First Caudal Epidural Injection

I have had severe lower back pain and nerve pain in my legs. I'm completely disabled by it for 7 months now of bed rest. I try to stand and walk as much as I can, it's very difficult and my tolerance has not been improving despite my efforts. (I don't sit or kneel at all, sitting is immediately sorer with an increase in the already unbearable nerve pain and kneeling is like that to a lesser extent)

My case is not trivial, I had an MRI and it showed a single degenerative disc at L4L5 although not encroaching on the nerves nor herniated. The other discs looked fine

I was wrote off as being completely fine by all doctors since that MRI report (that I have seen thus far) and had to beg for a diagnostic nerve block procedure to see if indeed the degenerative disc was causing the pain or perhaps something else was (I've also been denied any further testing at all)

I was denied and instead given a caudal epidural injection.

That was the 10th of October.

I have had nothing but an increase in pain since and in particular an increase in difficulty walking and standing. My tolerance has nearly reached zero.

Can I expect this to go down? Shouldn't the steroid have kicked in by now?

I'll update here if it improves I guess.

Suggestions to see another doctor, specialist, get to a neuro, beg for help off anyone willing, I'm trying but nobody is listening, it's been really tough



  • Oh, the procedure was fine. It didn't really hurt to be honest. I thought I was getting a transforminal injection at L4L5 (makes you wonder how I passed the safety check where they ask you what surgery I was getting?) so I was surprised to feel the pain at the sacrum. I was under anesthesia for it so I was talking bollox. My friend drove me home and I was very tired. Slept well for the first time in months. Besides the increase in pain I have had no other side effects

  • Hi, thank you for your comment.

    I never got any meaningful relief from the caudal epidural injection and it's been six weeks now.

    I recently got dynamic x-rays and a CT scan and am trying to get diagnostic injections, a transforaminal injection or a CT discogram. I'm in contact with a surgeon abroad and am seeing a neurosurgeon locally next Wednesday. The pain is so bad that it's basically fighting for my life. I've been bed bound for 8 months now at the age of 27. It's nuts.

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  • By the way I did notify my doctor and he never responded. He quite clearly doesn't give a rat's arse about me so I'm not going to see him anymore. I also reported him to the patient advocacy group at the hospital for his overall lack of empathy and unprofessional behaviour. I'm sure it won't achieve anything but maybe a #MeToo will start happening from chronic pain patients in medical care.

  • memerainboltmemerainbolt IndianaPosts: 3,386

    Thanks for updating us on what's going on. Did you get the results from the X-rays and CT scan?
    I know how bad pain can get. With 4 ruptured disc, 2 broken vertebra, scoliosis and a long list of other things, I understand.
    Keep us updated next Wed. and let us know what you find out.
    Take care.

  • Hey, another update!

    I got the results of all my new imagery. A new MRI shows a big HIZ suggesting of an annular fissure, an osteophyte formation and mild modic changes in the bone, altogether suggesting an inflammatory process in the L4/L5 disc. All other discs were fine with no changes. An x-ray showed a mild slippage of the L5 vertebra over the S1. A CT scan was used to see if there was a pars defect, but the facet joints were well preserved and so spondylolsthesis was ruled out. Conclusion was the most likely source of pain is an annular fissure at L4/L5 with associated inflammatory process. I have been offered a combination of Radiofrequency Discolysis with Facet denervation as a step between total conservative treatment and a major surgery. I have been offered a disc replacement surgery as well. Tomorrow I meet with another neuro for second opinion and probably to discuss another epidural and better pain medication.

    So that's my plan!

    Sorry to hear about your ailments Sandra. How are you doing?

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  • memerainboltmemerainbolt IndianaPosts: 3,386

    Thanks for another update!  I'm really glad you're are getting another opinion from a neuro. as well as discussing other options. I think you are going about this the best way. So to speak, get all your ducks in a row and then decide. Surgery is a big decision but just maybe you could go the conservative route.

    I'm ok, just take it one day at time. Thanks for asking.

  • Hi. First, hello Sandra. Thank you fo r your comment, I'm glad you're ok.

    So, update:

    I met a neurosurgeon who has seen my new MRI, CT scan and x-rays. He said the most likely thing is an annular tear at L4/L5 causing the pain. So I am having guided nerve root injections on the 19th of December. As my pain is bilateral, we will be doing the left hand side first (it is worse and the HIZ on MRI was on the left hand side). If it fails to give enough relief, then I can try again and if that fails I can try the facet denervation, O2-O3 treatment and radiofrequency ablation of the compromised nerve roots. If that fails and my disc does not heal up, I can get an artifical disc replacement or if I'm not elligible a fusion. Tomorrow I have a DEXA scan to make sure my bones can support the artifical disc replacement. Also, I will probably need metal allergy tests.

    Most recently I tried coming off 25 mg of amitriptyline cold turkey. It was awful. So now I am starting a tapering schedule.

    I'm hoping the injections mean I won't be totally miserable on christmas day.

    I will try to keep updating. On the 19th of December it will be 9 months since injury. While pain has decreased, it has not been enough. I was told 18-24 months for a tear to heal up.

  • L4_L5LL4_L5 Posts: 1,127
    edited 12/11/2018 - 1:39 PM

    I’ve never heard a surgeon recommend surgery or a disc replacement for an annular tear. That’s the first I’ve heard of that.

    When I told my injection doctor “I’ve seen three spinal surgeons and all three said they don’t do surgery on annular tears”

    He replied:

    “That is correct.”

  • I had a sudden annular tear injury almost three years ago and I feel your pain. It’s been a massive devastating blow to my overall health and quality of life.

    But I don’t want to have surgery if the surgeons are all against it.


    Because it goes without saying that surgery can make a condition better, worse or relatively the same. 

    I have to trust that the surgeons are acting in my best interest when they say “no” to surgery, despite conservative treatments having been tried over and over again and failed.

  • edited 12/11/2018 - 8:50 PM
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