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L5 Epidural?

RICKRRICK Posts: 136
edited 06/11/2012 - 8:45 AM in Lower Back Pain
My lower back MRI shows a bulge at L5 & S1, my left leg is numb from my hip to the foot. My thigh feels like I have been to a dentist and I have hip pain. I am getting all kinds of opinions that range from the epidural will help to lots of people saying DON'T let them do anything.
I have had two neck surgeries a year apart (08 & 09) C4-7 front and back due to a failed fusion and now I am on SSDI. This MRI will be done on the 26th of July and now I am going nuts with all of these opinions (most of which I have not asked for). I know we don't give medical advice here but what have any of you done and based on that what would you do now?

Thank you.


  • Isn't it interesting (translate: frustrating!) when people tell you what you should and shouldn't be doing when it isn't their body that's in trouble, it's yours. The thing is, everybody is different and nobody can tell another person definitively that they should or shouldn't have an ESI or any other procedure. I have a friend who said Oh, don't do it! when I told him I'm having a lumbar fusion. Anyway, I'm getting off track...

    My L5 nerve root is being pinched and I had an ESI. I had conscious sedation so don't remember if it hurt or not but the benefit of having an ESI is twofold: In some people, it reduces inflammation and permanently (or at least long-term) relieves their pain/symptoms. In others (like myself) it serves as a diagnostic tool for the surgeon. It is very helpful for them if the injection relieves symptoms immediately but then the symptoms gradually come back. That tells them precisely where the problem lies (or at least one location, there may be others).

    One of the most important things, in my opinion, is to make an informed decision about your care. :)

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
  • It made my pain worst went from a consent 6 to a 10.
    They said that it would go down and it never did.
  • If your pain is still at a 10, how is it you're able to sit at a computer? That's the highest number on the pain scale and is supposed to indicate intolerable pain that has you screaming in the ER, so-to-speak.

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
  • I myself would do what ever is needed to be done. to get my health back. Or back to where I could live a better life.

  • I had a L5-S1 herniated disc and tear and still have same issues with DDD. In 2008 I had 2 Epidurals. 2009 I had 3 epidurals and now 2010 so far have had 4 epidurals. The injections help the numbness and tingling and pain for me in my leg. But also I take Cymbalta which helps nerve pain. Of course steroids have risks and ask your Dr. before hand. I would try anything for the leg pain. I've also had nerve blocks in butt, hip and leg to help as well as facet joint and SI injections for back pain. So this has been my experience and often wonder how I would be if I had been offered surgery and had a micro-disectomy but no one offered me surgery so I can only do what the Drs have offered me. I've been to 3 Pain Management Drs. and a Neurologist and Neurosurgeon and 2 Orthosurgeons. More opinions have made me feel better about it. Though concerned about the risk of steroids
    and it's side effects are still a concern.

    I've tried Physiotherapy, aqua therapy, acupuncture with my PT and exercise and medications.

    I also had an EMG and saw a Neurologist for the numbness so think that's the first Dr. I saw and good place to start as they deal with nerve compression. Take care and keep us posted how you're doing. 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
  • jlrfryejjlrfrye ohioPosts: 1,110
    You and are so similar in our medical issues. I also have the lower back issues involving the same disc. I had so many epidurals that I lost count. Yes it did help me in the short term. My disc are now bone on bone and am need of fusion of the lower spine. I will not have anymore surgeries as I have had enough. I hope the injections give you some relief.
  • 10 is not "squirming in the ER*

    10 is "the worst pain you can imagine."

    It is very relative. For some people, back problems are their only experience with severe pain and they really can't imagine something worse. So, for them, it is a 10.

    We even had a discussion up in chronic pain about breaking various bones and not really caring because the back pain is worse. I broke my foot last weekend and was walking on it the same day. My back, now that hurts. ;)

    Sorry, sidetrack, back to talking about Rick's back. Don't listen to them, do what feels right to you, based on the information your doctors give you. Everyone's going to have a story about their brother's cousin's wife's uncle who had back surgery and ended up a hunchback living in an attic with bats, but you have to deal with facts.

    And the facts are that you have a problem, and need to deal with it. There are limited choices with the spine, and most of them have some risk involved (bats aren't one of them). The best way to make those choices is through communication with your health care providers.
  • I'll just tell you my experience. When I started having lower back pain a few months after my ACDF, my surgeon did an MRI and found a bulging disc at L4/5, facet swelling and inflamation, and stenosis.

    My symptoms were lower back pain, hip pain and pain shooting down my legs to my calves in both legs. I had an ESI that helped a little then was put on a medrol steroid 5-day dose. After that, the pain down the legs stopped, then came back, but it was different (difficult to explain), but it felt wider and shorter, only down to just above my knees.

    It turned out that the ESI and medrol pack helped my bulging disc and its symptoms, but the other pain was coming from my facet joints, stenosis and spondylolisthesis. They tried facet joint injections, which didn't help, then tried a diagnostic nerve block to see if a rhizotomy would help. Those didn't help so my only option was a TLIF to open up space for the nerves (fixing the stenosis), fusing the facet joints and adding rods and screws to stabilize everything.

    So, with all that said, I think trying the ESI would be a good idea if that's what the doc suggests. Sometimes it's also considered necessary for insurance purposes before a doctor can take more aggressive measures.

    Take care and please keep us posted.
  • I just had my 2nd ESI today and for me they have helped lower my pain level. If you do go ahead with an ESI just make sure it's a guided one, no blind ESI.
  • I'm an overanalyzer when it comes to making medical decisions, so similar to you I really thought through whether to give ESIs a shot. It really has to be your own call, but for me it was worth it to have them because:

    1) I felt better, if only for a short period of time. It was a relief to know there was *something* out there to help.

    2) It gave my doctor more info about what was going on. My positive response to the ESIs provided further confirmation for exactly what was causing the pain and the location of the pain generator.

    3) Although they are not practical to do on a regular basis because in my case the pain relief doesn't last super long, it's good to know that if there is ever anything important where I absolutely have to have pain relief I can go in for an ESI to get some temporary relief. I think of it as a tool in my pain management arsenal- now we know ESIs work.

    4) There is the possibility for longer term pain relief. The amount of time they last varies from person to person, but for me the chance of something providing lasting relief was worth a shot.

    You just need to be aware of the risks to make an informed decision that you can be comfortable with. As others have said, communicating with your doctor about your reservations will probably help you make the decision. Good luck :)

    P.S. The procedure itself is not bad (if things like that don't bother you). Someone mentioned they had sedation for theirs, but I've had 3 now and have never been sedated. It's a fast procedure and relatively painless. So, sedation is basically just a personal preference thing.
  • I have also heard mixed reviews about the epidural. But I should also say I am awaiting my appointment to have it done. I am to the point, where I will try anything to have somewhat a normal life again. I will let you know how mine goes, hopefully it will be within the next few days. I am just awaiting the workmans comp approval. I wish you the very best and hope you find some relief. keep me updated on the epidural and your reaction to it.
  • Rick,
    We are all here to provided suggestions and proposals and not dissuade anyone from doing what is best for them when the time arrives, it would be wrong for me to use my failed fusion status as a measure of all those attempted and although these results were pertinent to me as an individual, I am encouraged to support others in acquiring some rest-bite.

    My own two epidurals helped mask the pain for about four months each time and were never intended to rectify my underlying condition, rather an incremental approach to the next step; we would not expect surgery to be used if a less invasive process proved useful. We have to keep what we read and hear in context and as Jim said most of us would do “anything” to get some improvement. With all the evidence your doctor will know what may be the next best step and although we all have doubts and distracting for the next impending procedure we need to equate the positives and negative aspects and alternatives.

    It is hard surmising what the outcome may be as we have no guarantee, we would all swap what we have for improvement and that is not always as definitive as we and others intimate at the beginning. We have to live with the results good and bad and that in itself is a difficult and demanding decision.

    What do you want to do, and what is the best route for you to achieve this ?

    We all had of have expectation of what result we would like or prefer and that is not to say that this will not happen, we have to be confident in the decision that we make and enter these challenging event knowing with all the knowledge and current evidence to hand we made a rational choice.

    Chronic pain is about making decision and many of them, with help and support we all try to make the chance of improvement more realistic.

    Take care

  • That was my first one. It was no big deal doing it. Pretty simple in fact.

    But I felt pretty good the day of the injection so it didn't really do much to improve my pain. It didn relieve the painful sensation I have in the low back that escalates when I have that part of my body touching something like laying on the floor or the back of a chair.

    But now almost two weeks later I don't feel very good at all. Increased leg and foot pain and that sensation in the low back has returned as well.

    I really fail to see the benefit of doing it if that is all the relief someone is going to get. A week is not worth it.

    A nurse said something about this procedure being a three step kind of thing. The first injection brings short relief, the second a longer period and the third even longer.

    If we are talking a month's relief that is just not worth it IMO.

    Now if it was a year (which they can't guarantee) that would be worth it.
  • The injections bring relief to a good percentage of people- a higher percentage than surgery. But it's not 100%.

    I just had my 4th. A little early, so I don't get a full series, but I was pretty miserable and my doctor wanted to do something. It really did help quite a bit, but only for about a month.

    To me that was totally worth it because I was really miserable, and I felt really good for a month, and even now am better than I was.

    I am at the point where even small windows of relief are worth it. I do not expect miracles.

  • My boss went for these twice a year(all his dr. would allow)for many years, and still might now that he's retired. He said they usually worked for 4-6 months at a time for him, though I remember at least one that didn't work at all. He was always quite happy to go for them as they allowed him to relatlive ively painlessly for months at a time. He has siatica and a herniated disk.
  • How are you doing? What did your MRI say?

    Please give us an update when you can.

  • Although these injections give short term relief in many cases, I would definetly take a week or month of pain relief over none at all.

    Each and every case will vary, along with the results they provide. I've had very many of these and got very little results, but results none the less. When you have constant, chronic pain, even a week seems like a life time when your pain level decreases.

    It's a chance you have to take. As long as you are well informed and feel that you have a good medical team, then you can make an informed decision. These injections are not designed to be a cure, but only another element of the whole conservative treatment plan.

    Best of luck to you! Whatever decision you make, do come back and let us know.
  • Hi everyone, The lower back mri showed L4, 5 & S1 bulge. I had the epidural Monday with no change I can see so far. The same doctor had done on my neck 2 years ago and when he did my exam this week he felt my left leg, foot and right foot toes (2) numbness is coming from a compression problem in my neck (the last thing I wanted to hear) and my hip pain may be something in my hip and not my back (great). So he did the epidural as a diagnostic to see what would be effected. They did a x-ray of my hip Monday, no word yet on it. I am expecting my PM doctor to start lineing up more mri and bone scan on my neck when I see him in Sept or sooner I hope.
    I have always heard of our on going spine problems after a 1st surgery but this I sure don't like this at all.
    My wife & have have started a 10 week chronic pain class at Kaiser, it offers some good options dealing with pain and a good support group also.
    Never give up.
  • I agree with you about the pain scale... As an EMT we are supposed to ask patients their level of pain on a scale of 0-10, however I used other signs such as elevated heart rate, hypertension, body positioning, crying, etc. to determine pain levels. I've have people tell me their pain is more than a ten and it was for a minor injury. Its all relative to the individuals experience with pain. For example, a women that has gone through child birth has an understanding of what pain feels like at a 10 so if I pick her up in an ambulance cause she fell and hit her head her pain might be just a 2-3, where others would say 7-8. I have a comparable story myself. I have kidney stones. I've heard many people say its comparable to child birth, but I have not experienced that...yet :) When I go to the doc for my back I'm in a lot of pain and barely able to stand however with the kidney stones I was on the floor in fetal position crying. It's all relative for each individual...
  • And this is so difficult, because we all deal with pain differently. I tend to internalize and I have a high pain tolerance, but that doesn't mean the pain isn't there. Just because I'm not yelling and squirming doesn't mean I'm not hurting.

    Showing my pain isn't my way. Not when I break my foot, not when my back hurts. I whimpered a little bit when I was in the emergency room for 2 hours strapped to a back board with 6 broken bones and no pain meds waiting for my CAT scan. I think the woman wailing in the next room sprained her ankle or something.

    I went a long time telling everyone my pain was a 4/5 because I had counted that experience as my 10. It took a long time for me to figure out I was really not using the pain scales correctly. Nobody ever explained them to me, even when I asked.
  • Hi Rick,

    I have had 5 ESI and one foramina - none of them gave me relief, but didn't make me feel worse either. Two days ago I had a caudal injection. I have been suffering for 3 years with back pain and sciatica due to failed back surgery, herniated discs, and DDD. Nothing has worked thus far for me...but knock on wood, I actually have gotten some relief from the caudal. I think that's because it went directly to my S1 (herniated at L3-4, L4-5, L5-S1) which is the root path that gives me the most pain/numbness. Due to my surgery, I have quite a bit of scar tissue which the doctor believes has prevented the cortisone from getting to the nerve. I hope you get some relief from your ESI - sometimes it can take a few days they say. My theory is that of many others who posted - it is worth it even if you only get a short time of pain relief. It's funny how those of us in pain have forgotten what it feels like not to have it be a constant in our lives. Best of luck to you!
  • It's been over two weeks sense my lower back epidural and my lower back is worse now, it kills me to sit in a straight back chair. They have referred me back to my PM doctor for follow up to check if I have neck compression causing the leg problems. This on going spine problems sucks and dealing with more than one doctor also sucks. I have a closed mind concerning any more surgeries, I just want to know what my long term life is going to be and if this is as bad as it will get than I will adjust my attitude for it, but after having two surgeries a year apart and things have gotten worse each time than I say STOP, I am done with their so call modern wonderful medical crap.
    My wife and I are 4 weeks into a 10 week chronic pain class looking to other things to learn to cope with pain.
    Take care and don't ever give up or give in to them.
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