Steroid shots?

Posted by melissa711 @melissa711, 6 days ago

I have been diagnosed with degenerative disc disease. I have inflammation and severe foraminal narrowing. So far I am very fortunate, I have no pain, just numbness and pins
and needles. I just saw a neurosurgeon and they are recommending pt and steroid shots. My question is do I really need the steroid shots? What benefit is there? I’m really concerned about the risks. Also, this is cervical but there is concern that I have lumbar involvement as well but I haven’t had imaging on that yet. Should I wait on pt until the lumbar is evaluated? I am so overwhelmed.

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@melissa711 You do not need to agree to steroid shots. Doctors use them to postpone surgery and sometimes because they don't want to offer surgery to a patient. The shot will not cure anything and it takes about 6 weeks for the body to clear out the steroid. If you need a new MRI, it will conflict because the steroid will obscure the imaging results and you would need to wait 6 weeks.

The question to ask the surgeon is if this required for your insurance company to authorize spine surgery.

I had an adverse reaction to a steroid shot in the neck and it was the most pain I have ever felt in my life. As a result, I had electric burning zaps in my fingers for about 6 weeks. I think I was allergic to component in the injection, likely polyethylene glycol. When a doctor brought it up again, I said no. You are correct that there are some serious risks. I did recover, but had cold sensitivity in my hand for a year and a half. The steroid shot may help by buying a little bit of space by lowering inflammation. If it doesn't help, you may have more pressure due to compression than can be helped with lowering inflammation.

PT can help somewhat, but when it fails to help with improvement, that is a reason for insurance to decide to cover surgery. Your surgeon knows because of your imaging what is wrong and how to fix it. Ask your surgeon how much risk you have now of loosing functioning of nerves because of the compression. If you feel you should address it now with surgery, speak up. You don't need to wait for the surgeon to make you jump through all the hoops. You are living with this, and it may get worse and cause permanent damage.

It would also be to your benefit to get opinions from other surgeons and you may need to wait a while for those appointments. You then have a choice among what has or hasn't been offered to you. It's an important decision, so make sure you find the surgeon who is right for you.

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Personally if I did not have pain I would not get one.
They were beneficial to me for about 3-4 years then they quit working.
The good part is it pushed the need for surgery further down the road for me.
Unfortunately the road ended.
I never had a bad reation to them and probably had 7 or 8

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Profile picture for Jennifer, Volunteer Mentor @jenniferhunter

@melissa711 You do not need to agree to steroid shots. Doctors use them to postpone surgery and sometimes because they don't want to offer surgery to a patient. The shot will not cure anything and it takes about 6 weeks for the body to clear out the steroid. If you need a new MRI, it will conflict because the steroid will obscure the imaging results and you would need to wait 6 weeks.

The question to ask the surgeon is if this required for your insurance company to authorize spine surgery.

I had an adverse reaction to a steroid shot in the neck and it was the most pain I have ever felt in my life. As a result, I had electric burning zaps in my fingers for about 6 weeks. I think I was allergic to component in the injection, likely polyethylene glycol. When a doctor brought it up again, I said no. You are correct that there are some serious risks. I did recover, but had cold sensitivity in my hand for a year and a half. The steroid shot may help by buying a little bit of space by lowering inflammation. If it doesn't help, you may have more pressure due to compression than can be helped with lowering inflammation.

PT can help somewhat, but when it fails to help with improvement, that is a reason for insurance to decide to cover surgery. Your surgeon knows because of your imaging what is wrong and how to fix it. Ask your surgeon how much risk you have now of loosing functioning of nerves because of the compression. If you feel you should address it now with surgery, speak up. You don't need to wait for the surgeon to make you jump through all the hoops. You are living with this, and it may get worse and cause permanent damage.

It would also be to your benefit to get opinions from other surgeons and you may need to wait a while for those appointments. You then have a choice among what has or hasn't been offered to you. It's an important decision, so make sure you find the surgeon who is right for you.

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@jenniferhunter. I heard that the shots only last a short time, and that after you have had several, you can’t keep doing them…almost all have steroids, which are not easy on the body and possibly could affect other necessary meds..a very individual decision— some people take them to put off surgery, to be able to attend weddings etc…Good luck !

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Profile picture for jlssurplus @jlssurplus

Personally if I did not have pain I would not get one.
They were beneficial to me for about 3-4 years then they quit working.
The good part is it pushed the need for surgery further down the road for me.
Unfortunately the road ended.
I never had a bad reation to them and probably had 7 or 8

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@jlssurplus I believe you are one of the lucky ones.

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I've done PT, had dozens of epidural steroid injections, and had six neck and back surgeries. You should not be in a hurry to have back surgery. My treatment plan with any orthopedic doctor or neurosurgeon was always to favor the most conservative and least invasive approach as long as possible. The risks associated with neck or back surgery are much greater than the risk associated with epidural steroid injections performed under fluoroscopy. If the injections don't provide relief or nerve compression is risking permanent damage, then surgery should be considered. And keep in mind that an MRI, epidural steroid injections, and back surgery will most likely all require insurance pre-authorization.

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Profile picture for vincescs @vincescs

I've done PT, had dozens of epidural steroid injections, and had six neck and back surgeries. You should not be in a hurry to have back surgery. My treatment plan with any orthopedic doctor or neurosurgeon was always to favor the most conservative and least invasive approach as long as possible. The risks associated with neck or back surgery are much greater than the risk associated with epidural steroid injections performed under fluoroscopy. If the injections don't provide relief or nerve compression is risking permanent damage, then surgery should be considered. And keep in mind that an MRI, epidural steroid injections, and back surgery will most likely all require insurance pre-authorization.

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@vincescs you have a point, from your experience… does getting the shots ever totally prevent surgery ? Or does it just put it off ? Of course, there are all kinds of complicating factors, like health status when choosing shots or surgery…

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Profile picture for nycmusic @nycmusic

@vincescs you have a point, from your experience… does getting the shots ever totally prevent surgery ? Or does it just put it off ? Of course, there are all kinds of complicating factors, like health status when choosing shots or surgery…

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@nycmusic - disc herniations can sometimes heal on their own with conservative treatment, so if you can break the inflammation cycle with one or more epidural steroid injections you may be able to delay or even avoid surgery. I managed to put off back surgery for 20 years with epidural steroid injections. Of course everyone's situation is different.

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Profile picture for nycmusic @nycmusic

@jenniferhunter. I heard that the shots only last a short time, and that after you have had several, you can’t keep doing them…almost all have steroids, which are not easy on the body and possibly could affect other necessary meds..a very individual decision— some people take them to put off surgery, to be able to attend weddings etc…Good luck !

Jump to this post

@nycmusic - I believe that in theory you could have a series of up to three steroid injections twice per year. I'm not saying that you would necessarily want to do that since at least for me the side effects are cumulative. For me that means temporary insomnia and 'roid rage after dozens of injections over two decades. But I would choose injection over surgery any day.

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Profile picture for Jennifer, Volunteer Mentor @jenniferhunter

@melissa711 You do not need to agree to steroid shots. Doctors use them to postpone surgery and sometimes because they don't want to offer surgery to a patient. The shot will not cure anything and it takes about 6 weeks for the body to clear out the steroid. If you need a new MRI, it will conflict because the steroid will obscure the imaging results and you would need to wait 6 weeks.

The question to ask the surgeon is if this required for your insurance company to authorize spine surgery.

I had an adverse reaction to a steroid shot in the neck and it was the most pain I have ever felt in my life. As a result, I had electric burning zaps in my fingers for about 6 weeks. I think I was allergic to component in the injection, likely polyethylene glycol. When a doctor brought it up again, I said no. You are correct that there are some serious risks. I did recover, but had cold sensitivity in my hand for a year and a half. The steroid shot may help by buying a little bit of space by lowering inflammation. If it doesn't help, you may have more pressure due to compression than can be helped with lowering inflammation.

PT can help somewhat, but when it fails to help with improvement, that is a reason for insurance to decide to cover surgery. Your surgeon knows because of your imaging what is wrong and how to fix it. Ask your surgeon how much risk you have now of loosing functioning of nerves because of the compression. If you feel you should address it now with surgery, speak up. You don't need to wait for the surgeon to make you jump through all the hoops. You are living with this, and it may get worse and cause permanent damage.

It would also be to your benefit to get opinions from other surgeons and you may need to wait a while for those appointments. You then have a choice among what has or hasn't been offered to you. It's an important decision, so make sure you find the surgeon who is right for you.

Jump to this post

@jenniferhunter thank you so much for your thorough response.

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Profile picture for nycmusic @nycmusic

@jenniferhunter. I heard that the shots only last a short time, and that after you have had several, you can’t keep doing them…almost all have steroids, which are not easy on the body and possibly could affect other necessary meds..a very individual decision— some people take them to put off surgery, to be able to attend weddings etc…Good luck !

Jump to this post

@nycmusic When I had the steroid shot in my neck, it took away all the pain for 5 days, then slowly, pain started returning and by 2 weeks, it was all back, and perhaps with a little less intensity. By 6 weeks, all the pain was back everywhere in full force. All that pain was cured by surgery and decompressing my spinal cord. It's a personal choice. The injections do help some people, but they are not good for me.

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