Steroid shots?

@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.

@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.

@jenniferhunter Jennifer, excellent post as usual.
If pressure on the nerves is causing pins an needles and numbness, would reducing inflammation with a steroid protect the nerves, or are the nerves even at risk?

@gently I think the extra "space" that you get by reducing inflammation with a steroid spinal injection is minimal, and when the steroid wears off and is cleared from the body, the inflammation returns to the damaged area and that "space " must shrink away. The risk to the nerves is from compression. With severe compression nerves can die and may not be able to regenerate. There is research going on of course in regenerative medicine, but there do not seem to be miracle cures for spinal cord injuries at this time. But that being said, there was some research at Mayo where a patient with a spinal cord injury was able to walk again with stem cell research, but that was unusual, and most patients in the study did not get such good results. Most spine patients tend to have compression over a period of time that eventually surgeons decompress to save the functional capabilities and prevent further damage.

I guess you can think of it in that steroid injections could buy some time or slow the progression of compression perhaps, but that also depends on how fast things are changing. That may not be the same for everyone. I know with my own MRI imaging of my herniated cervical disc that the amount of bone spurs growing around the herniation doubled in 9 months. My neurological and pain symptoms were also increasing at the same time. I regard the nerves as being at risk if there is compression or instability in the spine. My disk had collapsed by 50% and when I would side bend my neck, I could hit those nerve roots and cause a burning pain in my arms. I didn't have boney growth around the nerve roots, and it was simply that because the disc got thinner, the vertebrae were closer together and didn't have enough space to move without hitting the nerves. Since my fusion corrected that, I can no longer bend at that level and the space for the nerve roots is preserved.

@jenniferhunter question- is hyaluronic acid used in these cases ? I have heard that it is used for knees somewhat more successfully than some other injections.

@jenniferhunter question- is hyaluronic acid used in these cases ? I have heard that it is used for knees somewhat more successfully than some other injections.

@nycmusic
They are still using hyaluronic acid. I have no experience.
https://news.northwestern.edu/stories/2024/august/new-biomaterial-regrows-damaged-cartilage-in-joints
https://jointrehab.com/research-comparing-different-types-of-knee-injections/.
https://news.northwestern.edu/stories/2024/august/new-biomaterial-regrows-damaged-cartilage-in-joints
https://clinicaltrials.gov/study/NCT06915363

Get a second or even a third opinion before doing anything. See what the consensus is among the doctors.
Since your symptoms are not very serious I would delay any shots or surgery. See what alternate treatments first including some physical therapy.

When I had bad back pain I did the physical therapy first and it helped a little. I than went to the steroid shots every 10-12 months for 4 years. I had not ill effects from the shots and I got rid of the pain including the numbness in my legs and feet. I know some people do have some negative reactions.
Due to my spine getting worse I wanted surgery but I had to delay that because I caught cancer and the surgeon would not do the surgery. I went back to my pain med doctor and he suggest a treatment called Intracept. This heats the vein to stop sending pain signals to the brain. It is a bit more invasive but still can be done as out-patient. I scheduled this for the end of Jan.