It seems to vary from doc to doc whether they use sedation or not. I have not had any sedation for ESI or any other type of injection/block. Others seem to get it at the drop of a hat.

"C"

That's the same thing I was thinking about pain meds. I've only had Tramadol, Flexeril, and Norflex and they don't do a very good job. That's all my GP will prescribe and he says I need to stop the Tramadol. I've ran out of refills so I need to get in to see him again. I thought that the PM would give me something yesterday. It was my first visit to one and I didn't want to ask. They gave me Lyrica and a couple of Lidoderm patches. They also want me to get a tens unit. I just don't understand why they don't give me something. I can't take anything really strong without taking anti-nausea meds so it's not like I'd take to many. Sorry to go on so much there! I get very discouraged sometimes.
Hope you're having a nice day.
Debbie

I've found there does not appear to be any "normal" when it comes to spinal procedures. It seems to vary from doctor to doctor. Since 2005 I have had 3 different PMs. Two would ask if you wanted twilight sedation. My current PM does not as he wants the patient alert to answer questions or respond as he goes. Oddly enough, the only time I have had a response to an ESI or nerve block is with the doc who does not sedate.

They do use a numbing agent as they are inserting the needle so it isn't too painful. If you do get a zap as the medication goes in, it only lasts a couple seconds.

If you are really worried about this, perhaps you might want to look for a different PM or physiatrist.

I, too, am getting a little bit nervous about having my first nerve block and coccyx injection. My tailbone is just screaming mad these days and any relief would be a wish come true.

I have a consult appointment on March 15th with the Physiatrist, who will be doing the injections. (My PM doctor, my PCP and my Orthopedic Surgeon have all given high praises to this Physiatrist... which is always good to hear).

I see my Orthopedic Surgeon this Monday, to go over the CT scan done last Monday on my pelvis. I have the results and I have learned a lot of new terminology. "Calcified phleboliths" are seen within the anterior inferior pelvis, but my PCP assured me these are nothing to worry about and are commonly found.

It's nice to read the input from "C" and Gwennie.

Please don't feel like you are "going on" about your pain. You hurt, you're in pain and this is the place to share your feelings and get input and support from other members.

Do you have another appointment set up with this new PM doctor? If you could chart your pain over the next month and bring the logs with you on your next visit, the PM doctor might suggest something else to take for your pain. When your pain spikes, write down what medication you take and the level of relief you feel from that medication. I chart mine on a 24 hour basis and include all activities and exercising I do. BionicWoman has a great link for a pain chart to use, which you may find helpful.

I will be wishing you the very best success with your injection.

Thinking of you and wishing you less pain, my friend!

I'm nervous, too.

Tammy

I won't lie, I am nervous about it. I know it'll problably be okay but I'm a worrier. I'm usually pretty tough when it comes to pain though. I'm sure it can't be much more painful than an injection I had in my foot between the toes!(can it?) That one brought tears to my eyes! Still, I'll worry until it's over. This PM is the only one near here that accepts our insurance so I'm pretty much stuck with them. Please keep your fingers crossed that the injection will give me some relief okay? Thanks

Debbie

I'm glad that it helped you a little. Hopefully it'll last a long time. I didn't realize they cost that much! I have to go to a day surgery center for my ESI so that means there'll be an additional facility charge. The facility isn't in our network either so I can end up paying pretty much after insurance. God I hope it works or my hubby will have a fit. lol. Do you know if the ESI costs about the same? Thanks.

Debbie

I'd say anywhere from $2,000 to 3,000 is a fairly common amount. I didn't really notice much difference between various injections, nerve blocks, caudals, etc.

I've only had "precedures" in my lumbar spine, so I hope I am not misleading you. Ask him why he will not give you any sedation. It's always interesting to hear their reasoning.

Hi Debbie, When I was getting the steroid injections before my first surgery. My P.M. Dr. was set up to do them in a part of his office. On an x ray table In a small room. He would give me a mild sedation. I have "white coat syndrome" and even after the sedation, I would practically tremble right off of the table. That dosen't work for him. So he gave me another. He says he has to be verry precise. I have a high tolerance to all of that stuff, it just dosen't do much for me. He was very good at putting it right where it needed to be. And he would tell you ahead of time. To stay off of your feet. and try to stay off of your feet for at least 24 hrs. I had a friend that first told me about the benefits of the ESI.s and he said he liked to get them on a Friday. So he could stay off of his feet all weekend. He had such great results. That I did the same. My P.M. Dr. would say, don't stand, because I don't want all of that stuff leaking out. Now I have never herd anyone on this forum say that their Dr. required that. But I had excellent results doing that for 4 yrs. And most, I hear from on this forum don't seem to get the good results that I did.( they allowed me to get a extra 4 yrs.) Before I had to have surgery.
When I got nerve blocks by a different P.M. Dr. He didn't give any sedation. And he did them in a out patient surgery center.
Good luck, Jim
P.S. The ESI.s really weren't that painful.

I wondered if they want you to take it easy after them. I thought it would be kind of like when you have a myelogram. They don't want you to lay flat for 24 hrs. I'll take your advice though because I want it to work...the first time hopefully.
How are you feeling Jim? I hope you're getting along well.

Debbie

I'm going Wednesday for an ESI with my new PM Dr. This will be my 6th one since last year and hopefully with better results. There's no sedation for me just a numbing agent is used first. I take a mild sedative and painkiller before I go in though.
I will also take it easy for 2 days after. Last time I walked 2 blocks around the house because my leg pain was so much improved. But this time reading Jim's post I will take it easy afterward.
I do some deep breathing through the procedure to get me through. I hope your injection goes well. Take care. Charry

I hope your injection goes well and provides more relief than the others did. Let me know how it goes and do try to take it easy. I'll follow Jim's advice too.
Take care
Hope you're having a good day.

Debbie

Some doctors will provide some form of mild sedation, while others do not.
I have had it both ways. Even when it was the same Pain Management Center, but two different doctors.
Honestly, it really didnt matter much to me, but that was because I was also on Oxycontin during those ESIs, so my judgment on sedation vs non-sedation would be somewhat cloudy.

I don't have any pain meds right now other than muscle relaxers and a few hydrocodone. That's what worries me. Is it fairly common to have even more pain for a few days after these injections? I know when I had an injection like this in my foot it was much more painful for the first three or four days after and then nothing. All my PCP will give me is muscle relaxers and tramadol. The last time he refilled my tramadol he said that I need to get off of it. I don't understand why no one wants to give me anything for pain. I didn't ask the nurse at PM about my prescriptions because I knew if I did they'd think I only want drugs. What am I supposed to do? My mri's plainly show what I'd call a just cause for me to need something stronger than Tramadol. At least I think so. Ah, I guess they think I should be able to handle it who knows? I wish I could!
Hope you're as well as can be Ron.
Debbie

See if your doctor can prescribe a small amount of a pain medication that works for you.

Yes, you can experience some pain and discomfort the first 48-72 hours after the ESI.

When I had any of my Steroid injections for my shoulder, the Orthopedic doctor gave me a script for 10 pills of vicodaine (not a high dosage). He did that even knowing I am on Opana daily. There is a difference in the way our body handles acute pain vs chronic pain.

Wishing you the best

I had the twilight type too--you are under,but not really--for the ESIs I have had.I have had 2 coccyx injections right in the Dr.office with no sedation.It hurt,but it was worth it to make that pain go away!

Thanks for sharing about the coccyx shots and relief!

Debbie might need these, also, once she gets her neck taken care of.

So happy to hear they have helped you.

Take good care,

Tammy

LOL, I also do things and don't remember them when I take Ambien!

Regarding the OP- I've had 2 so far with no sedation, but I believe they give sedation on request. Today's was more uncomfortable than the last one. I am usually not the type to need sedation or pretreatment for anything.

I was scared when I had my first ESI AND IF YOUR PM numbs you good it really is not bad at all, the only concern I would have is not having anything for pain because the eve of you shot it takes time for the steroids to crystalize and increases the pain for a couple of days, get your ice pack ready and rest the evening of your shot ..I had myself terrified and I have a good pm doc he numbs really well and I was like what was I so scare for, my blood pressure was way high and I also talked to people on here that was really comforting..

I really appreciate all the help and support. I admit I am nervous about it. I've never even met the doctor so that adds to it. I'm also more nervous because of the terrible experience I had with a myelogram. I usually don't need any sedation for minor procedures either but that darn myelogram has caused me so much trouble. They say I shouldn't have the same trouble with this but it sounds like the same type deal to me. Just not using as much contrast dye right? I asked for pain meds at the pm office yesterday when I picked up the tens unit and they said the doctor will see me before the procedure tomorrow and I can ask him then. The pain afterwards is what worries me worse than the injection itself...it's not really the needle I dread (much). I just hope that it helps and then it will all be worth it. I always think I can stand anything for a little while but it gets very old having it everyday doesn't it? Thank you all very much for all your help. It means so much to me to have all of you to discuss this stuff with. (I'll probably be back asking more before the day is over.)

Debbie

I had a good experience with my last ESI and facet joint and S! injections. Even with my 2nd PM Dr. but the first PM Dr. was a little rough but he said I had a lot of tissue to go through as I was 40 lbs overweight then but have since lost the weight but hopefully you won't have any bad experience like with your myelogram that is a scary test to me since I never had one. I'm wishing you have an overall uneventful painless experience that I had recently. Take care. Chary

There's actually quite a difference between an ESI and a Myelogram. The ESI is not introduced into the thecal sac, so there's no intentional puncture of the dura as there is in a Myelogram. With an ESI, the injection is given into the epidural space which surrounds the thecal sac.

Imagine that the Myelogram is like intentionally sticking a needle into a balloon to fill it with dye.

An ESI is like taking a needle full of a special cocktail and spraying it onto the outside of the balloon and to the areas adjacent to it. Never puncturing the balloon.

So you shouldn't fear a repeat experience like you had with the Myelogram.

"C"

Dear Debbie,

I've been thinking about you since this morning and I hope tomorrow will be a positive experience for you.

You have a lot of people who will be thinking of you tomorrow and also saying prayers that this new experience will be a breeze for you. Hold tight to the good wishes being sent your way.

I like the comparison "C" made above, regarding the horrific Myelogram. That would be a great visual to keep in mind, during the procedure. Remember what Charry has shared above, too. Her experience has been awesome!

This time tomorrow, it will all be over and done with. If it works like a charm, you will be looking forward to any other ones you may need!

Best wishes to you tonight, tomorrow and afterwards,

Tammy

Okay here's my experience with my first ESI. The nurses and staff were all just great! The doctor who did the injection was really nice and explained everything well. They took my BP, temp and all and started an IV. I thought, hmmm, they are gonna give me something after all! Then the anesthia(sp?) guy came to get me and I asked him why I needed the iv and he said they were gonna give me something to relax the muscles. I said cool. On the way we stopped at what he called the liquor cabinet and I told him I'd take mine straight. lol. He had me get on the table on my stomach with a pillow under my chest and my forehead on a rolled up towel. The anes. guy then started hooking me up to the bp cuff and stuff and said he was gonna see if I was alive and see if he could keep me that way. I said if you can guarantee me that I'll take you home with me. Then in a little bit I said here you've got me with my face buried in a pillow and are going to smother me to death before we ever get started. (I'm a real cut up most of the time and when I'm nervous I'm worse. But I really wasn't nervous by then anyway.) The doctor came in and then they gave me versed I think. I told them it wouldn't take much to do me. He numbed my neck and it didn't hurt. I never even felt the needle with the steroid and numbing stuff. Then it was over. All that worrying for nothing! He already scheduled another one for April 19 cause he said I had a lot of inflamation in there and he couldn't get the medicine exactly where he wanted to. He wouldn't give me any prescriptions because they said he's not really my doctor. He's just filling in for him???I said well who is my doctor? They told me his name but I don't have any return appointments at the office so I don't know. I'll have to make an appt with my GP and see if he'll give my refills. They said to expect increased pain for three or four days and if it is that'll mean the medicine is where it should be. Sorry this is so long I just wanted to share for anyone else who fears this like I did. I feel okay now except for a headache from my neck the way I was laying and I'm hurting through my shoulders and upper chest probably for the same reason. I'll let you know how it goes from here. I thought of you all and felt much better just thinking of having you all behind me. Thanks again.

Debbie

That's great! you had the sedation for your cervical ESI. I had lumbar so think that was better although I think I would want sedation for cervical. Sounds great and take it easy don't overextend your neck to look or turn too much. I took it easy with barely walking or exercising until 3 days after my injections. Just so the med can get in there and work. I hope your headache is gone now. I hope you have great results. I know for mine I had depo-medrol so I only had a 40mg test dose and I get the full 8omg next month April 22nd. I really can't wait. I had Kenalog steroid which is probably what you may have had? I hope you feel better soon. Charry

Thanks for thinking of me. I don't know what kind of stuff he used in the injection. I don't think he even told me. I do know he said something about the steroid being oil based but that's all I know. My head is still aching but that's nothing new and probably has nothing to do with the esi. I am having some funny feelings in my head right now. Feels like it gets cold chills or something is crawling in there. lol. Probably normal also. I will try to take it easy and give it time to work. I'm glad to have got the versed (I think it was) but I don't think it would've been very bad without it. The staff there was so great and really did everything to make me comfortable. Just talking with them made me calm down before they ever gave me anything.
Do you think you're feeling better since your injection? I hope that your next one helps also and gives you lasting relief. Even a few months would be worth it wouldn't it? I could actually turn my head today when I got back in the car!
I hope you're having a good day Charry. Take care.
Debbie

Yes still doing well. Thank goodness. I've been able to go for walks although not today as it's rainy and windy here and supposed to be like this for a few days. I hope to get a little housework done. Good to hear you're able to turn your head now it sounds like it's working. Wishing you better days up ahead. Charry

I'm glad that your experience was a pleasant one. I hope you find that the injections help you out. Do you know what level the injections were at? The ice cold tingly crawly stuff across the head can be from the C2-C3 area if either of those nerves were bathed with the steroids. I've experienced that with nerve blocks to that area.

Well keep us posted on how you are doing and if you get relief from the injection.

"C"

I understood that the NS wanted me to have the injections at C4-5 but it seems to me he put it really low. You know where the little lump is at the bottom of your neck? It's about two inches below that (or at least the puncture site is). I thought I felt really good when I got up this morning but now I have an excruciating headache that goes up the back of my neck, head, and behind my left ear. Not that it's from the esi though because I often have these. The tingly, crawly feeling comes and goes and is only on the left side of my head. Really funny feeling isn't it? I'm really hopeful that these will help me because I'd much rather deal with temporary side effects from the injections than to possibly deal with permanent ill effects from surgery. My next esi is scheduled for April 9 instead of the 19 like I thought.
How are you doing today? I hope that you have a great weekend.
Thanks for all your help.
Debbie

After any injection into my neck, whether it be Botox or a block, I would need to use a heat pad to loosen up the knots in the neck caused by the injection. Sometimes it would take heat and ice alternating. Otherwise a nasty ache would develop along with a muscle tension headache.

Doing well today, getting ready to head out for the day.

Have a great day.

"C"

I was so happy to read that everything went well for you yesterday. (I kept checking the forums for your post yesterday).

I'm really glad you had the Coctail Doctor greet you and treat you to one of his specialties. What a nice surprise! (I'm hoping his brother will be down here when I go in for my block and injections).

I hope your nasty headache starts to subside real soon for you. "C" always has great suggestions. Maybe alternating the heat and ice will help you, like it has for her. It's definitely worth a try.

Take it real easy and just baby that neck area, so the medication can bathe the nerves. You'll be getting another injection real soon, so more relief will be on it's way!

So happy that your experience was a good one. What a relief.

Take good care, Debbie.

Hugs to you,

Tammy

Thanks for thinking of me. Now it's time to start concentrating on your injection Monday. All of my positive thoughts are coming your way. I can't wait until you can give us the update on your experience and that it was a great one as well. I hope the doctors and nurses who treat you will be as great as those I had. Honestly they were great. This facility isn't in network with my insurance so my copays are higher there but it's worth it to have such great care.
Take care and have a great day. Hope you can get your walk in today.
Debbie

Hi Debbie,

Thanks a bunch for the well wishes. I really appreciate it.

My consult appointment went very well this morning. The doctor was full of knowledge regarding the coccyx area and has been doing injections for over 20 years.

I am set up for Wednesday morning! She will be doing a sympathetic nerve block with coccyx injections. I asked about light sedation and she said.... yes!

I can't wait... I am so ready for relief in the tailbone area and sacrum. Like you, I am a bit nervous.... but very anxious to feel relief.

I'm going to start another thread, so I don't continue to hijack yours.

How are you feeling? How is your headache and the other sensations you were feeling?

I hope all is okay and you are feeling relief from the injection.

Take good care and hope you are doing well,

Tammy

I answered your other post as I saw it first. I'm glad things went so well today. I'm looking forward to hearing how it goes on Wednesday. I'm not sure yet how much this esi helped. If this one doesn't show much improvement maybe the next one will. I'm still having a lot of shoulder and hand pain today and really feel kind of like I've been hit by a bus or something. Have also been very dizzy/lightheaded but it may not be connected with the injection at all.
I'm so glad you get the sedation too. I don't see why all doctors don't use it.
Take care and try not to worry.
Debbie