I've had 5 epidurals within a year which is too much I think if ESI's are what you mean. I've had 3 sets of 8 facet joint injections as well as trigger points which were endless it seemed. I heard it was 3 ESIs a year but that's only what I've heard. I've had two Pain Management Doctors and awaiting a Pain Management clinic at a hospital. I think it's good to always get a second or third opinion. Good luck tomorrow! Take care. Charry

provider. I know in my case 3 ESIs are the maximum in any given year.
Other injections are much more flexible. I think I have had about 25 trigger points in one year. I cant speak personally about facet injections

This will be my 3rd and then 4th the following week on the other side. Then the first 2 times I also had Nerve Root Blocks along with the ESI's. I;m just wondering if I'm going to get these next few and then a HUGE bill for it or something b/c the insurance won't cover them. Plus I can't imagine that these are really the best on your body. Especially someone of my size (i'm 5'2 at 100lbs). Ya know what I mean? I'm willing to do whatever it takes to aid my back pain, as long as it not going to destroy my body.

I have always been told that it is not good to have more than 3 ESIs in a 1 year period. My doc will not even give more than 3 within a year.

Thanks for the imput everyone.

Having steroid injections is NOT the best thing for your body. When it is really needed, it can help, but having too much can start to cause some muscle and other damage, some long lasting problems.
My pain mgt doctor keeps track of every treatment I have had, so when recently I went for two cortisone injections for my shoulders, she started to get concerned because between my ESI's and Cortisone Injections for my shoulders, that would place the number of separate steroid injections in the past 3 years to about 8. We are trying to work out a plan to eliminate steroids for a while and if necessary come up with other options

I was just questioning my surgeon about this topic yesterday...and when I asked the same question previously, I got the same answer...which is that the typical response is no more than three in a year...the thinking being that if the first two aren't working, there isn't much point in continuing to inject.

However, I have exceeded that number as we've been trying to track down which nerve is the pain generator...my surgeon said the amount of steroid is so minute, that it really isn't a problem. Where people really get into trouble with steroids is like in the case of an athlete or a dancer who is getting a large hypodermic needle full of cortisone right into the joint several times/week so they can go on playing or performing. This eventually destroys or can destroy the muscle tissue and cartilage.

Most pain management offices keep track of the number of injections you are getting and call the insurance company beforehand to see how many your policy allows during a given period. Hopefully that is the case with yours, and you won't end up with a nasty surprise.

because I also have issues with my hand and fingers. I have had 2 steroid injections with in the last year in my hand. I went to my hand doc yesterday and found out that I can not have anymore injections in my hand because 3 or more injections may cause the ligament to rupture. Needless to say I am headed for surgery. I have read numerous articles that say even 1 small dose of steroids can cause many issues with your organs later in life. Ultimately the decision must be yours but I always opt to play it safe. Here is some info that I found on this site-

A local injection of corticosteroids delivers a high dosage of the medication where it is needed with little being absorbed into the bloodstream – minimizing systemic side effects of steroids. However, since some medication is absorbed into the bloodstream, most physicians limit the number of Epidural Steroid Injections to three per year to prevent systemic side effects of steroids.

Corticosteroids (or steroids) are similar to cortisol, which is produced naturally by your own body, but these synthetically produced steroids are more potent and longer lasting. Corticosteroids have powerful anti-inflammatory effects.

Local Side Effects of Corticosteroids in Spinal Injections: Too many steroid injections into the same area may weaken tendons and ligaments and cause thinning of joint cartilage.

I'm scheduled for ESI #2 next week but my doc reminded me that I can cancel it if I feel that my nerve pain has improved enough. I also agree with the max # of injections is no more than 3/year. I also have to take into account that I must premedicate with 150 mg of prednisone over 12 hours the night before my injections due to a contrast allergy. Also, one has to keep in mind any Medrol dose packs...my doc and I have tried to do no more than one every 9 months.

I have had my share of the dose packs myself. It sounds like you and your doc are taking just the right amount of precautions. I hope that you get some good pain relief next week! Keep us posted.

I get weekly cervical nerve block injections, 6 each time, which are strictly anesthesia. I've had cervical facet joint injections, one injection in two different joints, left side, and am waiting to get my 2nd set done. My pm also said that he can not do more than 3 sets of the facet injections, so if this next set doesn't work better, he is going ahead with RFA. Every article I've read, suggests no more than 3, as someone else mentioned earlier, if it doesn't work by the 3rd, it's not going to work. Hope your shots today helped!!

for number 2 tomorrow OOOCCHH!

You are not supposed to have more than 3 injections of cortisone in a year. I know that some doctors do more than that but they are endangering your body.
I have only had two, but just found out that I have avascular necrosis in my wrist, and also possibly in my hip joints. I have been having pain in my hips for months, incredible, disabling pain so much that I can't put my foot down when it hits, and the spasms that come with it are indescribable.
Recently I picked up a bag and by the end of an hour later, my wrist was swollen and painful. The next morning my forearm, wrist and fingers were also swollen so I saw my GP who ordered an xray and splint until the results of the xray came back. It shows that the lunate bone in my wrist is dead. The blood supply is lost to that bone and now I am waiting for an MRI to show the extent and if any of the other bones are also effected.
Avascular necrosis comes from too much prednisone/cortisone/kenalog or any other steroid. It somehow disrupts the blood supply to the bones and as a result, the bones die off. Treatment is based on the stage of it, but involves surgery, maybe bone grafting as well, depending on the area.
I was never told anything about this possibility and I wonder if any of us are when we are facing these injections. There is no scale that tells us when too much steroid is given to us, but I had a recent injection in my hips, and now this....the ortho that I saw said this is a direct result from the steroids that I have been given. I just want to warn you to really think about how much steroid your body is taking in with these injections or if you have asthma or any other inflammation, steroids are usually given to us....
Here are a couple of links to avascular necrosis in case anyone is interested ..
http://www.eorthopod.com/public/patient_education/6458/kienbocks_disease...

http://www.eorthopod.com/public/patient_education/6554/avascular_necrosi...

I've had 12-13 injections over the last year before and after surgery. I've had ESI's, front joint nerve block injections, stellate ganglion blocks, medial branch blocks on all levels of my neck on both sides. Most of my injections were for diagnostic purposes only. I personally can not handle any more injections. The 4 ESI's I've had increased my pain to unbearable for weeks. I personally think that they are much eaiser to cope with when you have the IV sedation. I only had the the IV sedation on 3 seperate occasions.

I'm sorry for your condition and know the pain.
I had avascular necrosis in my right humerous, ended up with a titanium cap. Nasty, nasty pain. It went undiagnosed for about 6-8 months. The pain from surgery was worse.

My dad had avascular necrosis in his right wrist and had a rough time getting it to heal. They had to put in plates and a bone graft. I don't want to panic you or anything, but if they do this do EXACTLY what the tell you, you can do and nothing more. My dad returned to work and suffered through the pain. his first plate came loose and the graft failed and they had to go in and do a larger plate and second graft.

I was very, very careful with my shoulder, remembering dad's problems.

I'm so sorry to hear you have this.

When I had mine there was nothing positive about steroids being the cause it was all conjecture they thought there might be a link. In my case I believe the damage was because of crushing injury to the front of my shoulder when I landed on it and my head. I had very limited steroid exposure and still developed the condition.

I've had 2 ESI's, 3 weeks apart from one another for an L5S1 bulge/annular tear.

Relief only lasted about 2-3 days w/ each.

Interestingly, I had the same level of relief w/ oral prednisolone, which also only lasted about 2-3 days.

30-40, folks, in the past 10 years.