Anyone ever get a spinal epidural?

[scarlet knight]

I was diagnosed with spinal stenosis. M6 orthopedist did recommended a shot could help. Anyone have one? Did it help for long? Painful?

[TK-710]

Originally Posted by scarlet knight

I was diagnosed with spinal stenosis. M6 orthopedist did recommended a shot could help. Anyone have one? Did it help for long? Painful?

I have had them. I did not have a good result.

I was in the military at the time. So my activity level was extremely high. I had three ruptured discs and severe compression to my sciatic nerve. They selected this treatment option in lieu of surgery to keep me going.

Short term: it was extremely effective with pain control.

Long term: I have now had two back surgeries to include fusion and I have significant nerve damage in my leg and bladder. I believe the shots are to blame. Not directly of course but indirectly.

The shots treat a symptom not the cause. In this case pain, and they did a great job masking it. I think at the time they were allowed to do three shots a year. But they didn’t do anything to help fix the actual problem which I continued to make worse because I was feeling such relief.

So imo if the whole purpose is to keep doing what you’re doing, and what you’re doing is causing the damage, I think the shots set you up for failure.

Thats why I say, ultimately, for me, I think they were a bad idea.


Summary:
If you’re looking for pain relief and are willing to significantly reduce your activity so that your back can heal then I say go for it. If you’re looking for relief so you can get after it I say go a different route.

My opinion, my experience. Sample size 1.

[brandrea]

Originally Posted by TK-710

I have had them. I did not have a good result.

I was in the military at the time. So my activity level was extremely high. I had three ruptured discs and severe compression to my sciatic nerve. They selected this treatment option in lieu of surgery to keep me going.

Short term: it was extremely effective with pain control.

Long term: I have now had two back surgeries to include fusion and I have significant nerve damage in my leg and bladder. I believe the shots are to blame. Not directly of course but indirectly.

The shots treat a symptom not the cause. In this case pain, and they did a great job masking it. I think at the time they were allowed to do three shots a year. But they didn’t do anything to help fix the actual problem which I continued to make worse because I was feeling such relief.

So imo if the whole purpose is to keep doing what you’re doing, and what you’re doing is causing the damage, I think the shots set you up for failure.

Thats why I say, ultimately, for me, I think they were a bad idea.


Summary:
If you’re looking for pain relief and are willing to significantly reduce your activity so that your back can heal then I say go for it. If you’re looking for relief so you can get after it I say go a different route.

My opinion, my experience. Sample size 1.

Thank you for sharing this. I truly hope your quality of life improves with time.

[1st amg]

Oh my. I hope TK-710 you keep on learning how to deal and cope with this

[scarlet knight]

My orthopedist said no one would start with surgery. So rock and a hard place. Hope TK-710 finds relief.

[Maleg]

Originally Posted by TK-710

I have had them. I did not have a good result.

I was in the military at the time. So my activity level was extremely high. I had three ruptured discs and severe compression to my sciatic nerve. They selected this treatment option in lieu of surgery to keep me going.

Short term: it was extremely effective with pain control.

Long term: I have now had two back surgeries to include fusion and I have significant nerve damage in my leg and bladder. I believe the shots are to blame. Not directly of course but indirectly.

The shots treat a symptom not the cause. In this case pain, and they did a great job masking it. I think at the time they were allowed to do three shots a year. But they didn’t do anything to help fix the actual problem which I continued to make worse because I was feeling such relief.

So imo if the whole purpose is to keep doing what you’re doing, and what you’re doing is causing the damage, I think the shots set you up for failure.

Thats why I say, ultimately, for me, I think they were a bad idea.


Summary:
If you’re looking for pain relief and are willing to significantly reduce your activity so that your back can heal then I say go for it. If you’re looking for relief so you can get after it I say go a different route.

My opinion, my experience. Sample size 1.

Excellent advice. Several friends and acquaintances over the years had similar experiences. The sample size is greater than 1 IMO.

When I was in your position (4 herniated L’s and 2 herniated C’s) I had the luxury of options and chose to adjust my lifestyle, eliminating activities that aggravate the condition. Plus, I changed my workouts to strengthen my core and maintain flexibility. It’s been 30 years, no strong pain killers (OTC naproxin is my limit), and no surgeries.

For those who are newly diagnosed and whose work gives them the option to adjust to the new reality, I recommend lifestyle adjustment with core and flexibility exercise over medicinal pain management.

[scarlet knight]

My diagnosis was moderate to severe spinal stenosis. Somehow I don’t think that bolstering my core strength will alleviate this problem, with all due respect and admitting that I could be wrong. Epidurals and surgery are not appealing, though.

[JasoninDenver]

I am having one on Wednesday morning after a massive flare-up of S1 nerve root irritation that is not improving. Possibly resulting from a small cyst near the nerve root rather than a disc bulge or herniation for which most people have to undergo these procedures.

However, from being a plaintiff's personal injury lawyer for 25 years, I have had clients go through hundreds of these. All with massively differing results.

These injections serve two purposes in conservative management of such injuries. First, they are often used to pinpoint the exact source of problem and make sure that any future procedures focus on the exact source of the pain. For example, mine is being done to see if the nerve pain is coming from the cyst or arthritic changes in my facet joint. Second, they can be used to minimize pain just enough to allow a patient to make gains with physical therapy and avoiding surgery.

I would say that most clients with stenosis saw moderate relief in the short term. Enough to gain progress in PT that eventually helped them reduce their symptoms when the stenosis was not caused by boney growth. For those with decreased canal space due to arthritic changes, disc herniations or bone spurs, relief was temporary (i.e. less than 3 months per injection). It did help them function without much pain medications, which is very good. But most with severe symptoms ended up progressing towards surgery.

I have had several injections in my neck and shoulders and can say they are not pleasant but not necessarily a torture session. They will progressively inject lidocaine to minimize the pain of the needle and also give 2-4 hours of immediate relief. Hopefully you will feel better after a day or two. Best case scenario, you are good to go after that but realistically you will have a few weeks of relief and then look at another procedure.

[JasoninDenver]

Originally Posted by scarlet knight

My diagnosis was moderate to severe spinal stenosis. Somehow I don’t think that bolstering my core strength will alleviate this problem, with all due respect and admitting that I could be wrong. Epidurals and surgery are not appealing, though.

Core can be very helpful and helped me keep my symptoms at bay for over 10 years. You are right in that it does not solve the problem, though. Sadly, I think your opinion on surgery will change over time.

[Maleg]

Originally Posted by scarlet knight

My diagnosis was moderate to severe spinal stenosis. Somehow I don’t think that bolstering my core strength will alleviate this problem, with all due respect and admitting that I could be wrong. Epidurals and surgery are not appealing, though.

Your diagnosis is similar to mine. But it’s your body and your path. Everyone experiences pain differently. Core training takes time and diligence to feel relief. That may not work for you where you are now.

[Krash]

I have back problems, too (herniated disc). I’m also apprehensive about surgery. In my case, I just know several people who didn’t do well after it. Actually, in both cases, things got much worse for them after the surgery. I was looking at some stats on Google. And the success rate could be as low as 60%.

Ironically, I had open heart surgery three years ago to repair a defective valve and the success rate for that procedure is 98%.


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[TK-710]

Originally Posted by Krash

I have back problems, too (herniated disc). I’m also apprehensive about surgery. In my case, I just know several people who didn’t do well after it. Actually, in both cases, things got much worse for them after the surgery. I was looking at some stats on Google. And the success rate could be as low as 60%.

Ironically, I had open heart surgery three years ago to repair a defective valve and the success rate for that procedure is 98%.


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With spine surgery I’ve always heard the results as the 1/3 rule. 1/3 see positive results. 1/3 see no improvement. 1/3 seem to get worse.

I was definitely fortunate with both to have had improvement. But for medical reasons I had no other options. My first surgery was 12-13 years after the initial injury. Unfortunately due to bad care and bad medical advice when I was is the military for the first 11 years after I had a partial parachute malfunction things continued to get worse. I believe it was those factors that resulted in spinal fusion at age 32. Had I received appropriate care at the onset and reduce my activity initially I think I would have been able to avoid surgery all together. But when you land hard enough to bend a barrel on an M249 SAW and they treat it with Motrin long term side effects should be expected.

If I had any other options surgery would have been a hard no. Physical therapy, developing a strong core, walking as much as possible, and reducing long distance running and long periods of sitting has helped tremendously.

Weight management is also paramount. That’s the hardest thing. If you end up aggravating it, you can sideline yourself for a long time. That’s when the weight creeps up. That extra weight exacerbates the injury. Losing weight and maintaining weight loss requires proper diet and exercise. Exercise can increase the risk of aggravating the injury. It’s a never ending cycle!

[Halothane]

Originally Posted by TK-710

Summary:
If you’re looking for pain relief and are willing to significantly reduce your activity so that your back can heal then I say go for it. If you’re looking for relief so you can get after it I say go a different route.

My opinion, my experience. Sample size 1.

The epidural steroid shot is designed to reduce inflammation of the nerve caused by a herniated disc or impingement (spinal stenosis). This offers short term relief so that the patient can engage in physical therapy and core / back strength exercises. The shot is not a cure but more of a temporary reduction in pain and improved mobility to help people get better. I've seen people get a year relief from an epidural steroid shot and I've seen them get zero relief. More often it takes a series or 2-3 shots. If you don't do the physical therapy it is likely a waste of time except for some rare exceptions. I would always try alternative/ less invasive options before surgery. Good luck and choose a provider who specializes in pain management should you proceed.

[Krash]

Originally Posted by TK-710

With spine surgery I’ve always heard the results as the 1/3 rule. 1/3 see positive results. 1/3 see no improvement. 1/3 seem to get worse.

Weight management is also paramount. That’s the hardest thing. If you end up aggravating it, you can sideline yourself for a long time. That’s when the weight creeps up. That extra weight exacerbates the injury. Losing weight and maintaining weight loss requires proper diet and exercise. Exercise can increase the risk of aggravating the injury. It’s a never ending cycle!

Yeah, I’m riding my bike 4 miles a day and staying fit. I also go to the gym 3 days a week. The nice thing about bike riding is I could ride 20 minutes a day, get my heart rate at 85% max, and suffer no back pain whatsoever. In the gym, I stick to weight lifting that does not aggravate my back in any way. So staying fit is a top priority to me despite my ongoing back problems.


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[East Bay Rider]

After several rounds of spinal injections stopped working, what should have been a routine spinal fusion surgery turned out to be my biggest mistake and I suffer much worse now than I did before the surgery. Without going into it all in detail again,(I've posted about it before) I didn't heal into a solid bony lump (cadaver bone fragments are supposed to stimulate growth) so the screws and rods continue to be what holds it all together but the whole mess still moves and shimmies. I suffered a recurring blood clot (feels like a Charlie horse that doesn't stop) and now use a cane for support and balance. So now I have constant back pain with burning, numbness and paresthesia. It's pretty much all encompassing, alternating from mild activity to rest in order to alleviate alternating symptoms from the next and now live on prescription pain medication.
By all accounts it's no one's fault but mine. I simply have a hard time healing. I sought other opinions and they all confirmed that supposedly my surgeon did a perfectly good job. The problem is with me and no one could tell in advance.
So while people suffering debilitating back pain are looking for relief from surgery, while rare, the possibility is very real that it can become much, much worse, and there is likely no way to tell in advance if it'll happen to you. This isn't meant to discourage, just know that it really does happen sometimes.

[scarlet knight]

Originally Posted by East Bay Rider

After several rounds of spinal injections stopped working, what should have been a routine spinal fusion surgery turned out to be my biggest mistake and I suffer much worse now than I did before the surgery. Without going into it all in detail again,(I've posted about it before) I didn't heal into a solid bony lump (cadaver bone fragments are supposed to stimulate growth) so the screws and rods continue to be what holds it all together but the whole mess still moves and shimmies. I suffered a recurring blood clot (feels like a Charlie horse that doesn't stop) and now use a cane for support and balance. So now I have constant back pain with burning, numbness and paresthesia. It's pretty much all encompassing, alternating from mild activity to rest in order to alleviate alternating symptoms from the next and now live on prescription pain medication.
By all accounts it's no one's fault but mine. I simply have a hard time healing. I sought other opinions and they all confirmed that supposedly my surgeon did a perfectly good job. The problem is with me and no one could tell in advance.
So while people suffering debilitating back pain are looking for relief from surgery, while rare, the possibility is very real that it can become much, much worse, and there is likely no way to tell in advance if it'll happen to you. This isn't meant to discourage, just know that it really does happen sometimes.

Like Jason, I was a personal injury arrorney. I cannot tell you how many people were disappointed with their spinal surgery. A lot. Don’t blame your healing process. I think that the current state of medical technology does not result in a high rate of success. Hoping it will at some point, to our benefit.

[JasoninDenver]

Originally Posted by Krash

Yeah, I’m riding my bike 4 miles a day and staying fit. I also go to the gym 3 days a week. The nice thing about bike riding is I could ride 20 minutes a day, get my heart rate at 85% max, and suffer no back pain whatsoever. In the gym, I stick to weight lifting that does not aggravate my back in any way. So staying fit is a top priority to me despite my ongoing back problems.


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One fitness machine that helped me like no other has been a Versaclimber. Very low impact and the best way for me to strengthen my back while getting a fast high intensity workout. A lot of gyms have them now. I used to own one and will be buying another shortly as my new gym does not have one.

[JasoninDenver]

Originally Posted by scarlet knight

Like Jason, I was a personal injury arrorney. I cannot tell you how many people were disappointed with their spinal surgery. A lot. Don’t blame your healing process. I think that the current state of medical technology does not result in a high rate of success. Hoping it will at some point, to our benefit.

That explains your reluctance for surgery. You know the stats. The 1/3 rule was exactly what I saw.

I am terrified of a fusion but in the last few yearsI was practicing, I saw a pretty dramatic improvement in the success rates for decompressive microdiscectomies.

[JasoninDenver]

Originally Posted by TK-710

With spine surgery I’ve always heard the results as the 1/3 rule. 1/3 see positive results. 1/3 see no improvement. 1/3 seem to get worse.

I was definitely fortunate with both to have had improvement. But for medical reasons I had no other options. My first surgery was 12-13 years after the initial injury. Unfortunately due to bad care and bad medical advice when I was is the military for the first 11 years after I had a partial parachute malfunction things continued to get worse. I believe it was those factors that resulted in spinal fusion at age 32. Had I received appropriate care at the onset and reduce my activity initially I think I would have been able to avoid surgery all together. But when you land hard enough to bend a barrel on an M249 SAW and they treat it with Motrin long term side effects should be expected.

If I had any other options surgery would have been a hard no. Physical therapy, developing a strong core, walking as much as possible, and reducing long distance running and long periods of sitting has helped tremendously.

Weight management is also paramount. That’s the hardest thing. If you end up aggravating it, you can sideline yourself for a long time. That’s when the weight creeps up. That extra weight exacerbates the injury. Losing weight and maintaining weight loss requires proper diet and exercise. Exercise can increase the risk of aggravating the injury. It’s a never ending cycle!

A neighbor was an anesthesiologist at the VA and had to leave because he was so pissed with the outdated treatment protocols. In fact, he went on to open his own pain management clinic on a model of actually trying to treat the pain rather than hand out hundreds of pills and pushing people out the door. I am just glad you did not wind up hooked on the opioids.

[RolexAwaytheDew]

As a radiologist, I have performed many, many of these procedures. The goal is both diagnostic and therapeutic. If you are injecting a specific level, and the pain improves for even a short period of time, this is valuable diagnostic information. Sometimes an injection can break up a cycle of inflammation and allow the body’s natural healing processes to work. I have seen structural abnormalities (even disc herniations) improve over time, but not so much with spinal stenosis.

More likely, the result will be temporizing, and the symptoms, if improved, will return over the next weeks or months.

Not all epidural injections are the same. Some are done “old school” with no imaging. Thankfully, these days, most are done with imaging guidance. The experience and skill level of the injection specialist is also important and the choice of exactly what/where to inject will significantly impact the result.

Finally, while the risk of these injections is low, I have known of a small number of catastrophic complications (aka death) from these so-called minor procedures. It is extremely rare, but, as in any medical procedure, there is always risk. That said, as a physician, I would do just about anything to avoid spine surgery (which also has risks) and would probably try a properly planned and targeted injection prior to agreeing to surgery.

Best of luck!