Lumbar injections

Posted by melhen @melhen, Feb 28 11:32am

Thoughts on medial branch block and neurotomy
And lumbar injunctions, etc

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@jonc59

Hi!
I've had many steroid epidural injections over the past 7 years. I've been very fortunate to find a pain management Doc that is very gentle, I went twice to a different PM Doc before my current, & the injections were absolute agony... I broke-into cold sweats & almost vomited from the pain in my knees, which felt like were going to explode.

Yep, your PM Doc matters, these injections (& RF Ablations) can be made "comfortably"!

Using injections to target specific locations enabled us to pinpoint the source of my discomfort. (HINT: we were somewhat surprised to discover the actual location of my pain)

I personally feel that steroid injections are a very effective tool for targeting discomfort, at least it was in my case.

For me, L1-2 was the culprit - I'm 3-weeks post-op PLIF (I'm now fused from L1-S1), & I'm cautiously hopeful!!

Good luck with your journey!!

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That is very comforting to know. Thank you! Wow. You’ve been through so much! Wow, I guess this is a journey and not a rush to a ‘finish’ line. I can handle one shot at a time (i think). I will need a degree of patience to know that shots are to be expected and it will take time to get relief. I think I waited too long to get the shots and think I’ve been in denial about my pain and condition. I’ve always thought, hey, maybe it will go away. Well its progressed so need to nip it in the bud. I waited until the pain was intolerable. Not smart. Not good. So, I live and learn. Hopefully learn from others experiences as well (which I am) yay! Lol

The pain doctor was specific with target areas based on last years MRI’s and the two nerve studies (which need updating).

Thank you again and I hope you really do well. I’m so glad they determined the trouble spots to nip them. How is the fusion? Has it helped any to date? Or will it take time to see?

Feel as best as you can!

💜

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@nemo1

Hi Phil,

Well, I started to notice the swelling in my legs is virtually non existent now! How did that happen? So, that is big. Now you can see how skinny my leg is at calf, ankle and top of foot. So that is one thing.

It is affecting my ‘body’ in that the little stinging pains have diminished.

The calf and back spasms are still happening as is the severe pains that strike at any time. It w continues to wake me up from a sound sleep to apply the lidocaine ointment. Oh Gosh, that hurts! Thats the nerve pain. Bottoms of feet are still raw and sensitive to pain. So I’m waiting for help there. Also in waiting for landing gear adn upper back help.

It would improve pain. They didn’t say I’d be pain free. So I don’t know about that. I’m skeptical until I feel a difference which I’m starting to.

It is “activating”. She said they will work on lower back first then work their way up (the mid back and neck areas). I will see what types of therapy shots she will/might give for those areas. I’m hoping the neck is just a shot and not more. She was a doctor of few words.

Thank you for your thoughtful reply!

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Most doctors are "people of few words". Sometimes that demeanor can be a challenge when a patient has lots of questions. You've already found MayoConnect which can be a very useful place for sharing experiences, concerns, and questions. When you do meet with the docs - do you take with you a list of questions to be addressed? I think the docs can be more open to providing lengthier answers when they relize the patient has seriously pre-thought what they'd like to know...

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@nemo1

Had the epidural yesterday. Too soon to see any difference. Injection site still sore. That was not a pleasent shot. It takes some effort/time to get the shot to the right spot. I don’t think there was a numbing agent. Felt like multiple bee stings.

The injection caused tingling down both legs. It hurt, they repeated, ‘its pressure’. So now it’s sore/uncomfortable (at injection site). They said no heat but ice was okay. Indirect application helped best.

All and all, if this works, I’d do it again. If not, well we know thats not gonna happen lol.

They said 2-10 days to see improvement in pain. So, the clock is ticking. I guess there is such a thing as waiting too long, but I’d recommend, fact check recommendations. Thats not to say you don’t trust. You would be backing up/corroborating their findings. I delayed “treatment” (the epidural) because a doctor said it would make my balance worse. She said she did not recommend it. Come to find out it was not the case!! I quickly made appointment for this shot. I still have crappy balance, but hopefully as/if pain reduces, it might improve (it’s the pain that has something to do with that, that and the messed up signals my brain is getting!

I will let you know how effective this shot was on me. What works on one might have different results on someone else but I say, when you are in hellish pain that does not seem to weigh in too much. What’s good for the goose!

Be as well as you can be!

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My epidural has reduced my pain medication by 50%.
However, I recently had painful cramps in both ankles, in addition to fatigue and less balance while walking.
I don't expect the reduced pain to last long, but I am delaying any further treatment. This is getting to be an expensive ordeal with no end in sight.

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@upstatephil

Most doctors are "people of few words". Sometimes that demeanor can be a challenge when a patient has lots of questions. You've already found MayoConnect which can be a very useful place for sharing experiences, concerns, and questions. When you do meet with the docs - do you take with you a list of questions to be addressed? I think the docs can be more open to providing lengthier answers when they relize the patient has seriously pre-thought what they'd like to know...

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I agree. Pre thought questions. I have realized quite a bit of what I’ve felt went unspoken, my problem and fault. I thought some times that it was too much complaining, so I just said a couple of things. Lesson has been learned!

I have all my documents and a list to be addressed with my dr, to get mri and to tell him whats been happening for early next week.

I’m not letting this go gently into that good night.

Thank you so much for your thoughtful reply Phil. The folks here have helped me so much. Wonderful group.

The test of my having learned this, will be next week. So, wish me luck. Have to be confident and not shrink in front of the white coat. lol

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@nemo1

I agree. Pre thought questions. I have realized quite a bit of what I’ve felt went unspoken, my problem and fault. I thought some times that it was too much complaining, so I just said a couple of things. Lesson has been learned!

I have all my documents and a list to be addressed with my dr, to get mri and to tell him whats been happening for early next week.

I’m not letting this go gently into that good night.

Thank you so much for your thoughtful reply Phil. The folks here have helped me so much. Wonderful group.

The test of my having learned this, will be next week. So, wish me luck. Have to be confident and not shrink in front of the white coat. lol

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I'm smiling as I read your comments. Having your list of direct questions in hand plus your understanding how to balance "getting your point across" vs merely "complaining" shows you understand how to communicate with the doctors.

I love your positive attitude about never giving up. Being your own best advocate is a great strategy!

Best of luck next week. Let us know how that goes...?

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@charlie92plus

My epidural has reduced my pain medication by 50%.
However, I recently had painful cramps in both ankles, in addition to fatigue and less balance while walking.
I don't expect the reduced pain to last long, but I am delaying any further treatment. This is getting to be an expensive ordeal with no end in sight.

Jump to this post

I am glad you had some help with the epidural. I wish it helped you more…we take the wins we can get.

I am sorry. Don’t lose hope. I know how that is and feels. When things look like they won’t or aren’t getting much better. To think the pain will be endless. Please don’t give up.

What did the doctor say about your ankle pain, fatigue and balance issues? Please do tell (if you have not already) let him now the pain scale number you are at.

How long have you had the 50% relief from the time of injection? Did they anticipate 50% or greater? I’m so sorry you are having these problems. Have they projected any other pain relief?

When things seem hopeless it affects us profoundly. It is good to talk about it like you are.

I hope you get answers and speedily and pain relief soon. I know soon enough can’t happen as fast as we would hope.

Please take care and let us know what happens, how things progress.

💜

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@upstatephil

I'm smiling as I read your comments. Having your list of direct questions in hand plus your understanding how to balance "getting your point across" vs merely "complaining" shows you understand how to communicate with the doctors.

I love your positive attitude about never giving up. Being your own best advocate is a great strategy!

Best of luck next week. Let us know how that goes...?

Jump to this post

Thanks so much Phil. I am working at being a communicative patient. 😊

Its something. Needing a ‘strategy’ a plan of attack! I’ve heard something in the recent past to be proactive not reactive. It resonated.

Thank you for the well wish. I will bookmark this post to recall and let you know how it goes.

I’m a little nervous. It’s supposed to be a physical. Well, might need to reschedule that and discuss this…will see. He’s a relatively new Primary Care Physician. But I find him to be terrific. He’s helped me at every turn so far!

Well, spring bulbs are coming up. Spring can’t be far. Have a great day.

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@nemo1

Had the epidural yesterday. Too soon to see any difference. Injection site still sore. That was not a pleasent shot. It takes some effort/time to get the shot to the right spot. I don’t think there was a numbing agent. Felt like multiple bee stings.

The injection caused tingling down both legs. It hurt, they repeated, ‘its pressure’. So now it’s sore/uncomfortable (at injection site). They said no heat but ice was okay. Indirect application helped best.

All and all, if this works, I’d do it again. If not, well we know thats not gonna happen lol.

They said 2-10 days to see improvement in pain. So, the clock is ticking. I guess there is such a thing as waiting too long, but I’d recommend, fact check recommendations. Thats not to say you don’t trust. You would be backing up/corroborating their findings. I delayed “treatment” (the epidural) because a doctor said it would make my balance worse. She said she did not recommend it. Come to find out it was not the case!! I quickly made appointment for this shot. I still have crappy balance, but hopefully as/if pain reduces, it might improve (it’s the pain that has something to do with that, that and the messed up signals my brain is getting!

I will let you know how effective this shot was on me. What works on one might have different results on someone else but I say, when you are in hellish pain that does not seem to weigh in too much. What’s good for the goose!

Be as well as you can be!

Jump to this post

I had many injections years ago, they never really worked for me. Two years ago I had three Colon surgeries in 30 days, the last one caused a Fistula and that infection went into my Spinal Column. I went home and fell, my wife called an ambulance which rushed me to Miami Kendall Hospital, when I got there I could not walk. I had a Fushion injection of steriods and after twenty days they sent me home. Then my wife had to inject me with anti biotics for--8--weeks,I still could not walk,so back to Kendall,more steriods and back home after another 11 days. Then at home,--8--more weeks of anti biotics and now I can finally walk waring a full brace, and happy I can get around now but still very painful. I'm retired--41 years as a mail man--and was in really great shape until the Colon surgeries which nearly killed me. Good Luck with your treatment,Bobby Pazo

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Oh my God, Bobby!! 🤗 What an absolute horror. Such a nightmare for you, your wife and family. Such an ordeal to be forced to deal with. I’m so sorry what you had to endure and still endure!

Wish you did not have pain and hope the full body brace is not for a very long time.

Hoping they are doing SOMETHING to aide your healing and pain and hope talking about it, if even a bit, vents some of the anger and dismay at this predicament.

I will say when pain is extreme, when I think how bad it gets and to know it could last for a more prolonged time, it makes me have dark thoughts. But then there are better days when it’s not as bad that gives me a little relief. That said, my hope has taken hits over the last three years.

As this nerve thing progresses, I need to have answers just so I can prepare myself mentally and emotionally to what is ahead. I hear ringing in my head, ‘take one moment at a time’. It’s the one thing that keeps my mind from running like a freight train into depression.

Still hopeful for straight answers even if it’s more testing. I want the best case and worst case scenario. Not to plod along at this rate.

Pain really affects us. It is I’ve found to be a lonely road, in my head. Until a person walks in the shoes, cant see it, can’t feel it, don’t experience it, so how could a person understand. But the good news support comes from different places. Namely here, people who understand and know pain well.

What I’ve done is drawn up a ‘pain related mind map’ to show a doctor. If he or she would like to understand ‘at a glance’ pain. I will include a picture of it. It may not do a thing, but in my head I think it could. Because pain for the most part is an invisible ‘ailment’.

It was therapeutic to draw this pain mind map. For each person has their own pain maps that run parallel or detour out, the thing remains, is how much it affects us, without talking a lot about those extensions is a shared condition. Where support is more often than not, just around the bend.

💜

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Had my injection. Was a piece of cake. I have 80% less pain but Dr. says that may be due to the lidocane. He stated that I should feel less pain as the days/hours go by. So far I am quite happy and glad I did it. I know some of the risks and decided to go ahead anyway, as the risks are minimal. I was very happy with my Dr. and staff at Charlotte Hungerford Hospital in Torrington CT. Will keep updating as the days go by.

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