Epidural steroid injections

Hey there.
I've given up on the alternative treatments.
The chiropractic and acupuncture just aren't helping get rid of the chronic pain I'm in from my C5-6 disc herniation.
I'm getting pain radiating down my right arm, pins-and-needles, and general weekness in the right tricep muscle.
So, I saw my orthopedic surgeon, who wrote me a 'script for an epidural injection with a pain management office at the local hospital.
When I made the appointment (a full MONTH away! Lord, they're busy), she said "no restrictions" and I could drive after the appointment. But, she said I probably should not ride my bike (I usually commute by bike to this hospital for appointments, as I know one of the administrators and he lets me park my bike in his office).
So....Can anyone tell me what I can expect with this injection? What's the procedure like? What kind of relief can I expect and when should it kick in?
Thoughts, advice, etc., are welcome.
Thanks!

Well, I haven't had these injections, but my DH has had plenty. I am surprised that they said you can drive!
Clint has had the injections at L-4 & L-5- the lumbar area- I just relaizied that your post said C- so that's the opposite end of the spine- still I think the procedures should be very similar!
Even though he is alert aftern the procedure, I'm required to sign him out at the clinic, and say that I will drive him home. Usually they strip him down to a gown, hook up IV fluids, give him
some sedation and then do the injections. The doctor said the point is to
'saturate' the joint/discs with the steroids and painkillers. This is expected to give relief for about a month or more.

After his first injection about 4 or 5 years ago he was able to walk without pain for the first time in weeks. For him they did lose some effectiveness as he had them more often. He also has a differnt kind of injection that's done in the hospital, they give him more sedation and use a fluoroscope to target the disc.

Good luck!

Hi Regina, I've had these injections(C6-7 herniation with pain and numbness going down my right arm). I had a series of 3 - once a week. I couldn't drive home. They hooked me up to monitors, an IV. I never had any pain etc.. afterwards. I didn't start feeling any relief until the 3rd one. Good luck.

Ho-man!
Whiiiiiine........
Now I'm *really* starting to get stressed out.
Multiple injections? Temporary relief?
I was kinda hoping - one needle, boom! Done.
Guess it's a bit more involved, eh?

Regina, around here it's the practice that they give a series of 3 injections. I was a little nervous too. Didn't feel a thing, give me a small amount of some good 'stuff'. Not too much, I moved myself over to the table and back to the gurney. It was worth it to get rid of the pain.

I have 2 bulging discs at C2-3 and C-4-5 from a serious whiplash injury in 1998 (hit in the left front of my Jeep Cherokee by a truck doing 50 while waiting to make a turn). I had may of the same symptoms you are describing. Long story short, I had almost 5 years of various treatments, including steroid injections, 4 rounds of PT, chiropractic care, alternative treatments, Prednisone, anti-inflammatory and narcotic medications, including Oxycontin. I also had 2 radio-frequency nerve treatments to "burn" the nerve endings in the facet joints to try to stop the pain signals. It was 2 treatments because the specialist doing this procedure did the wrong facet joint the first time! The last treatment was about 6 months in an outpatient pain management program at a rehabilitation hospital. Most of this was ineffectve, and as time went on, the discs stabilized somewhat and the pain subsided, although it has never disappeared completely, and some days are better than others. I did a ton of research on my own and found some good books for dealing with neck pain, and also developed a serious distrust of the medcal profession. I found too many "professionals" with the attitude that if the patient is not responding to our treatment, it must be the patient's fault.:mad:

Regina - have you worked with PT, or just with acu and chiro? I'm wondering why they have you going to pain management, when you have weakness (motor) as well as sensory symptoms. Did they explain things well to you? Can you ask the doc's office or the pain management folks the same questions you asked us?

I've just started working with a McKenzie clinic, they do some cool stuff. I'd be interested to know if you've done any McKenzie stuff, since it's all about getting discs to behave. (Have you seen the book "Treat Your Own Neck"?)

Quote:

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Originally Posted by KnottedYet

Regina - have you worked with PT, or just with acu and chiro? I'm wondering why they have you going to pain management, when you have weakness (motor) as well as sensory symptoms. Did they explain things well to you? Can you ask the doc's office or the pain management folks the same questions you asked us?

I've just started working with a McKenzie clinic, they do some cool stuff. I'd be interested to know if you've done any McKenzie stuff, since it's all about getting discs to behave. (Have you seen the book "Treat Your Own Neck"?)

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Thanks, Knot. I think the Orthopod addressed things pretty well - other than what the actual process is like. I intend to ask the Pain Management folks lots of questions. These...and more.

I have not seen a PT, to the extent that my Chiro had been doing things like massage, e-stim, ultrasound, traction, and the like. Orthopod said that weakness was directly related to the foraminal stenosis (hope that's the right term) in the neck and would go away when the nerve issue is resolved (assuming the epidural works). You can almost trace the sceaming nerve from my neck, down through my back, behind the arm, past the elbow, and into the hand. Oh, the joy.

I've been suspecting that chiro and acu were addressing the symptoms and not the cause, and I'm hoping (?) that this will address the "cause" and get me over some hump I have thusfar been unable to get over by way of other methods. Am I off base with that?

I'm not familiar with McKenzie's "stuff". Gotta link?

Quote:

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Originally Posted by Regina

Orthopod said that weakness was directly related to the foraminal stenosis (hope that's the right term) in the neck and would go away when the nerve issue is resolved (assuming the epidural works). You can almost trace the sceaming nerve from my neck, down through my back, behind the arm, past the elbow, and into the hand. Oh, the joy.

I've been suspecting that chiro and acu were addressing the symptoms and not the cause, and I'm hoping (?) that this will address the "cause" and get me over some hump I have thusfar been unable to get over by way of other methods.

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A stenosis in your vertibrae refers to the donut hole closing in and becoming smaller. Nerves and stuff run through those openings so if you're having nerve problems (i.e. like pinching) then it makes sense that the stenosis is a likely cause. Now an epideral being the resolution to that I have no idea.

In my own opinion and being engaged to someone who's a Certified Athletic Trainer (think Physical Therapist but for athletes who are as highly trained as Orthopedists), Chiropractors are an aweful breed in the sense that they practice false medicine. I mean this in the sense that all they do is put a bandaid on the problem - it provides temporary relief (also forcing you to continue coming back) and most importantly, they only treat the symptoms NOT the problem. It's common practice for them to make assessments and provide treatments that are out of their scope of practice, which is not okay. I guess they have their own motives why they do these things. :rolleyes:

I suspect that the epidural will not address the cause. It is a symptom relief technique, and since you are reporting motor issues (that weakness) I'm thinking you need something other than a pain symptom relief.

Yeah, the epidural will take away the pain, but it's not likely to correct the mechanical issue that is causing the pain and weakness in the first place. In fact, with no pain to guide your body's behaviour I'd worry you will go into positions that increase the pressure/impingement on the nerve roots. (so that your motor issues will increase and when the epidural anesthesia and anti-inflammatories wear off you will have more intense symptoms than before.)

http://www.amazon.com/Treat-Your-Nec...1360164&sr=8-5
http://www.amazon.com/Treat-Your-Own...1360164&sr=8-6
http://www.amazon.com/Steps-Pain-Fre...1360164&sr=8-2

I sleep with one of these cervical rolls, but mine is stuffed with buckwheat hulls. I've used it for maybe 10 years now, and it makes a huge difference in my neck pain and the numbness in my left arm/hand. (if I sleep without it, I get all kinds of nastiness: headaches, neckaches, numbness) You can easily make your own roll with a towel, and stick it in your pillow like the diagram if you wish. I keep my neck roll on top of my pillow so I can move it around as I sleep.
http://www.amazon.com/McKenzie®-Cerv...1360164&sr=8-1

A good PT can be an incredible guide as you heal your neck. If you can find one or get a recc for one from someone you know, I'd like to recommend you try good PT before the epidural.

I agree with what Knot said above. I found that the injections I had caused worse symptoms afterwards, for up to 2 or 3 weeks, and then the pain and tingling in the right arm and hand would revert back to previous levels. They are designed to treat the symptoms only.

As far as pillows, the Mediflow water pillow works great for me. It is like a waterbed for your neck, and you can adjust the level of support by varying the amount of water. I have recommended it to 3 or 4 people who absolutely loved it. I have used it exclusively for over 5 years.

http://www.mediflowtop10sleeptips.com/index.html

The McKenzie techniques were helpful to me, and there is also another book out written by 2 doctors about all the various treatment options which is very comprehensive:

http://www.amazon.com/What-Pain-Neck...1386987&sr=1-4

Regina--I can't add anything helpful here, but it sounds like Knott, et.al., have given you good advice. Sending you lots of good healing thoughts. You've been dealing with this for awhile, haven't you?

Thanks all.
My Dr. seems to think the epidural WILL help address the cause - which is the stenosis of the neural foramen. The epi will/should bring down the inflammation that is causing the nerve that exits the C5-6. It's the inflammed nerve that is causing so much issue "down stream" - i.e., in my arm, including the weakness in the tricep. His big question is how long it will be effective - if it is effective at all, which is it may not be - granted. My hope is that it will be effective long enough to have other rehab options (pt, whatever) be effective over the long term.
I had my acupuncturist start to focus more on my neck vs. my arm. A drastic improvement in one day (by my darned lifestyle is still going to do me in....bike riding and computers are BAD for me!). I'd really prefer that route (yeah - 20 needles a week, rather than one big honkin' one).
As for pillows...we have the shaped tempurpedic ones that seem to help me a bit already.
Yeah, VB, thanks - I've been dealing with this since approximately last September. It's a major drag. I understand many folks have herniated discs and are asymptomatic. I really wish that was the case for me!

What caused the inflamed nerve in the first place? Pressure from the disc? What made the disc herniate?

Quote:

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Originally Posted by KnottedYet

What caused the inflamed nerve in the first place? Pressure from the disc? What made the disc herniate?

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Not really sure. Probably a car crash in May '05. I was rear-ended while looking up into my rearview mirror (saying "Please don't hit me. Please don't hit me."). Neck/shoulder/arm pain started in late July or August '06 (It moved from annoyance to major issue by September) when we started ramping up mileage on the bikes in preparation for a Century. MRI finds "multilevel degenerative disc disease extending from C3 through C7" with minor bulging at the other discs and a full blown herniation at C5-6.

Sorry about your pain.

I had those injections in the L4-5 area 10 or so years ago. They didn't help at all. The only thing that helped was surgery. It is a "procedure" and not just a shot, where they give pain meds, IV, etc. You will need someone to drive you home.

My dad had the exact same sort of accident, and ended up having to have surgery as well. I hope you didn't settle with the insurance already. Dad ended up having to get an attorney to make sure he got compensated for what he'd been through.

Karen

I also had the same thing & ended up with surgery. 1.5 years later, no numbness, no pain, everything is good.

Caveat - the MRI's did NOT show that I had a disk implanting itself into my spinal cord. The surgeon earned his money digging that sucker out. He used bone from my hip & made disks, fused the whole thing and I'm good as new.

Regarding chiropractors - I saw one. It felt great for about 6 hours and then the pain & numbness came back with a vengence. I believe that he could have paralyzed me, knowing what I know about the disk & my spinal cord.

Have they done an MRI? I agree with the others about getting to the cause rather than treating the symptoms.

Bumping this up. Hey Regina! Did you get the epidural? Did it help?