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annular tear L3/L4 and disk bulges

Good Afternoon Everyone

first time posting, but have read some of your stories in the past few weeks while suffering for the first time from severe back pain

this all started 10 weeks ago after a workout. i tried to stretch and touch my toes, and thats when i knew something was wrong. pain like i have never felt in my life

from the beginning i begged for an MRI, only to be told i need to see a physiatrist and start physical therapy. physical therapy didn't help, and the therapist advised me to stop until seeing MRI results. finally after 6 weeks i was approved an MRI

prior to the MRI they prescribed me oral steroids, which totally screwed me up. my heart would race, and slow down. my temperature would go from fever to chills. i couldn't stop vomitting until the last dose was out of my liver, this went on for hours. smells, tastes, sounds all were almost out of a horror movie--everything made me vomit.

i called the Dr and he said to stop the steroids immediately, felt nauseous all the time for the next 2 weeks or so, finally its gone.

the pain however, at its worst, is just as bad as it was on day 1. finally i received my MRI results showing an annular tear at L3 L4 and 2 disk bulges. at this point, i still can't work for more than 3-5 hours (desk job, even with breaks standing and walking), i am taking 1-3 Perc10s a day, and my quality of life has diminished a lot (i'm only in my 20s)

so here i am at 10 weeks and epidural (ESI) is the topic of the day:
doctor 1 recommends it, says there is a chance it might not help but that it could very well make me start to feel better/begin physical therapy again
doctor 2 does not recommend it, says it will not help me

the thing is, doctor 1 is the one who gave me the oral steroids, and he does not seem to be concerned that i had a horrible reaction to the steroids. i have read some posts on ESIs and the horrible side effects some have had seem eerily similar to the ones I experienced on oral steroids. can anyone weigh in on this?

i have seen a lot of health care professionals in this short time, but most have been kinda short on the "care" part :(

thanks in advance to anyone with advice/opinions



  • LizLiz Posts: 8,835
    edited 04/26/2013 - 6:33 AM
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    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • hopefully a few of you that have had experience with oral steroids or ESIs can tell me about your experience.
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  • I had so many injections, honestly like 20 different types to places including radiofrequency ablations. Nothing helped me.

    I work with a man who has a herniated disc and he gets an injection bi yearly and he is great.

    In my opinion, the longer your spine/brain has the pain, the longer it takes for it to forget it.
  • i have had 5 ESI's over the last few years. 3 lumbar followed by 2 cervical. by the time i got to the 3rd lumbar i was having miserable migraine headaches for weeks after the procedure. finally started to correlate them with the steroids. (it took a while and quite a few oral steroids as well.) so when they recommended the cerrvical ones, i was not thrilled about the possible side effects. they used a different steroid, shorter acting, and i was ok for the 1st one, but not the 2nd. well, fast forward a couple of years now, and i tell all my doctor's that i am allergic to steroids. even though my reaction is not a true allergy, its a sensitivity, i refuse to chance 2 weeks of migraines for the steroids. none of my docs will recommend an ESI at this point, they won't try to convince me to take oral steroids. one of my orthopedists has tried to convince me for a cortisone shot in the past, saying that it shouldn't cause the reaction the steroids do, but so far i haven't taken a chance on it. I am sure it would help some of my problems, but its not worth the others it would cause. I'd be chasing one medication with another to get through the weeks following a steroid of any sort.

    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • pandqmama and tran92 thank you so much for taking the time to post your experiences. tran92, i'm thinking that im like you as far as steroid sensitivity and reactions. from your perspective, do you think i should at least try the ESI once so I can rule them out?

    tomorrow i will be seeing a 3rd opinion so maybe i will have more closure or options after that.

    the doctor addressed my oral steroid sensitivity as probably arising from sensitivity in the GI tract and said that I should be a good candidate for ESI *shrugs shoulders*

    what im wondering now is, does the steroid have to pass through the liver regardless of whether it is orally administered or injected? because if so, i feel that it wont matter the way it is administered and that i will get just as sick off ESI.
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  • If you haven't had one, you truly won't know how you react to it, compared to oral steroids. but then again the reaction to oral doesn't sound pleasant, and i'm not sure i'd want a repeat performance of that. I would ask the docs very very specifically what would be done if you do have a reaction, what they can do to minimize the chance of if its really a good idea to even try it at all.

    i know when i took oral steroids, i'd get migraines from hell. and i got the same problem from the epidurals. but i had done both several times before it all started to click and i realized it was related to the steroid itself.

    my original surgeon pushed the ESI's even knowing my problems with the steroids. he felt the benfits would outweigh the problems if i still had them. my current surgeon has never recommended them knowing my reactions. i would see what all the docs say and pick the choice you're most comfortable with.
    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • tran, thanks again so much for your reply. i think i might try the ESI just to rule it out as a treatment option. ill keep posting my progress in the thread. you have really helped me to understand
  • I have come back to update about the ESI

    I received the ESI a week and 2 days ago. The actual shot was pretty easy, what hurt most was when they put the numbing needle in first.

    Immediately after the shot, I saw my boyfriend and just started laughing for no reason, I don't know if they gave me something because I was nervous or what, but I definitely felt loopy immediately after (is this normal?)
    I felt like I had energy to do more than previously

    For the next few days my moods were soooo unpredictable and sensitive. It was very strange, as if the thoughts I was having were not my own. I drank 6 bottles of smart water a day, because once I felt myself dehydrating, I felt like I was getting the headaches I got from the oral steroids.

    I didn't vomit or have the crazy intense heart rate changes like the oral steroids, but I did have night sweats where I would wake up absolutely sweating with the chills, and some bouts where my heart would go a little nuts.

    As far as the pain, I feel like I have more movement that I didn't have before the shot. And there is slight relief, however the pain in the disc when I sit or drive is still there just the same. I follow up with my doctor in 2 weeks, so I guess I will then find out whats next.
  • came back to update my situation. about 2 weeks after the ESI, i started to find more relief and was starting to ween off the need for painkillers along with being able to do my PT exercises. (but still had very sharp pain in the disc where the annular tear is)

    i saw my doctor this past monday and he recommended I get another ESI since i wasn't feeling complete relief and he wanted to do it before it wore off. i told him i was feeling good for now and would do PT and acupuncture and get back to him in a couple of weeks if i started to deteriorate, he lowered my PK meds and i went on my way
    (also at this time he informed me that he had given me 2 shots last time--i thought i only received one)

    it has now been 1 month post-ESI and just yesterday (wednesday-2days after i saw the dr) i began having severe pain in the same area, like it happened all over again. last night i was crying in pain (hasnt happened in weeks). i am hoping that this is just a bump in the road, because blinded by the ESI and feeling good again for a couple weeks made me forget that this could be something more severe and long-term than i would like
  • anelsen15 said:
    Thursday, I would ask them to try to get the medicine as close to the tear as possible. I had great success with that.
    thank you. im afraid that i will have to get another ESI, and the doctor did mention going in through the center of the disk instead of the sides like he did last time. how long did it take for your tears to heal? i am just starting to feel the return of the pain/tingling in my legs that i havent felt in a while :/
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