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hello! Severe L5-S1 herniation patient introduction, about to get ESI

Hi everyone,

I've been reading these forums for a few months and have finally decided to start interacting with the community. I'm a 30 year old female who was initially injured mid January 2017. I had a VERY physically demanding job, and since I assumed my injury was just soreness I didn't take it easy and continued to give my all at work. This really began to effect my mobility, and the straw that broke the camel's back (ha) was a slip down the stairs mid-February. All impact absorbed by my rear end, I immediately cried from the resulting back pain. I was prescribed PT, Neurontin, and many physical restrictions. Finally had an MRI in April that revealed a severe L5-S1 disc herniation (12 mm extrusion), with an additional bulge at L4-L5 with an associated annular fissure. The Neurontin helps quite a bit, but if I do anything physically, beyond the basics of life or lift more than 5 lbs, I have pretty significant flare ups that result in various types of pain. I haven't been working since mid-February, and understand how lucky I am to have a supportive husband. 

Dealing with this injury for six months straight has been very humbling and eye opening. It's such a mental journey that I continually have to navigate. I wish there was a way to know where this will go and how it will progress, but I've mostly had to make peace that I will know as I know. 

At this point, I've met with a spine surgeon and am under the care of a pain management doctor. I've been advised to try more conservative methods, which is a relief. The idea of spinal surgery at 30 just doesn't feel like real life to me. I was initially diagnosed with lumbar radiculopathy, but I've rarely experienced the sciatic problems associated with this. Most of my pain is in my back and near my tail bone. I think this is likely due to the Neurontin, I've played around with that in the past just to see how my body responds and when I'm on lower doses I do feel more sciatic pain. I tend to feel it on the outsides of my thighs or exclusively in my calves. It's more dull than sharp, thankfully.

Anyway, I'm scheduled to have interlaminar ESI's this upcoming Tuesday and am starting to feel nervous about them. I've made peace with possible side effects I may incur, and have done a LOT of research on them and spoken to my doctor about my numerous concerns. I was particularly worried about Arachnoiditis, and this doctor has done over 10,000 ESI's and has never had a patient develop it. The procedure will involve lidocaine initially and will be conducted with fluoroscopy. What I'm focused on now is fear of the actual procedure. I've read that many people experience only mild to moderate discomfort and others experience severe discomfort. I definitely fear the unknown pain, but I'm also concerned that if the procedure does end up being quite painful, how I will be able to hold still with a needle in my back.

I'd appreciate any feedback people have on how their procedure's FELT. Thanks!
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Comments

  • Sheri76Sheri76 Michigan Posts: 646
    edited 06/16/2017 - 1:21 AM
    Hi....
    Everyone seems to have different experiences with injections, just like surgeries and recovery.

    Personally, lumbar injections haven't helped me much for pain, but I know of people that have had success with them.

    Prior to having a fusion, giving injections a try, the first worked for 2 weeks (all except for the numbness and tingling down right leg and foot, which never hurt anyway), then after sneezing while sitting down. the sciatic pain came back. And after having my first lumbar injection, I swore I'd take a Norco prior to having another injection, and I did, and it helped ease the pain of injection, but that injection didn't help with any of the sciatic pain.

    I've had a couple other much less painful injections (different Dr) in SI area since having a L4-5 fusion, but the injections didn't help.
  • tkdttkd Posts: 53
    edited 06/16/2017 - 4:09 AM
    Hi, I've tried 2 in the back,  the main process was bearable, although the first guy hit the nerve..BIG OUCH..think thats what i said.  Fortunately he only did it once.  The second guy was much better.

    They didnt work for my back, have had a few others steroid injections before (ankle hand shoulder ) that did work. Definitely worth a try.

    Good Luck
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  • memerainboltmemerainbolt IndianaPosts: 6,354
    hello kaycla7

    welcome to spine-health

    please click on the welcome link below as well as the system tutorial for more information.

    welcome to spine health

    all new members should take the system tutorial 

    every doctor does them different. i've had several done by different doctors but they always gave me a small injection, a little sting, first to deaden the area. talk to your doctor before he does it and ask him about this.

    good luck and keep us posted.
    Sandra
    Veritas-Health Forum Moderator
    ---------------------------------------------------------------
    Please read my  Medical History
  • Hi Kay,
    I only had on ESI and it help a very small amount for a couple of weeks.

    I had no pain during the injection. I was surprised at how cruddy I felt for a few days afterwards. I get very nauseous with pain meds and anesthesia. Other than that, I had no problems with it.

    Good luck and kerp us posted!
  • Hello Kay, I was very nervous about how my injections at L5 S1 would feel too, and understand as a young patient how hard it can be to digest news that you have to face this big medical thing that affects your mobility (I am 31 and just had a spinal fusion, at 26 I had a laminectomy).

    Everyone is different, but for me the discomfort and pain from the shots wasn't even 1/10th as bad as the pain from the herniation. For me it felt dull at first, then as the needle began injecting the medicine, I felt a sharper ache in my left glut. My doctor was wonderful and talked me through everything, explaining that the radiating pain into my glut meant that the needle was right where it was supposed to be, since he wanted to get the medicine as close to the problem area as possible. For me the fear (sometimes panic) that comes from pain is almost worse than the pain itself, especially when I'm stuck immobile on a table, so it helped a lot to know that what I was feeling was normal and not something going wrong with the procedure. As soon as they removed the needles the first time, I was like, "That's it? It's over?" and nearly bounced (as much as I could bounce) up from the table, knocking into the imaging device above me. That made us all laugh a little.

    Also, I don't remember exactly how many seconds the pain lasts, but it was a very short period of time, especially compared to how long you have been dealing with the herniation pain! You got this!
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  • Hi everyone, 

    Thank you so much for your kind words and support. I was supposed to get the injection on Tuesday June 20th, but developed a migraine on Monday afternoon. I was instructed not to take any medication with acetaminophen 7 days prior to the injection, and no NSAIDS 3 days prior. I did my best to tough out the migraine, hoping it would pass on it's own. But after 8 hours I couldn't cope any longer (vomiting, extreme sensitivity to sound and light, it was just awful) and took ibuprofen. Relief is one of the best sensations in life, I think. 

    I called my doctor's office as soon as it opened on Tuesday to explain what had happened and was told it would be fine and to come on in anyway. So I did, and it seemed there was confusion amongst staff regarding whether it was ok or not. So I spoke with the doctor who would be doing the injection and he explained the schools of thought regarding spinal bleeding (NSAIDS increase risk of bleeding which can lead to permanent paralysis and emergency surgery). We decided to wait three days for me to be completely clear of NSAIDS because why even risk it. So he squeezed me in on Friday June 23.

    Even though he told me he would numb me up as much as I wanted and was very reassuring that he did not want any of the experience to be painful for me, I was still incredibly nervous. Like trying not to nervous puke as I laid on the table. Stress is funny, isn't it?

    I have to say, it was nearly a delightful procedure! I literally only felt pain from the first numbing injection. I felt some pressure during the rest of it, and honestly it was kind of cool to feel the fluttering of the contrast material being injected. He didn't tell me when he was inserting other needles (though he would've if I had asked him to, I just didn't want to know), and the banter between him and the nursing assistant kept everything light and stress free. I even laughed and joked around with them throughout the procedure. 

    I had no issues following the procedure-- wasn't too numbed up to the point where it affected my lower body gross motor control. After 20 minutes I had increases in pain, but I was expecting that. Ice and NSAIDS did away with that. I developed a headache in the afternoon and was wary that it would be a spinal headache, but more NSAIDS solved that problem too.

    So overall, I feel really good! I have feelings of hope and excitement that I'm trying not to completely let take over. It hasn't even been 24 hours yet, but I feel better in a lot of ways! I don't want to get my hopes up, I know this may be temporary. But for now, I'm happy :-). I'm glad I did this. I felt silly for being so scared once the procedure was over. I'm thankful for my doctors, and I'm slowly letting myself latch onto the concept that maybe this will be the answer for me and life will return closer to what it was physically before this injury six months ago.
  • I'm glad to hear it went so well for you Kay! Hopefully you will see continued improvement.
  • Just popping in for an update since it's been 3 weeks since my injection.

    Unfortunately, despite the procedure going smoothly, my symptoms significantly increased within 2 days of the injection. In the last three weeks, I've had maybe 3-4 days where I have felt the way I did before the injection. I had a follow up with the spine surgeon who recommended I try the injections and he said it's time to schedule surgery. I feel very ready for this and honestly, am relieved. I've kind of known in my gut for a while that surgery is where I was headed, so it is what it is. Once I have a date I'll start posting in one of the Surgery Buddy boards. A microdiscectomy has been recommended, but it's possible it will be a laminectomy. Unfortunately, my doctor's contract is up so he is moving out of state, so he's referring me out. Luckily, it's to a very prestigious and renowned spine center, so I feel good about it. Just waiting to get a call about making an appointment.

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