topic Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding! in Wellness

When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

sfnative — Sat, 26 Aug 2017 05:40:12 GMT

Had an epidural today at the L4-5 nerve root on the left, where it's being compressed. My ortho spine doc indicated a two-fold purpose for this: it really might do some good; and, diagnostically, if it doesn't do squat, then we'll travel down a different road.

4.5 hours after departing the same day facility, pain level was up to 4, then 2.5 hours later to a 5. When I reached 6, took an oxycodone, which has taken the edge off.

Would be curious to know if any of you had pain ramp up after your epidural. Many thanks in advance.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

Kachina624 — Sat, 26 Aug 2017 06:09:40 GMT

I spent one summer with a pain management specialist getting an epidural every week, in a different spot and on a different side trying to find the magic place where one was effective. Yes, it's one of those things where you feel worse before you get better. You should feel better in a day or two. Just the trauma of the injection causes the area to ache.

After weeks of trial and error, I never improved one iota and the doc finally said he'd done all he could do for me. He suggested a therapeutic corset, an idea I immediately nixed.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

Toppers3 — Sat, 26 Aug 2017 09:04:02 GMT

Hi @sfnative,

I can remember it taking a little while before I started to feel better from the epidurals.

I had them done in both my cervical region and in the upper area of my mid-back.

I usually felt sore around the injection site after all of the numbing med. wore off.

I would feel worse before I felt better too, and I remember my Pain doc. telling me that it would take several days before I would feel better from the injection--before it would really take effect.

I did get relief from them, but I usually needed a series of them to get the full effect of relief, and then I wouldn't need them again until the following year again.

They were most effective in my mid-back.

You're right about them being a diagnostic tool, too, as I ended up having Radio Frequencies done in my neck, and those were helpful for me.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

Himi lover — Sat, 26 Aug 2017 15:05:41 GMT

Was that a "facet" injection vs a epidural? I had a facet injection into the nerve area in that general area. It was a prep injection for considering "burning of the nerves". It just made my pain worse. Epidurals have done nothing for me. However, I hope you have success.

@sfnative

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

sfnative — Sat, 26 Aug 2017 15:50:17 GMT

@Kachina624 wrote:
I spent one summer with a pain management specialist getting an epidural every week, in a different spot and on a different side trying to find the magic place where one was effective. Yes, it's one of those things where you feel worse before you get better. You should feel better in a day or two. Just the trauma of the injection causes the area to ache.

After weeks of trial and error, I never improved one iota and the doc finally said he'd done all he could do for me. He suggested a therapeutic corset, an idea I immediately nixed.

@Kachina624

Were you ever able to get any pain relief? Your case sounds similar to mine. My foramina are sooooo compressing nerves at various levels it isn't funny. I do hope you've found something to at least take pain down a few levels.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

sfnative — Sat, 26 Aug 2017 15:58:33 GMT

@Toppers3

Thanks so much for your input. I'm not a candidate for RFA, as my issue at L4-5 is with in the vertebra and specific to the foramina, which have narrowed terribly and are compressing herve bundles.

My otho spine doc already said that if the epidural(s) don't work at all, his thinking is in terms of a lateral fusion. This was an unusual first take that physicians/surgeons usually don't take, unless the patient has already taken alternative steps (I have) and the pain is debilitating, with more than just a little leg pain and numbness.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

sfnative — Sat, 26 Aug 2017 16:03:36 GMT

@Himi lover wrote:
Was that a "facet" injection vs a epidural? I had a facet injection into the nerve area in that general area. It was a prep injection for considering "burning of the nerves". It just made my pain worse. Epidurals have done nothing for me. However, I hope you have success.

@sfnative

@Himi lover

(Love Himilayans, too!)

No, it wasn't a facet joint injection. It was an injection in proximity of the left foramen of the L-4 vertebra. It say proximity, because the nice space which should exist in the foramen for the nerve bundle is about the size of a thing piece of yarn.

In the spring of 2012, I had a series of epidurals in the level below and they didn't to anything either, so time will tell. I just never experienced the same day pain in 2012 as I did yesterday. That was quite nasty.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

Himi lover — Sat, 26 Aug 2017 16:25:52 GMT

@sfnative

Have you ever considered surgery? I was told a few weeks ago, from a neurosurgeon in Philadelphia, that my osteoporosis was too bad to consider surgery. The screws and metal they use might tear my bones. I've been on osteoporosis meds for several yrs, did nothing. Then they changed the class of drugs last year, and my recent dexascan hasn't improved. Anyway, that's my sad story.

Back pain changes your life. I'm on pain meds, they help some, but I still have a lot of pain.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

sfnative — Sat, 26 Aug 2017 16:50:23 GMT

@Himi lover

My ortho spine doc indicated he wanted me to have the epidural to see if I received any relief at all, hoping that I would. If not, then his opinion was that we would consider a lateral fusion, which is not as invasive as other fusions.

So... the next few weeks will tell in terms of success of the epidural. Will see.

So sorry about your osteoporosis. I'm a ticking clock there, as I'm osteopenic now. My dad's side of the family is riddled with osteo. Baaaaaaad gene!

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

Himi lover — Sat, 26 Aug 2017 16:53:50 GMT

@sfnative

Take care of your bones! I let it go too long and didn't take it seriously.

I wish you the best.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

hckynut — Sat, 26 Aug 2017 21:50:46 GMT

Hi Reb @sfnative,

Sorry you are going through so much pain. It has been many years since I had any type of injections for my lower back. The ones I got years ago did nothing for my issues at that time. It wasn't the debilitating type of pain I had prior to having my L-5/S1 surgically removed years ago. That was from a complete rupture.

Eventually, my L-3 ruptured and that is when my friend did the then "experimental scope type surgery in his office". Went into his office with about a 5+ pain level in left hip/knee, and of course my back. Left 2 hours later down to a 1 pain level. Think that was about 2009.

Haven't had a serious back issue since then, a few backaches, but nothing that lasted more than a few days. I kinda took it easy until things felt better. Still have some back fatigue after ice skating, which I am now going as often as I can, usually at minimum of 2 times a week. Think you read my "return to skating stories".

Once my Cardiologist said I could quit the BP meds, I bought me a Teeter Inversion Table, and I love that thing. All I can say is it just plain makes my whole body feel better. I also do some of my Ab workouts while fully inverted, not an easy thing to do.

Nothing that I can say that you do not know. Since I no longer do my 52 year adult hockey league, I don't see my Spinal Surgeon friend very often. Usually only when I am at the hospital getting an Iron Infusion, or some other procedure that takes time.

I sure have not forgotten what the pain of my L-5/S1 did to me, and I am so sorry you seem to be dealing with something very similar, if not the same. My hope is you can find some relief from this pain from something. Keep me in your loop, my thoughts and hopes are always with you my friend.

JOhn

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

Kachina624 — Sat, 26 Aug 2017 23:11:40 GMT

@sfnative I have tried virtually every procedure and medication that has been suggested to me and nothing has helped. I've seen four neurosurgeons and all have said surgery wouldn't help. I go back every 4-5 years in case there are new developments in medicine that might help. I've had the radio frequency ablation and it didn't help either.

Fortunately I only have pain when standing. It often takes as little as 3-4 minutes of standing, then I'm ready to kill someone if I can't sit down, at which time I get full relief. Needless to say, it's hard to get anything done when you have to sit so frequently.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

aubnwa01 — Sat, 26 Aug 2017 23:21:13 GMT

Are you a candidate for a foraminectomy? I had really bad arm pain in 1999 from nerve compression at C-5 & C-6 & after trying PT & steroid injections which did nothing, I was losing muscle tone & mass in my arm, my neuro doc referred me to a neurosurgeon for a foraminectomy & laminotomy. It fixed it about 90% but still have flares of occasional pain because I have spinal stenosis, but nowhere near as bad as it was.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

chrystaltree — Sun, 27 Aug 2017 00:14:56 GMT

I see both a pain specialist and a spine specialist for my back pain; together they decided to skip the epidural injections and do the vertebral facet injections under fluoroscopy in interventional radiology. I get the injections at 3 levels and under radiology guidance the doc can see exactly where to inject. I get my injections every 3 months and I'm one of the fortunate ones, I get about 80% pain relief. Right after the surgery, I have no pain but that's temporary due to the anesthetic, the pain comes back after about 8 hours but only to the level that I had it prior to the injection. It's never worse. Over the next week, the pain gradually subsides to the point that I only have pain if I stand to long or walk to far and at sometimes at night. It stays that way for about 12 weeks and then pain begins intensify....and then....it's time for the injections again.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

sfnative — Sun, 27 Aug 2017 04:01:08 GMT

@Kachina624 wrote:
@sfnative I have tried virtually every procedure and medication that has been suggested to me and nothing has helped. I've seen four neurosurgeons and all have said surgery wouldn't help. I go back every 4-5 years in case there are new developments in medicine that might help. I've had the radio frequency ablation and it didn't help either.

Fortunately I only have pain when standing. It often takes as little as 3-4 minutes of standing, then I'm ready to kill someone if I can't sit down, at which time I get full relief. Needless to say, it's hard to get anything done when you have to sit so frequently.

@Kachina624

That's difficult news to bear. I know exactly what you're talking about regarding static standing. That used to get things going for me, too. But now I've surpassed that, unfortunately.

Hopefully, there will be answers for all of us in the years to come. I continue to look at the Duke, Cleveland Clinic, Mayo, etc., sites, and also look at the New England Journal of Medicine and other journals at the library, just to keep current.

All the best.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

chrystaltree — Sun, 27 Aug 2017 04:17:20 GMT

@sfnative wrote:
@Kachina624 wrote:
@sfnative I have tried virtually every procedure and medication that has been suggested to me and nothing has helped. I've seen four neurosurgeons and all have said surgery wouldn't help. I go back every 4-5 years in case there are new developments in medicine that might help. I've had the radio frequency ablation and it didn't help either.

Fortunately I only have pain when standing. It often takes as little as 3-4 minutes of standing, then I'm ready to kill someone if I can't sit down, at which time I get full relief. Needless to say, it's hard to get anything done when you have to sit so frequently.
@Kachina624

That's difficult news to bear. I know exactly what you're talking about regarding static standing. That used to get things going for me, too. But now I've surpassed that, unfortunately.

Hopefully, there will be answers for all of us in the years to come. I continue to look at the Duke, Cleveland Clinic, Mayo, etc., sites, and also look at the New England Journal of Medicine and other journals at the library, just to keep current.

All the best.

Neurontin helps me and there is surgery. The newer techniques aren't as invasive or risky as the older techniques and they work. The injections work for me but I'm not "I'll just suffer" type of person. When I get to the point where the injections are not controling my pain as much as I need them to....I'll have the spinal surgery and be done with it all. As good as the surgical technique is now, it will be even better in 5 or 6 years.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

sfnative — Sun, 27 Aug 2017 04:32:07 GMT

@aubnwa01 wrote:
Are you a candidate for a foraminectomy? I had really bad arm pain in 1999 from nerve compression at C-5 & C-6 & after trying PT & steroid injections which did nothing, I was losing muscle tone & mass in my arm, my neuro doc referred me to a neurosurgeon for a foraminectomy & laminotomy. It fixed it about 90% but still have flares of occasional pain because I have spinal stenosis, but nowhere near as bad as it was.

@aubnwa01

Funny you should ask. I had an anterior diskectomy with fusion at C5-6 with foramenectomy in 1994 by a great neurosurgeon in S.F. My neck, going into surgery, was so bad I had only 5 degrees of rotation to the left. After surgery, I had my neck back!!!

My spine surgeon has already indicated surgery as a possible option. In looking at the MRI, the nerve bundles on the left and right are as thin as a thin piece of yarn - they're so compressed. Just waiting now to see if this darn epidural works. Another miserable day today at Level 6 pain. Darn.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

aubnwa01 — Sun, 27 Aug 2017 05:59:49 GMT

@sfnative My surgery was done in Seattle & I was so impressed with the surgeon who did it.

Re: When they said my pain might be worse after the L4-5 epidural today, they weren't kidding!

terrier3 — Sun, 27 Aug 2017 16:14:58 GMT

@Kachina624 wrote:
@sfnative I have tried virtually every procedure and medication that has been suggested to me and nothing has helped. I've seen four neurosurgeons and all have said surgery wouldn't help. I go back every 4-5 years in case there are new developments in medicine that might help. I've had the radio frequency ablation and it didn't help either.

Fortunately I only have pain when standing. It often takes as little as 3-4 minutes of standing, then I'm ready to kill someone if I can't sit down, at which time I get full relief. Needless to say, it's hard to get anything done when you have to sit so frequently.

I would try John's idea about the Teeter.

One of my advertising clients is a plastic surgeon in his early 70s. He uses the Teeter in between operations. He told me that surgery is terribly hard on the back and the Teeter relieves the stress that builds up.

Worth a shot! (no pun intended)