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Epidural injection

BirdbackpainBBirdbackpain Posts: 39
edited 06/11/2012 - 8:40 AM in Lower Back Pain
Hi all I was recently diagnosed with a herniated disk in L5 S1 after 3/4 of a year going the chiropractor route. I am still young (24) and my chiropractor thought it was a twisted pelvis that kept getting out of alignment.

I went and got a MRI and was suggested to a pain management doctor that then scheduled me for a cortizone epidural injection. Long story short I heard him while giving the injection say that my l5 S1 was " too close to get in" so he went to the disk above. This does not seem right to me. What is the size of a needle? How was it too tight to get a needle in? Would the anti inflammatory medicine work from being injected so far away?

It seemed to relieve the pain for a week but now I am back to the same old crap of waking up in pain.

Any thoughts on this?

MircoD of L4-S1 on 3/5/2014

MRI stating either re-herniation or post-op granulation tissue- 5/16

Re-herniation confirmed, ESI on 5/29


  • Sorry you are having disc problems, but glad to see you found your way to the forum. It is hard to give you a specific answer to your question as there are various locations where an epidural steroid injection can be placed, various needles that can be used to reach that particular location, etc. It does sound odd to me that he couldn't get the needle exactly where he wanted it. I am assuming that it was done with the guidance of a fluoroscope to aid in placement....?

    Unfortunately it is fairly common to have the reaction you did...a bit of relief for a period of time. ESIs are often recommended in a series of three, spaced a couple weeks a part. Sometimes, there will be no reaction to the first, a bit more with the second, and in some cases, complete relief with the third. Some people have no relief from any...usually if there is no or little relief after two injections, they will not bother with the third.

    But, generally speaking, the doctor is injecting the steroid at the level of the patient's problem. It may be that he was injecting in a more generalized way where he could place the needle a bit higher up and the steroid would "bathe" the entire area, rather than be laid in right up against the S1 spinal nerve root.

    Don't be afraid to ask your doctor why he did it that way...or why he couldn't get the needle where he wanted it. (I think doctors today are used to being asked lots of questions, and they don't feel challenged by it the way doctors in decades past might have.)

    This website has articles authored by spinal specialists, videos, etc. that can help you understand your condition better. I recommend reading and learning as much as you can so that you can work in partnership with your doctors and you can understand what they are recommending. You might be interested in starting here:

  • I'm just speaking from personal experience as I just had my first epidural injection on 12/7. The doc explained that he did my injection at the L4/L5 level, however the site of my failed fusion was L5/S1. He did this so that the medicine could work it's way from the l4/L5 down to s1. I don't remember the technical terms he used.

    Unfortunately for me, the 1st injection did not work either. I am scheduled for another one on 1/11.

    I've had various other injections before surgery that were all unsuccessful as well.

    My advice is to stick it through the injections and try any other conservative treatments you can before considering surgery.
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