Spinal steroid injections

Posted by chuckiepoo1 @chuckiepoo1, Feb 16, 2023

Recently I had X-rays and MRI of the lower back after about a very severe pain for weeks. The diagnosis was osteoarthritis and moderate to severe degeneration of L4, L5 and S1. I can't control the pain somewhat with medications but do not like taking too much of these. My orthopedist has suggested I try steroid injections which may give relief for up to 6 months, but if the relief turns out to be short-term it is not a good option. Has anyone had the steroid injections into the lumbar area? If so, what were the results and how long did the relief last? I am 78 years old and have been very active all my life, and maybe this is the problem. The only other option suggest it was Fusion but I had rather stay away from that as long as I can.

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@irene5

@marlenec Clearly over time and having frequent steroid injections can’t be good for any of us as they tend to weaken bones, so it’s a catch 22 really. My bone density has been low, but I take Premarin which I believe has helped. Taking thyroid medication increases the likelihood of one of the osteo conditions so what’s a person to do? I take 75 mcg of levothyroxine daily for hypothyroid. ( since age 18). And then if you take bone strengthening medicine that becomes problematic for dental implants!! I will have steroid injections till I have no other choices. I’m a type A personality so if I rest - I rust. I guess that has held me in good stead as moving is good. Teaching K and 1 for 43 years kept me moving as well, although admittedly I wear a large brace with those metal stays to hold me together when I am in a lot of pain. Medical marijuana helps with pain. I am
not a party kind of gal, so my card expired. I tried it twice. Since I have 10 children I didn’t want to have to explain that - although I am sure they would have been fine with it. Everything in moderation is probably ok, so I think infrequent steroid shots are not too problematic. I would say to explore all options before having a fusion. Even nerve ablation is a thought. Seriously, this growing up thing is highly overrated! 🙂 irene5

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@irene5

Irene, I was interested in what you said about bone density and thyroid medications, and bone building drugs with dental implants. I found a few articles that explain the relationships. It seems that with thyroid medications (either synthetic or natural) they must be optimal doses and that changes with a patient's age, and not an overdose because an overdose increases the activity of the cells that break down bone. That is balanced against the cells that build bone which allows the body to heal and replace bone over time. Too much thyroid hormone tends to tip the scales toward lesser bone density.

https://link.springer.com/article/10.1007/s00198-017-3981-8

The article about bone building drugs and dental implants seems to be focused on failure rates of implants of patients who are already taking the biphosphonate drugs. I'm curious about what applies to patients who get dental implants, and later in life need the biphosphonates to treat osteoporosis, and if that is an increased risk? In other words, is it the healing phase after oral surgery and dental implant placement that has the greatest risk with these drugs? I wonder what other medications could also affect this situation and add to the risk. These are good questions to ask if you are older and on common medications to treat various conditions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5005105/

I do have dental implants, and do take thyroid medication for hypothyroid. My mother has severe osteoporosis and is on medication for that. My doctor does monitor and test thyroid hormone levels and is doing a bone scan. I also take bioidentical estrogen and progesterone replacement which does help for retaining bone density. Thanks for your post. I learned something today!

Jennifer

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My understanding Jennifer is that it is a bad idea to get implants if you have been taking any bone density medication for a long time. I was on Actonel briefly years ago , and when I went to have my necessary implants that was the first question asked by the surgeon. That and about smoking. I am a non smoker. Apparently as you mentioned taking those types of medications result in poor implant success. Additionally smoking is bad as well for implant success. The way it was explained to me is that the bone becomes too dense from the medication for the implants to hold well. As far as thyroid medication, an old doctor told me once he didn’t want to increase my thyroid amount because it would worsen my osteoporosis and hence my bone density as well. Tis such a catch 22 and a good lesson in cause and effect. 🙂 I don’t know what smoking does for implant failure since I don’t smoke. 🙂 I take calcium and Vitamin D and a small amount of daily Premarin. Unfortunately my gynecologist who loves and owns horses told me about the awful process to get it. Broke my heart and is very troublesome!! I would have gone on a plant based estrogen, but my insurance wouldn’t cover it. Something needs to be done about that! And we live next door to a riding stable!

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@lizann45

I had RFA early last year. At that time, I was having right & left leg pain. After procedure, left leg better but right leg pain returned. I recently had the MILD procedure. Now right leg pain free, but pain in my left leg now! Especially in the morning. Trying physical therapy again to see if that helps. May try dry needling too. Has anyone tried dry needling?

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Thank you for the info!

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What is RFA?
What is MILD? Thanks.

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I have degenerative disc disease (DDD) of my lumbar sacral area & severe arthritis in the LS region as well. I've had spinal injections with excellent results. The last injection only gave me moderate relief but it surpassed having surgery which is probably in my future, i.e. - fusion procedure.

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@cjmd

Has anyone had success with RFA? Insurance does not cover this, and I'm interested in hearing about the success rate.

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Excuse me what us RFA?

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@bsaunders73

Excuse me what us RFA?

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RFA is radio frequency ablation

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