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November 8, 2008 - 10:02pm
cortisone injections-how many?
Hi. I just had my first set of transforaminal injections last Sunday. Ouch!! So far it is helping but still have mid-range pain. Is it likely my MD will do another set before I get released to full duty? How long do these last? I just have 3 bulging disks and some narrowing of something I can't remember the name of.
The shots (4) hurt like you know what but I'd do it again if I could get the pain down lower. I don't see my doc again till next Thursday
P.S. I had cervical dissection 4/07 C4-C5
What's transforaminal injections? I have my 3rd epidural Monday and also get trigger point therapy injections. I'm going for a second opinion Pain Management Dr. also because I think this Dr. is injection happy with me. 6 weeks of 8 injections(trigger) now 10 weeks of epis. No way I'm done with this Dr... I hope your injections are helping you. Charry
Any answers I have is not medical advice only a Doctor can help you with that. Just sharing my personal experience as a fellow Spine Health member only.
Mild lumber DDD. L5-S1 herniated disc and annular tear not seen on 2nd MRI. Off work LTD x 2-1/2 yrs. C6 DDD C7 nerve impinging-numb & pain in left arm. Oxycontin 40-2-3 day,cymbalta
The transforaminal injection differs from an epidural in that it is done under a Fluroscope in the OR as an outpatient using dye to place the blunt needle point into the Neuroforamen space. This enables the surgeon to place the cortisone much closer to the root with less chance of damage to the nerve root. Success rate is 71 to 84%. Only 15 to 61% of physicians use the transforaminal approach. All use the epidural approach.
They did 2 injections on each side of my spine in the L3 L4 area. My surgeon also did my C5-C6 dissection/fusion with plate in 07 which has done very well for me. He is a very accomplished Ortho Surgeon and specializes in spine issues. Of course I work at the hospital where he practices. Before I had surgery I spoke to many RN's in the OR and in Sterile Supply and asked them about him and other doctors who do the same thing. It is nice to have inside informers.
Sounds like you do need to see someone else if he has done this that many times and with no relief for you. It is so important to trust in the person doing your treatment. I was injured here at work, so all my stuff is covered under workman's comp. I am trying to avoid back surgery for awhile at least, but if I do I'll go back to the same guy for sure.
I had epideral's always under fluroscope. I never heard of it not being used.
Are the ESI helping your pain at all? I just had one a week ago and I think it may of helped a little so I think I will see if they will do another.
Ellin, Mine was a fluroscoptic too and they gave me some meds before hand so I didn't notice any pain when he did it.
I was just all happy for a while.
I've had epidurals, but I'm not sure whether they were "transforaminal." Mine helped tremendously. Well, not the very first set, but after that I felt "cured" when I got the shots. The relief wears off in time, though. For me, after three months or so, I was in pain again.
The more shots I got, the shorter the relief lasted, though, and the less effective they were. In all, I had ten sets of the epidurals. By the last set, the pain relief was minimal. At that point, my doc said, "enough," and suggested surgery.
Hello Pamlee,
To answer your question - The rule of thumb is a max of three injections in a given year. Just check out the info on Spine-Health. Also the spine surgeons I have gone to say the same thing.
I have had several ESIs and each one has helped to reduce the inflammation and the pain. Most important is that the doctor use a fluoroscope so that he/she can better see how to guide the needle to precisely the exact location it must go. To me no fluoroscope, no injection. AND it is extremely important that the doctor who gives you the injection be an expert at doing the injection.
I get one injection every four months. That is adequate for me.
Take care. Have a Merry Christmas.
RichT
i had many many injections this year... up to 7 under floroscope at one time... but im guessing a total of over 20 for the whole year.... he also did some rhizotomy... i have read from this site i had way more than should of been allowed... i did have bladder problems after a round of the shots over the summer..... where i just couldnt go to the bathroom - it was 24 hours before i pee'd... be careful of these shots... and ask questions from the doctor giving them and your primary...... i also got migraines from them now that i think back.. and we ended up having to do medrol packs to get thru the migraines from the shots... it got ugly for a while!!!
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permanent stim put in 12/2009
2 level XLIF l3-4, l4-5 - 3/2009
Total Colectomy 12/2008 (diagnosed with motility disorder)
severe gastroparesis diagnosed 2008
C5-6 Fusion - 2006
Physical Therapy 04/07 - 12/07
DDD
To many to count steroid shots
Rhizotomy
bone scan
2 myelograms
Discogram - 2 Full Length annular tears L3-4 L4-5 - protrusion at both levels
Congenital fusion at L5-S1.
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Hello TCR,
In my opinion you need to find a new doctor and do it ASAP.
Find the very best spinal surgeon/pain management doc you can find in your area. Frankly, your current doctor needs to have his license revoked.
Very disturbing, VERY disturbing.
RichT
Hello Everyone,
The term "cortisone injection" is a term that is very often used by doctors, and then of course we as patients use that term without understanding exactly what was in the injection.
Cortisone is a natural steroid produced by the human body to ward off inflammation. It is also very short lived.
Because of its very short half-life (term employed to describe how long a chemical will last), cortisone today is very rarely used, if at all.
Today the injection will contain rather than cortisone, a synthetic corticosteroid. Very similar to cortisone, yet significantly much longer lasting than cortisone. One of the corticosteroids used is Kenalog (trade name).
At least for this ole retired chemist correct terminology is important. lol
RichT
Before my dr. diagnosed me with annular tears, he knew i had bulging discs from the MRI, so he gave me an lumber epidural steroid injection, a LESI, and it only made me worse. Then I had a Discogram and he said those types of injections would NOT help me because my L4-L5 and L5-S1 discs have annular tears and I need a multi level spinal fusion.
After a year of pain I got depsarate and he tried facet joint injections, but they were so painful I couldn't endure the entire procedure. I need surgery. And more pain meds. I'm on 4 10MG Lortab a day. It's NOT enough.
On/offgoing pain in lumbar region since 2002, after hurting myself using a pick-axe. Pain grew progressively worse until 2009, when I suffered severe annular tears in L4-L5 and L5-S1 during a cave exploration trip. Have had nerve blocks and Epidurals, to no help. Had FJI's which did NOT help and made me worse, along with the LESI's and nerve blocks. Had a discogram to see if my discs were leaking and indeed, those 2 are. Neuro and surgeons all agree I need a MLSF. Taking Lortabs 10 mg 4x a day, plus now morphine (15 mg) 3x a day, amytriptaline, neurontin, lyrica, ambien, xanax, or valium, and flexerill for muscle pain.