How many have you had?

How many have you had?

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lilmama
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How many have you had?

I'm going to have my 3rd injection tomorrow on one side and another set next week on the other side. My question is how many have you had overall or in a year? My last set I had about 3??? weeks ago and didn't last very long. It was amazing while it lasted, but it wore off fairly fast. At what point do you think is too many, or is there a point of too many? What's your opinion?

charry
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Hi Lilmama

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

DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN

dilauro
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The max number sometimes depends on the Insurance

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

Ron DiLauro Spine-Health System Moderator
Dont laugh at me

lilmama
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This will be my 3rd and then

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.

J.J.Grey
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Steroids

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.

lilmama
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Good to know

Thanks for the imput everyone.

dilauro
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J.J., that is very valid

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

Ron DiLauro Spine-Health System Moderator
Dont laugh at me

gwennie17
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injections--

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.

J.J.Grey
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I would not have more than 3 per year

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.

Farmgrrl
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#2 for this round...

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.

J.J.Grey
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Exactly

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.

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