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Back Pain Worse (and different) after Cortisone Injection.

Jodenice1JJodenice1 Posts: 10
edited 06/11/2012 - 7:54 AM in Lower Back Pain
Hello all! I'm new and in need of advice, if anyone can help?

In December I fell over in the ice and hurt myself. Months of pain & physio followed, which was confused slightly by my sympoms changing (at first only had burning cramping pain in leg and buttock and this could only be relieved by crouching/squatting down and leaning forward slightly, this looked ridiculous in the supermarket!) , this then changed to tingling legs, numbness and leaning back, rather than forward to get relief). An MRI scan was taken and showed '
disc degeneration L3/L4 & L5/S1.
L3/L4 there is right sided posterior annual tear and bulge but no significant root impingement.
L5/S1disc protusion and left S1 nerve root compression.

I had a cortisone injection last week for the root compression and it HURT! But i was willing to put up with this for possible relief.

However, my pain is worse now - but its different again. I've gone back to my first set of symptoms. I can only get relief crouching down on the floor and leaning forwards (although it hurts to get into this position). My pain is no longer in my lower back and thigh but now is nearly all in my left buttock and I can't even roll over in bed without shrieking out in pain. It also hurts a bit behind my left knee. If I walk that area of buttock gets an almost chronic cramping spasm. I'm no longer getting any numbness. It hurts incredible amounts to walk but also really aches after laying down or sitting for too long.

Work have been very sympathetic but are losing patience. i have the hospital next week but I can't even do any of my old exercises as it hurts too much, I don't know what to do. I usually speed walk about an hour and twenty mins a day (even if it hurts I can manage), however I have stopped this as I can't get to the end of the road.

I'm beginning to suspect that either: the injection didn't work and stirred something up or it worked and the pain relief has let the pain from something else come through or something new entirely is happening! Has anyone got any ideas?


  • Sometimes the needle goes where it shouldn't and aggravates the nerve. You might ask your doc if an epidural would be beneficial. (from what you posted, it sounds like you had a facet-type injection). I used to get spinal blocks and they helped, but epidurals were so much better. I also have it where being in a curled position helps, so I empathise with you. If you don't have a break-through medication, I'd ask for one. It certainly sounds like you would benefit from one.

    Good luck on getting relief soon! :)))
  • Hi and thank you for taking the time to respond. I did have an epidural steroid injection (the reason it hurt so much is that the surgeon started doing it before thelocal anaesthetic kicked in - I lost all dignity and howled the place down!). I've only had it once but I thought it either wouldn't work or itwould, not that I'd hurt more!
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  • Hello, I just had a cortizone shot in my rt. hip and after I had tremendous pain a few hours later, it was in BOTH hips all the way down to my shins, eventually to the top of my right foot. It was soooooo bad I had my hubby take me to the ER after suffering from 2pm Friday to Saturday around 6:30am, thankfully the ER doc controlled my pain and gave RX but damn WTH ??? I have been calling my Ortho to find out what it might be but to no avail. Did you get any answers yourself? If so pls share .. I do not have a PM Doc, I was discharged due to 3 apt. changes so Ill be going back to my GP and praying he can help me. I hope we get some answers as to wth could cause MORE pain from a shot that was to help us relieve the pain .. Tracy Dx Legg Perthes disease @ age 7, 4x total hip replacements, multi findings on MRI from horrid back pain,cant recall the formal dx names lol : age 37 <3 what dont kill me makes me stronger!!! ~RRRAAAHHHHHH~ 8}
  • I am confused, i have had two lots of spinal injections, the leg pain has deminished after both lots of injections, but i still have the awful lower back pain, i had surgery last November for 2 h-discs. i did all the right things post op. the surgeon says he needs to isolate the right area for a fusion. i went in the injections thinking that i would have less pain, but seem to have the same pain in some ways a little more harsh
    different, have pins and needles still in feet and some times down legs. I can tolerate that. but lower back pain some days is very distressing, taking allot of pain killers. just a little stressed, anyone please could they clarify for me
  • There's probably a FAQ on steroid injections, pain blocks & epidurals somewhere, but I will tell you all what I know that may be helpful.

    1. Steroids injected at the site of pain do not always work. Your doctor should tell you that even though they have a pretty decent track record, they do not work for everyone, your condition can worsen, and a whole list of 'possible' side effects.

    2. Make sure you're going to a reputable doctor with good reviews. For Heaven's sake, and yours, don't randomly pick a doc from the phone book. If your GP refers you, research the new doc before you go. Don't be afraid to cancel the appointment and pick another doctor if your research red-flags the one you've been referred to. (you may have to get another referral, depending on insurance)

    3. Ask the doctor questions before any procedure. Success rate? Side effects? Can I get worse? Will I be sedated? What exactly is this procedure and how is it done? Are you going to do it, or will an intern or associate be the one there? In office or hospital? Knowledge is power to make good decisions.

    4. In spite of all your diligence in selecting a doctor and asking the right questions, doctors make mistakes. They typically use fluoroscopy to help guide them, but even so, moving a needle with dexterity to the spine without hitting a nerve or missing the spot is not easy. You always run the chance of being one of the unsuccessful cases.

    5. If you have pain from multiple areas, you're only going to (potentially) get relief from the area injected. Injections only cover certain areas when properly placed. I used to get facet blocks and epidurals at the same time to cover a wider area, and that was a good mix.

    6. You could get worse. Not only can you be on the 'unsuccessful' list, if the attending doctor hits a nerve accidentally, drives the needle in too far, etc, you will suffer for it. Given my experience and that of my friends I haven't seen this often, but does happen. It happened to me during RFA. Don't be afraid to change doctors if they don't meet your standards. Even good doctors make mistakes, but if they do, they should be willing to remedy the situation/make sure you're in as little pain as possible while you recover. If they avoid you or can't admit a failure and still help you, if it were me, I'd run.

    7. Having said the above, steroidal injections can be wonderful things. Before my problem areas multiplied and I was still a simple case, I got 3 a year, and they were divine. I was treated in a hospital by my doctor, not an intern; I was sedated intravenously as well as the local (that stings a bit) during the procedure(s). I never had a bad experience with facet blocks or epidurals...the only bad thing was they became ineffective as my condition worsened. Just do your homework.

    8. If you did get worse from the procedure, it's likely to be temporary, but not always, so get right back and see your doctor. Don't risk complications! I had RFA and it worsened my condition for about 7 months. I did go back to the doc after a week (the time you can expect RFA to worsen you), and told him the details, and he advised me. So seriously, if you're worse, go back for a check-up!

    Best wishes to everyone on getting relief! :)))
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  • belyc, upon reading your last post I was able to discern that I was indeed one of those very rare cases in which an Epidural actually transferred the pain and intensified it several fold. Lucky me. I have DDD, started experiencing problems at 23, I'm now 31. Most of my problems are with the L4-L5 and L5-S1 discs, which have posterior bulges, and I have compression of the S1 nerve root. I also have mild to moderate foraminal narrowing, mild facet hypertrophy and spinal stenosis. After many conservative treatments, I received an epidural last year. It literally ruined my life as I knew it, as I wasn't able to get up from lying face down on my floor due to terrible sciatic and lumbar back pain which curved into my abdomen region. As with your botched Radio Frequency Ablation, I was suffering for about 6 months or so in this state. I would have gone back to another doc, but I lost insurance during this time period. Long story short, I am at a crossroads now as the symptoms have lessened, but I still have constant sciatic pain if I'm not on high doses of neurontin, and constant lumbar pain regardless. I have an ortho who says he hasn't done any fusions on someone my age, but it would be the only thing that alleviates the sciatic and the back pain. Any advice or comments would be appreciated. thx
  • I recently had a sequence of facet injections for my lower back pain about a week ago and was feeling worse and different just as you did. I sense it the greatest when I wake up in the morning. I seem to be close to baseline pain levels as I make my way through the day, but it still hurts a lot when I wake up. Also felt strange butt pain after the injections which I never felt before but that seems to be subsiding. Hoping that this increased pain level is only temporary.
  • pkttrain21, first let me say I'm sorry your epi had such terrible results. I empathise with you, and hope you are recovered from the procedure now. You mentioned losing your insurance. Do you have coverage now? If you do, I'd recommend researching neurosurgeons in your area...not just your city/town, but also the larger urban areas within a 2 hour drive. My doctor is 1.5 hours away in another state, but I make the trip because he's a little bit of awesome. ;)) Neurosurgeons usually can get you in with the best pain docs, so another good reason to see one. Also consider well-known medical centers in your general region. I live in southwestern Ohio and have been told by my other docs I should visit the Mayo Clinic, which is quite a schlep. I haven't yet because things are under control, but don't be afraid to seek the best help available, just because it's not close. After all, it's your life, you're young, and why should you live in misery until the end of your days?

    If you don't have insurance and you can afford it, 'medical holidays' have become popular. India has some top-notch doctors that work for a fraction of what American doctors charge. One of my docs here is Indian, received his training there, and I wouldn't trade him for a pot of gold. So research doctors elsewhere if you're not covered. If you Google "medical holiday back pain", it's a place to start.

    I wish you the best care available to relieve your pain!
  • Thanks for the advice Belyc, I do appreciate all the empathy and time you have given to my situation. I fortunately have insurance now; I actually moved with my girlfriend all the way from Colorado to Massachusetts spending 4 painful days in our car, in order to receive state sponsored healthcare (not the only reason we moved, but a major one). I definitely underestimated how hard it is to establish a continuum of care here, but it's still the best decision I've made for myself in terms of my health!

    With that said, I had to automatically wait a month before I got state healthcare. Before coming to Mass I was on mild narcotics everyday for breakthrough pain, and I had to go a whole month and a half just gritting it out. Once I finally got a chance to see some doctors, absolutely nobody (not even an ortho in one case) would grant me a prescription even though I had all of my old doc's notes, MRI's, etc...The abuse of narcotic pain meds here in Mass is so out of control that Doc's are reluctant or will flat out not write for them at all. It makes the situation for people who are in real pain exceptionally frustrating and Painful! I don't do the doctor shopping thing, and thank the stars I luckily ended up getting a very compassionate PCP who listens, and takes great care of me!

    I also just had another ortho appointment today to go over my recent MRI, and he basically said there were three options...you can do nothing and just manage the pain, get more injections (both epi and facet joint) or be more aggressive and have surgery (most likely fusion and laminectomy). Regardless of my first experience with EPI shot, I feel as though if it's done correctly this time it may give me relief, and I've never had a facet joint injection, and was told I have some moderate facet arthropathy. I think diagnostically that may be the way to go as well? Don't want the surgery to tackle one thing, and then find out it's not the main source of pain right? Anyway, thx again for your advice, I will def be heeding your advice when it comes to searching for more reknowned Doc's even if they are farther away geographically. This is the first time I've ever had the opportunity to explore any options at all, so I'm taking full advantage. After all the pain I've endured already, what's a little extra travel time to see a better quality doc? http://www.spine-health.com/sites/all/modules/smileys/packs/Yahoo/smile.gif

    And just out of curiosity, why would you recommend a neurosurgeon instead of an ortho? My ortho is part of the Spine clinic where I go...Are Neurosurgeons totally dedicated to the spine? Would I definitely get better treatment?

    Thanks again, I look forward to hearing more of your comments in the future, and hope your situation stays stable!


  • I'm glad you've got coverage and a PCP who listens and responds to you :))) That's so very important!

    When I mentioned going to a neurosurgeon, it's just me speaking out of my own experience, not that one is necessarily better than the other. I had a great Orthopaedist when I was 24; he did my initial surgery and he was great. At that time I had relatively minor issues and he addressed them with excellence. When my problem returned (as I was told it eventually would), I was referred to a neurosurgeon who specializes in back, neck & head problems. Since my problem relates to the nerves, and I have permanent nerve damage, and it was pretty clear I would need surgery again, I preferred a neurosurgeon. I talked to a family member in the medical profession about my situation, and his recommendation was a neuro with a practice that's either exclusive to or very focused on back problems. But the right doctor in either specialty can usually do the trick. Orthopaedics specializes in bones and neurosurgeons specialize in nervous system. *shrugs* It widens your options if you consider both. B)
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