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SI inj vs. Epidural...thoughts please!

FarmgrrlFFarmgrrl Posts: 146
edited 06/11/2012 - 8:43 AM in Spinal Injections
Hey all,

I'm currently recovering from a laminectomy with a repeat discectomy at L4-L5 on Jan 26th this year . We know that the level above and below the site are messed up but are believed to be stable.

I'm still under the care of my NS but I returned to see my PM doc last week because of continued stiffness, 'nerve jolts' if I move the wrong way and pain across my lower back as well as tenderness. She did about 15 trigger points on me from my neck to my butt, and noted that really all of my tight areas on my left side (I had left sided herniation too x2). After performing her physical exam, she thinks I might have an SI joint issue. We agreed to schedule an SI injection for this coming Monday (tomorrow).

I've had a total of 3 ESI's previously so I have a pretty good idea of what to expect. My 2nd one hurt like h#ll (she was trying to get the needle into a tight foramen space) and the 3rd one was not as bad. I did request Xanax before all 3 just to calm myself a bit.

What can I expect with an SI injection? Should I just go ahead and ask for the Xanax? Should I premedicate with pain meds? I do find some relief with my Zanaflex and Percs but would that mask the results if we want to find out if the SI joint is an issue?



  • Christine...I don't have insight but wanted to stop in to say hi and I'll be sending positive vibes as you continue down this journey.

    Can I ask why they thought to check your S1 joints? I have been having pain that I describe as "butt bone pain". I had my PT check me for alignment and he says I'm generally ok so he's not sure what to suggest other than to call my doctor. (I see my doctor this week).

    It sounds like your doctor is still optimistic on your progress if you can just get past the stiffness and tenderness in your back.

    IS your leg better? Are you back at work?

  • i had had s1 epidural and it did not work as did all the other injections but my back is in a particular bad way .many people get some degree of relief with epidurals but they never last as long as the medics would have you believe .don't worry about it and ask for sedation .they should give you midazolam or similar and you wont remember anything !
  • I've had 2 sets both sides of S1 injected approximately where your dimples are on your back. It wasn't that bad though I take my pain pills everyday I also took a mild sedative but I was getting facet joint and an epidural the same time. She also injected my hip and that was painful and tight. I've had good relief from pain after the injections and looking forward to my 3rd set May 27th. Best wishes and hope it helps you. My Dr. said she can give up to 6 epidurals in one year so don't know why other Drs say only 3. Best wishes tomorrow and pray it helps you. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • I guess I should have clarified. I didn't actually have an epidural injection at S1 but an injection to my sacroiliac joints. We did both sides since we're not sure if both were pain generators for me. The same meds were used as for epidurals (pain med and steroids) under fluroscopy. My left side hurt a whole lot more than the right. I actually cried out loud and scrunched up the paper on the table it was that bad. The doc said it was from the needle popping through the ligament and into the joint and that my left side was particularly tight (surprise, surprise).

    I kind of had to argue with the nurse just to get a Xanax to help me relax before hand. She tried to convince me that it "wasn't as bad as the epidurals" and that I'd "have to wait an extra 30 mins to let it kick in". I was pretty adamant that she just give me the dang thing (in a nice way of course) and I made that thing dissolve under my tongue in less than a minute! They taste awful but they do help me a bit. Its not meant to take away the pain but I've had a pretty painful experience with epidurals before. Anyways, she finally gave it to me then told me next time take a Benadryl (???) before the next one. WTH is wrong with people? After she was done with her speech I then proceeded to bust out in tears LOL. Part of it was the anxiety about the procedure and a lot of it had to with just being there for me. I haven't had the best recovery since this last surgery and wasn't expecting to have to deal with this pain in my lower back. It was almost a post-traumatic moment for me. I finally stopped crying and got in the room and got it over with. I was still pretty sore afterwards at the injection sites but my pain continued in my back, so maybe the SI joint is not the issue? My understanding is that they do these not only to treat the pain but also as a diagnostic tool to see if the SI joint is the problem. We'll see how I feel in the next few days as the steroids kick in (fingers crossed!).

    Hey there. I went back to my pain doc last week to see if she would let me try Celebrex or Mobic for my lower back pain since it is known that I have arthritis at the L5/S1 foramen as well as the DDD changes at L3-S1. She said she feels Aleve is just as good and vetoed my idea. When she palpated my back, she found tender areas just above and to the left and right of my butt crack and that's where the thought of SI joint dysfunction came into play.
    I'm not back to work. The NS doesn't want me working at the bedside anymore so I formally still do not have employment. (The hospital terminated me at the end of Feb for overextending my FMLA for the year..Liver surgery in June + Intermittent FMLA for my back only left me with 4 weeks of FMLA for this surgery)
    So, I am officially on the job hunt for a nursing position that doesn't require lifting >15 lbs and 'severe' bending. (haha, that's pretty much a joke in the nursing world!) I'm not released to actually work until May 20. I had an interview last week with a major insurance company last week that would be a desk job and I should know more by the end of this week. (Fingers doulbe, triple crossed...it would be awesome to get in there!) Thanks for asking! How are you doing?

    Again, thank you everyone for your input. I haven't seen a whole lot of talk about the SI joint so I was just wondering... :)
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