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New here, and need opinions

Blue_LaceBBlue_Lace Posts: 8
edited 06/11/2012 - 8:59 AM in Chronic Pain
Im 32 years old, female, been having lower back pain, muskoskeletal pain, and nerve pain shooting down my right leg since 2005. I did endless doctoring for it, had numerous MRI's. They determined my spine is degenerating and I have a bulging disk at L4. I live in constant pain, just varying degrees of it. I take way too much ibuprofen, and am on gabapentin (600 mg) to control the nerve pain.

As soon as my insurance kicks in I can get a cortisone shot. This is where my question comes in. I had 3 roughly 2 years ago. The first one worked for 6 weeks, the other two didn't at all. Is getting another shot a waste of time or would ya'll recommend trying it again? I'm desperate for some pain relief, but I don't want to be unrealistic about the chances it'll work either.


  • It seems that cortisone rounds are like pregnancies: each one is different from the one before. There are lots of variables. The doctor providing the shot might treat a different structure or use a different combination of medications.

    Don't automatically assume that the #3 will fail because #2 did.
  • I'll tell you what my pm doc told me "shots don't fix problems". I know we all want pain relief and if this is how you get it then I don't see a problem with it really. I see his point but is getting repeated cortisone shots better or worse than being on opiods for pain? I'm not looking for an answer just posing a question to think about. I take various medications for my chronic back pain and sciatica and it works reasonably well. Can you get something else for pain to go with the gabapentin - it is my understanding that it is just for nerve pain and you would have to have something else for the rest of the pain. Also gabapentin needs to be increased from time to time to maintain its effectiveness. Hope you find something to relieve your pain soon.
  • Cortisone is pretty much the best anti-inflammatory you can get, right where you need it (let's hope it goes where you need it) sometimes its just injected into a muscle for your body to absorb. It's bound to help with your pain. The question is.... How much will it help? and for how long? ....There is no telling, you just have to try it to find out.

    If it calms things down for you...at some point whatever is causing the inflammation in the first place will "flare" back up. You might get one week of 40% relief, you might get 6 months of 80% relief. Everyone's issues are different so some get substantial relief from injections. It can even be a home run for issues like tennis elbow or a trigger finger if you are lucky. For back pain I feel it's less likely to be "the cure" unless you just have a common back ache from doing too much yard work one weekend. For something causing chronic pain it's pretty much a short term solution for a long term problem. Still is worthwhile for lots of folks. hope this helps put some perspective on things.
  • Thanks for the comments so far. Do you notice that the pain intensifies in the cold? I could ask my doc for opiates, but the last time I seen her I led her to assume I don't want them. I've been on Tramadol and that worked ok, but if I go back on it I want an extended release version.

    Cortisone seems like a good answer, IF it works. I have a TENS unit and that works wonders on the muscular pain. Right now the big problem I have is this nerve pain. My toes tingle and my whole foot feels cold a lot of the time. Maybe the gabapentin does need to go up. Good thought! Keep the comments coming. I feel like I've finally found people that understand what I'm going through. Everyone around me is seemingly clueless how it is to live in constant pain.
  • I have been getting cortisone shots in my knee for about 3 years and it has worked wonders for me except for the very first shot.

    My GP gave me my first shot in my knee but it did nothing for me.

    My orthopedic surgeon gave me my second shot and the next day I was free of my brutal pain!! I now get them every 3 months. The surgeon told me they would eventually stop working for me. But so far so good.

    He also told me the reason the first shot given to me by my GP did nothing for me was because it was not put in the right place on my knee. Neither does it help with pain in other parts of my body.

    There must be something to "getting it in the right place" My surgeon always puts it in the very same place and it has never failed to help, except for the first one given to me by my GP.

    Hope you find relief soon.


  • Hi Blue Lace,

    Have you thought about Nerve root blocks these are done using live x-ray to target the exact spot in the facet joint for me,I had one yesterday at L5/S1 for sciatica /leg pain/ and foot pain.this is the first one in my lower back,I have had several others in my neck with mixed results,Yesterday's went fine with relief to my foot especially.

    The other thing you mention is disc bulge at L4 with degeneration,how bad is this ? you may find it needs surgery if it intrudes on the spinal canal,hopefully not.Have you seen a spinal unit or orthopaedic specialist? they will guide you as to the best treatments.

    I had decompression/fusion 8 weeks ago after many years of pain and drugs etc and so far it is the best thing I have done,no one wants surgery but sometimes it is the only way,one thing to remember is surgery will not guarantee a cure but may help.

    Injections can relieve muscles around nerves to give them a chance to calm down but often come back again,it is a never ending circle of experiments,the one thing you have is a TENS and can be great for short term relief,alternatively the Physiotherapist has more concentrated things like interferential,infra red,etc these can be good with muscular problems.

    If the injection has worked for you in the past it may well be worth another go,but as you said two failed,it could all be down to correct placement,do you know if all 3 injections were done in the same place? I know when I had these my pain consultant wanted to target different ares each time this way he could identify where my pain was coming from.

    Hope you get better soon

  • Agree that the ESI's can be hit or miss. However also keep in mind that they are a valuable tool at helping locate problems.

  • Some people here have had shots and unfortunately nothing happened, not even six weeks of improvement, and any reduction of the pain is preferable than none. As ap said, each time and event differs, this process is only a short term interim option and never intended to replace surgery that may be a future alternative, higher up the managing and repair process.

    We all start will lower order non-invasive tools and move incrementally towards that inevitable surgery option, or not. Was my one month traction, PT and 3 epidurals a waste of time and money, perhaps not I had varying success and some relief even though the final outcome was a laminectomy and subsequent fusion. Would you be happy with 6 weeks of reduced pain.... a 33% chance of some help is good.

    In 1981 I was asked in the hospital if student doctors could observe my epidural and 20 white coated young people turned up, that was my gift to progress !

    Good luck and take care. John
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