I have two herniated disks that are causing me discomfort (not excruciating pain). My orthopedist recommended I get an epidural steroid injection (already completed a pill regimen) prior to physical therapy. If anyone has any comments on this procedure, please chime in.
Thanks,
Charlie
One of my co-workers had this exact proceedure done just last week. After 6+ months of hobbling around the office moaning and writhing in pain, he showed up the day after the procedure and started DANCING around the halls! He's never been happier.
I can put you directly in touch with him if you want to talk specifics. Email me: Bob at eeny dot net
"I have a herniation of the L5-S1 disc which inflames my sciatic nerve down my left leg. I've done steroid pills and physical therapy. No long term relief.
I had my first shot a couple years ago but didn't follow up with that doctor due to her not being part of my medical network. I had a brief respite from that injection but then the discomfort returned. In 2006 I had a series of three injections through the spring. My back was looser and I was able to ride more aggressively over the course of the summer. In the fall the effects wore off.
I still have the herniated disc. I still have the chronic but not debilitating pain/discomfort. I don't think I will get another round of injections. I have heard positive things from people who have gotten the surgical procedure. There is concern from certain medical fields that long-term results from surgery are no better than other treatments although the procedure has improved very much in recent years.
I have seen the infomercial for the ""stretching"" machine. It seems plausible but may be ineffective."
My dad had a couple of these shots for a herniated disc and his pain (which was considerable) completely went away. He had previously done physical therapy, which didn't help much.
I can't tell you what to do, but here is my personal experience:
I had my first series of 3 ESI (Epidural Steroid Injections) in 1996 when I was 23. At the time it was very painful and not as a very precise science as it is today. The pain, although not completely gone, was livable for 3 years.
Then I re-inflamed my L4-L5 and L5-S1 herniated discs in 1999 and went though another series of 3 ESI. Much less success this time but still slightly better then before I started the series.
Finally in 2002 after the pain came back in full force I went in again, this time for just one injection. The technology had improved tremendously but this time it didn't help at all.
I have seen many, many doctors and from what I have read and heard, there is a split in belief as to whether these injections are actually a benefit long-term for your back.
I am a peculiar case as I now how virtually no discs between L4-L5 and L5-S1. I live in pain and cycling is about the only exercise I have finally found that does no immobilize me the day after the activity.
I again say that this is my experience and can't tell you what to do, but I would exhaust every possible, NON-Invasive option before going to the ESI.
Have you gone through a good series of Physical Therapy? That may be the best choice if you haven't yet.
Good luck, I know how difficult it is to live with back pain.
It depends on what, exactly, is wrong. Some folks get a great deal of relief from these injections. If you've tried all else and the only alternative is surgery, then by all means try it.
If you have not completed real physical therapy (meaning exercise, core strengthening), muscle relaxants and anti-inflammatory medicine, you ought to do these first.
Make sure your doc has done lots and lots of these before. Review the pros and cons and make an informed decision.
Good luck!
~Claudette
The only thing Claudette left out is: the degree of expertise and the INTEREST of the physical therapist to get you better! Having had 3 herniated discs for 10 documented years(my first MRI was in 1997) I have had the usual done. muscle relaxants-valium better than flexeril, anti-inflams, dose pack steroids, steroid injections(2)-PT etc---MOST back stuff gets bettr--good luck
"Another option is seeking another opinion: I can recommend Dr. Vijay Vad, with the Hospital for Special Surgery, who specializes in non-invasive therapy options for the spine (he has a book, called Back Rx).
You can check him out: Good"" target=""_new"">http://www.hss.edu/physicians_vad-vijay.asp
Good luck
Lynn"
Thank you all for your comments and suggestions. I've canceled the appointment and am pursuing physical therapy first. I think the recommendation from the doctor was a bit premature for my level of discomfort.
Alan - had I known you were experienced in this topic I would have mentioned it when we spoke yesterday on 3rd Ave (I'm Reyna's husband).
Charlie
I have one severe herniation, another bulging disk, facette involvement, blah, blah....all in all, pain and lots of weakness. I don't expect injections to change me for life. They give tremendous relief for a few months and then they wear off. That's worth it to me. I get two a season, carefully timed to cover when I most want to ride.
Vijay gives me the injections, guides my physical therapy, and has offered other non-surgical interventions. I once had an epidural by another doctor and it was a nightmare of pain and little effect. Techniques do vary. If you go this route, choose your doctor carefully. Done properly, there's little downside to trying it, and it may help tremendously, even if just through cycling season.
After years of chronic back pain and being diagnosed with degenerative disk disease what really worked for me was losing weight and strengthening my core. I have been injury free for almost 3 years now after suffering for the previous 15.
Come to think of it this was why I took up cycling.
MRI'd, xray'd, and examined by Dr. Jennifer Solomon at HSS (she's a runner and a cyclist). Very supportive and positive. Let me get up off the table and walk out of the epidural treatent room with a handshake and wish for recovery without the injection (staff dumbfounded). Background: Diagnosed in Nov 06 with degenerative disks, grade II spondylosisthesis (google that one), severe lumbar stenosis, hence my left leg numbness for past year+. Did I say I was an Ironman? Former SIG leader/captain? At worst, I'd need fusion at L4-L5 to stabilize lumbar area; at the least epidural treatment which I tried at HSS to no positive effect (ergo, walked out on 2nd one). Around November began daily Pilates mat routine and working with Pilates trainer. What an improvement albeit very slow and something I think I'll be living with/managing for the rest of my days (I'm 46). I'm ok in a couple of spin classes weekly right now, some light uphill treadmill jogging. Because I need to control torsion / motion very carefully while I rehabilitate the way I do just about everything, I've found swimming to be a great outlet (and it forces you to engage your spine in ways that reinforce strengthening). Don't have triathlons or SIGs / STS's much in mind anymore, but I plan to continue to be a cyclist (and a good one). I say, if you have the choice, avoid the surgery and focus on core strength and rehabilitation/prevention through physical therapies. Stay positive and check out Dr. Solomon or any of the team at HSS.
