompression. this type of treatment focuses on disc injuries and the problems they cause. i use the DRX9000 spinal decompression system in my office and it works wonders for people with these types of injuries. the DRX9000 is fda approved and is the best decompression system available (there are cheap knock-offs that don't give the same results).
my recommendation would be to research this treatment and then contact someone (usually a chiro) who uses it in their office. i would just google "DRX9000" to find info on it and doctors in your area who may have it. this treament is able to encourage the disc to go back to it's normal orientation and also rebuild its height--which then takes the pressure off whatever nerve it is compressing. this problem is not going to go away by itself and PT is not going to help. something needs to be done to change the discs and the only thing that can actually do this effectively is spinal decompression. PT's will argue on this but it's obvious that it isn't working for you. doing exercises or the mckenzie method won't do you any good because they can't change the disc.
this treatment is extremely effective for degenerative disc disease, disc bulging, herniation, etc. and also sciatica type of cases, especially if you haven't had surgery yet. i've had many patients who were scheduled for surgery, tried this treatment as a last resort, and then ended up cancelling their surgery altogether after treatment was completed. it really does work and that's what my recommendation would be for you. good luck and hopefully this gives insight to others experiencing similar problems--there is a solution!!!
9. Yes, they WORK! I just opted to have second injection last week.
I had SEVERE nerve pain down my leg from the same injury L5-S1 (overuse type). First treatment was prednisone for a few days, and then my first injection. The pain relief came about 24 hours after the injection and was remarkable. I was even able to travel to Europe and limp around for a week, when I was unable to stand, walk or sit for longer than 10 minutes the days preceeding.
My injections were done by my doctor in his surgical OR / clinic (sports orthopedic doc). He specializes in this. Make sure you find a GOOD doc, who knows what he is doing, AND your insurance covers it. They are spendy $1200 or so a pop.
That said, I need to find out what the cause of this is. The injections just mask the pain, allow the nerve to heal, but don't address the WHY.
10. I like this answer before me. How epidurals work great and they're going in to get another one. Obviously they don't work if you're going in for another. And they even said it themselves that it only masks the pain and doesn't solve anything.
Well susan, if you're looking to figure out what the cause is there's some great answers already sitting in front of you--especially from moist the chiropractor. Just open your eyes and read a little.
Chiropractic has been the best thing that has happened to me for my low back problems and I highly recommend trying it--the normal medical model just doesn't do anything to correct the problem.
11. First I would like to respond to the neuromuscular therapists comment that "physical therapists are not trained in postural alignment." That statement couldn't be further from the truth. It is the backbone (no pun intended) of orthopedic physical therapy and is learned from day one!
I think epidural injections get a bad rap, but I find they are highly effective when combined with physical therapy. My first question to you would be what was the basis of your physical therapy? Heat massage and ultrasound, flexion exercises, stabilization exercsies? These approaches are not very effective with accute herniation. I would highly suggest that you find a therapist who is trained in the McKenzie method which actually seeks to help the disc return to a more neutral position...and teaches you how to correct it yourself if it should ever happen again. Some people state that the exercises were too painful...yet they should not be, so often times this approach in combintation with a cortisone injection is helpful because the inflammation has been reduced.
The spinal decompression mentioned by the DC is also effective. No one method works for everyone. I've had patients that I have helped to heal that said that chiropractic was a "waste of time," yet I know I have had others I could not help that did find relief with DCs. Of course with PT, our goal is to educate you on how to correct the problem yourself if it ever comes back again and chiropractic care makes you dependent on them for further care...although they are very good at promoting a generally healthy lifestyle.
If you decide to go for the LESI, I recommend returning to PT with a therapist trained in the McKenzie method (or try the decompression)...the combination is higly effective for those who failed the first time around. (And yes, sometimes it takes more than one...not because they are not effective, but it takes significant anti-inflammation to reduce the pain/inflammation cycle that is so common with this problem.
And yes, McKenzie has been proven effective. It is the most highly researched PT approach. It has also been found to result in a 8.6 greater pain reduction that other standard therapies which included massage, general exercise, manipulation/mobilization, and strength training. See the source listed below
12. It depends on what is wrong with you. I have had 2 epidurals one without guidance and one with both failed and I have yet to get pain relief with out medication. You could try it some people find it works great for them.
13. I have complete loss of L5,S1 disc.. with formation of spurring to lock the region.. However, I remain symptom free.. whenever there is a flair up (twice in the past 50 years) I had nearly immediate relief from chiropractic care.May be worth considering. Particularly if you intend to continue working in your store, with minimal pain.
