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Questions. Need advice.

I herniated disc L5-S1 in March.

Since, I have went twice to the national spine and pain center in Hagerstown, MD and received steroid injections (First week of April and the first week of May). I feel like they wear off in a month.

Any way, all this time I've been under the impression that the steroids where reducing the swelling of the disc but as I keep reading more and more about these shots (especially today) it seems that it reduces the swelling and inflammation of the nerve and physical therapy is actually needed to help with the disc.

My question is, why has no one at the national spine and pain center told me this. I cancelled my shot for tomorrow because it would be like my last shot for either 6 months or longer. I forget the exact time frame. And the Dr told me to hold it off for as long as I could.

They know I'm trying to handle this without having surgery this summer or forever.

If this is all true what should I do? Take it up with my family Dr or the national pain and done center? I'm really concerned after reading that I might of missed my best chance for pt.


Wanted to give more information.

I'm not sure what exactly the pain is called that I endured. All I know is that it's sciatic. Not even sure if its called Radiculopathy.

I can look on a picture that shows where the nerves go after they leave the spine and my pain is where the l5 - s1 nerve would affect.

The pain was unbearable for around 3 weeks but thankfully I work from home now so I was able to rest most of the time. (In bed with my laptop and phone. laying on my left side). My horrible pain was located on my right leg on the outside of my calf. I have tingling there also along with part of my foot sometimes.

I still get the tingling in that spot off and on and a little pain there. I think it depends on how I'm sitting or what in I'm doing.

And no, the place that gave me my steroid injections, did not tell me that the shots where only reducing the swollen nerve. Maybe they assumed I knew but it was my first time ever doctoring for my back. But they charged me a couple grand for the first visit.

I prob shoulda went sooner by the looks of my mri. I have a bulging l4-l5 and a herniated l5-s1 with the stuff leaking out of the disc or wherever it leaks from. I'm sorry I'm not more fluent with back medical terms but I've just always been involved with electrical work and this is all fairly new to me.

So, is it true that the shots only reduces the nerve swelling?

Did I miss my window for pt?

Thank you...



  • SavageSavage United StatesPosts: 5,476
    You mention that through your reading, that you are concerned re steroid injection you had and doctor not ordering PT.
    It seems you would want to talk about your questions with the doctor who did the ordering of injection and said no to PT.
    That gives him opportunity to explain and or reassure you.

    Personally, I usually update all my docs about new scripts or situation. That way they all have general idea of what other docs are thinking and ordering, and my responses to treatment. I usually wait until I have better understanding and if not urgent, I let them know on next visit

    When it comes to researching our issues, it's good to take active role in wanting to do what's best for us in working with doctor.
    That's one of the reasons SH here with wealth of info.

    But most of us are not text book. Doctor can be thinking something different. Every situation is so individual.
    What can be beneficial for one can be harmful or ineffective to another.

    But it always good to feel free to ask your doctor to explain treatments to your understanding.
    Since so much info is difficult to take in, esp when we are in such pain, it may be helpful for family member or friend to accompany you and be second set of ears.

    For treatments, or meds, or whatever doctor prescribes, asks question of goal, how this treatment accomplishes this goal...etc.. for example.
    Ask anything you want clarified.

    On this site__search__upper right on page, may lead you to older posts that are interesting, or to articles and videos. I find articles informative, but I esp like the videos! it's all delivered in every person language. Easy to understand.

    I'm very sorry for all you pain. Sometimes treatments and meds are trial and try again.
    You're not alone. Hang in there!

    Spine-Health Moderator
    Please read my medical history at: Medical History

  • I have travelled a long road and had I not been my own advocate I'd probably still be traveling a very long and debilitating road.
    Everyones diagnosis is different and everyone can have the same diagnosis just depends on the individuals dr and the treatment plan. Here's a bit of what I learned going through this and you can read my original posts to see where I've come from to now...but for the epidurals, where are they being injected? what levels? How often are you having them?

    what concerns me even more is what is leaking out, and from where? the disk? just had surgery for that ...that is a serious condition. research annular tear please...
    Buldging disk generally don't cause pain hermiated disk usually does because it breaks off sits in a nerve

    L5 s1 is where your pain is coming from something is compressing that nerve root or you have a bludge or herniated disk. Did you have a recent MRI
    What the injection is trying to do is take the inflammation down in and around the area of the nerve. My dr tried it both ways its never too late or missed a window ...I had and injection after I began land therapy injection was at l4-l5 and this was about 8 weeks after having a microdisectomy on that l4-l5 in july last year the first injection did not work left me with very serious reaction....bed rest 5 days no relief what so ever obviously.
    As for PT when I had my injection and if it had gone well...dr suggested let the medication have chance to work sometimes with activity we are aggravating the area and not getting the relief from the injection, Are you on pain medication?

    It can be very overwhelming. Injections work for some long periods time not al all depends on the patient . I had another injection different med injected in october no relief I was doing aqua therapy at that point. Nothing was working for me.

    PT doesn't really for much for the disc itself what did you mean by that?

    Have you tried steroidal packs from dr?

    This site is very helpful in the search it will bring you to videos and descriptions but if your saying sciatica that is your nerve runs doe the back of your leg is it both legs or do you just have back pain?
    sciatica refers to pain in the nerve, radiculopathy refers to the nerve irritation and inflammation.. In my opinion your disc is not "swelling" its your nerves, it sounds like the integrity of your disk thats herniated is right now your biggest issue with relation to your pain..in my opinion.

    Speak to neuro surgeon and get a second opinion I know that your trying to out if of surgery trust me it was the last thing i wanted but nerve damage over time is irreversible which affects so many things not just walking.

    keep me posted or PM me i'm 13 days post op bone fusion l4 l5 for posterior annular tear...which a discogram was the only test to show my tear in my disk which had been leaking out onto my nerve roots 11 months of undiagnosed, misdiagnosed pain to the point where i lost my job...
    This can't be happening
  • Thank you both for your opinions.

    I'll try to answer a question or two you had. Yes I have pain in my lower back and my right leg on the outside of my calf. The outside calf was the worst as far as pain. I did have pain on the right side buttocks. However, when my calf was hurting my lower back pain and the pain in other areas of my right side seemed mild in comparison to my outside calf.

    I was on 2 Percocet every 4-6 hours as needed. It made it a bearable pain. But as soon as I could I got off of narcotics. By the time my first injection came along I had myself off of Percocet.

    The only thing I take now is 2 pills of 400 mg of gabapentin at bedtime. I just asked my doctor if I could cut that in half and he said yes. I haven't started the half dose yet but when I do, I hope it will help out a few side effects I'm having from it

    The last injection I got in the beginning of May went really bad. The Dr hit the nerve. Yes, they do use a big fluroscope. That was really horrible to get through because of the pain. She dumped the med and got out. They asked me if I could get up from the table ok and I said yes. Anyhow, next thing I knew I was in a wheelchair because I had no strength in my right leg. Lower back hurt all that night.

    I really would love this to heal without surgery so I don't need to have anxiety over the fact that I'm always worried about doing something that will take me back to the month of March when it was really bad. I worry about being on narcotics also. I've always refused narcotics from a few drs when I've had broken bones or horrible headaches. But... I didn't even argue with my doc or hesitate to take narcotics back in March with my sciatic pain.

    I was shot through my hip and out the inside of my upper leg when I was younger, so, I know pain. That outside calf sciatic pain compared to the pain I endured until I got morphine in me when shot.

    I also have a relative that has had terrible back problems with surgeries and I see him not only deal with that but also with addiction.

    I don't know anyone that has had back surgery that helped them with pain, it seemed to make it worse and their still worse a few years later. I know about 5 of them. So, I really really don't want surgery.
  • whats leaking out is the "jelly" your annulus which sounds like you have a tear. I would go with a discogram and this leak can cause nerve damage and its not something to take lightly, I am a little more then 3 weeks out and I can't say for sure because I had the microdisectomy to recovery from then the undetected pain for 11 months, and now the swelling and recovery from the bone fusion...I couldn't live my life the way it was and like I said if I didn't push for the test that lead to this surgery I could have irreversible damage to my nerves and that affects walking and my back I'm a 47 year old healthy adult not ready for giving up.
    This can't be happening
  • So did you have a microdisectomy or a fusion? Or both? Are you saying you had bad sciatic pain for 11 months and they didn't have a clue why?

    Yes I know the fluid from the disc is not good but my Dr seems to think with enough time listening to his advice there might be some hope. Im not allowed to lift anything over a certain amount of pounds since March and I follow that regiment.

    It seems after reading up on this it's possible to form a crust where the disc is ruptured.

    I can tell you that surgery is the last resort for me. I completely understand some people's willingness to want surgery. The pain is that bad. I understand my road is probably the slowest road to recovery but I do have my reasons.

    The only thing I might change is the Dr who gives me my steroid injections. I really don't need one right now and it's been over a month but if I do, I thinki want a older more experienced Dr to give it to me. The last time when the Dr hit the nerve with the needle was terrible. I know that's always possible. But I would think the odds are better to not hit a nerve with a more experienced dr who specializes in anesthesia.

    Right now just my lower back at the spine is sore some. It's been that way since the first week of April. I believe that listening to the Dr and the shots plus the gabapentin I'm on has this tolerable right now. I don't even take Advil or anything for the pain and im so grateful for that.

    Does sitting the wrong way or other thing make my back more sore? yes sometimes. Do I get a little pain in my calf on some days? yes I do. But thankfully it's tolerable. An I worried that someday it could just go back to the way it was in March? He&l yes. Am I keeping my hopes up? Yes!

    It is what it is. I can only do so much.

    I hope you get some kind of relief from your pain H.D.I.G.H.!

  • edited 06/07/2015 - 12:39 PM
    and I have a hard time finding those I've tried to communicate with on the site...even with going to my recent posts...

    In July of 2014 I had a microdisectomy. I respect what ever your reasons are I am not one to leap into surgery or take meds...unless a last resort. I will share with out too much detail. 3 c sections, thyroidectomy, skin cancer Mohs surgery, hysterectomy, (those were all done with out pain meds) I saw my sister battle addiction, thats all I can say on that, and now the latest as mentioned micro in july that failed, meaning it took care of the herniated disk it was a clear extrusion in bedded in the nerve giving me debilitating pain I drove to work crying and drove home from work crying....did that for 6 months and finally same day surgery did not want the shots, insurance didn't cover it first shot was 4,000$ just for the shot not even the dr or the facility charges. I'm no Rockefeller, and I have a family, which means I need my job. So being with the company 10 years I used the FMLA, I opted for surgery for job protection with them and also would be covered under 70% of my pay which would go back to my payroll deductions i;e; Insurances wasn't full pay but was due to be out only 6 months. After I started PT I started having pain some left sided due to recovery but all right sided and not typical sciatica. I truly was a mystery patient for 11 months 2 top Drs could not figure it out other then thinking I had a drug problem. They ruled that out with a 1,200$ urinalysis. This has been the only thing as I mentioned that I've needed pain meds for and I am very hesitant and don't tolerate it well..and have fears of course, and I believe a high tolerance for pain.
    Not even sciatic pain just extreme nerve pain radiating down the inner thigh down to my foot causing numbness which is the right foot which obviously is the gas pedal foot, and YES, they had no idea I did all my own research and was very diligent in figuring out what was wrong with me, because I know my own body very well and with EVERYTHING I did it caused debilitating pain.....could not live like that ended up exhausting my leave losing my job my drs would NOT let me return in my physical state with fear I'd do something worse to cause further injury.....

    So I found out about this discogram and asked the dr to perform it. It was the best test that gave precise diagnosis after 11 months....which 2 weeks later had to have a one level fusion at l4 l5 and not a 2 level fusion at l4 l5 l5-s1....any input or questions you have I have a 3 inch binder of medical and HR (human resources) info regarding whats available to you while needing to be out if you decide surgery. I wish mine would of resolved itself however activity increases the jelly to squish out and it can not recover on its own...its possible but highly unlikely given the amount and length of time it was...just continued to smother and damage the nerves.
    Let me know if I can help...

    This can't be happening
  • You've had a lot to deal with.

    My main reason for not opting for surgery while I have other choices is because everyone I know that's had it tells me their back is worse.

    You should stop pt if it's causing more pain.

    Back in the month of March I couldn't even imagine being in pt. I couldn't walk and even laying down on my side I was stiill in extreme pain.

    I think most people cannot afford to take off the first month or two the first time they have extreme pain in their leg. I wonder if more people could, would it be better on their back because their not aggravating the swollen nerve?

    I was blessed to be able to rest my back the month of March. Also, I still don't have to lift anything heavy.

    By the time my first steroid injection came around on April seventh my pain was almost gone and I was off Percocet a few days before the before the first appointment also.

    So that tells me my swelling was going down on it's own.

    Don't get me wrong , I'm still afraid I might do the wrorg thing and end up back to where I was at the beginning of March.

    I'm hoping that the longer I can go without sciatic pain the more things will heal.

    I couldn't imagine getting better if I was still doing commercial and residential wiring on job sites. Being a tech from home has helped.

    Thanks for letting me chat with you about my journey so far.

    I hope your journey brings you relief very soon.

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