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L5 Epidural?

RICKRRICK Posts: 136
edited 06/11/2012 - 8:45 AM in Lower Back Pain
My lower back MRI shows a bulge at L5 & S1, my left leg is numb from my hip to the foot. My thigh feels like I have been to a dentist and I have hip pain. I am getting all kinds of opinions that range from the epidural will help to lots of people saying DON'T let them do anything.
I have had two neck surgeries a year apart (08 & 09) C4-7 front and back due to a failed fusion and now I am on SSDI. This MRI will be done on the 26th of July and now I am going nuts with all of these opinions (most of which I have not asked for). I know we don't give medical advice here but what have any of you done and based on that what would you do now?

Thank you.


  • Isn't it interesting (translate: frustrating!) when people tell you what you should and shouldn't be doing when it isn't their body that's in trouble, it's yours. The thing is, everybody is different and nobody can tell another person definitively that they should or shouldn't have an ESI or any other procedure. I have a friend who said Oh, don't do it! when I told him I'm having a lumbar fusion. Anyway, I'm getting off track...

    My L5 nerve root is being pinched and I had an ESI. I had conscious sedation so don't remember if it hurt or not but the benefit of having an ESI is twofold: In some people, it reduces inflammation and permanently (or at least long-term) relieves their pain/symptoms. In others (like myself) it serves as a diagnostic tool for the surgeon. It is very helpful for them if the injection relieves symptoms immediately but then the symptoms gradually come back. That tells them precisely where the problem lies (or at least one location, there may be others).

    One of the most important things, in my opinion, is to make an informed decision about your care. :)

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
  • It made my pain worst went from a consent 6 to a 10.
    They said that it would go down and it never did.
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  • If your pain is still at a 10, how is it you're able to sit at a computer? That's the highest number on the pain scale and is supposed to indicate intolerable pain that has you screaming in the ER, so-to-speak.

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
  • I myself would do what ever is needed to be done. to get my health back. Or back to where I could live a better life.

  • I had a L5-S1 herniated disc and tear and still have same issues with DDD. In 2008 I had 2 Epidurals. 2009 I had 3 epidurals and now 2010 so far have had 4 epidurals. The injections help the numbness and tingling and pain for me in my leg. But also I take Cymbalta which helps nerve pain. Of course steroids have risks and ask your Dr. before hand. I would try anything for the leg pain. I've also had nerve blocks in butt, hip and leg to help as well as facet joint and SI injections for back pain. So this has been my experience and often wonder how I would be if I had been offered surgery and had a micro-disectomy but no one offered me surgery so I can only do what the Drs have offered me. I've been to 3 Pain Management Drs. and a Neurologist and Neurosurgeon and 2 Orthosurgeons. More opinions have made me feel better about it. Though concerned about the risk of steroids
    and it's side effects are still a concern.

    I've tried Physiotherapy, aqua therapy, acupuncture with my PT and exercise and medications.

    I also had an EMG and saw a Neurologist for the numbness so think that's the first Dr. I saw and good place to start as they deal with nerve compression. Take care and keep us posted how you're doing. Charry

    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
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  • jlrfryejjlrfrye ohioPosts: 1,109
    You and are so similar in our medical issues. I also have the lower back issues involving the same disc. I had so many epidurals that I lost count. Yes it did help me in the short term. My disc are now bone on bone and am need of fusion of the lower spine. I will not have anymore surgeries as I have had enough. I hope the injections give you some relief.
  • 10 is not "squirming in the ER*

    10 is "the worst pain you can imagine."

    It is very relative. For some people, back problems are their only experience with severe pain and they really can't imagine something worse. So, for them, it is a 10.

    We even had a discussion up in chronic pain about breaking various bones and not really caring because the back pain is worse. I broke my foot last weekend and was walking on it the same day. My back, now that hurts. ;)

    Sorry, sidetrack, back to talking about Rick's back. Don't listen to them, do what feels right to you, based on the information your doctors give you. Everyone's going to have a story about their brother's cousin's wife's uncle who had back surgery and ended up a hunchback living in an attic with bats, but you have to deal with facts.

    And the facts are that you have a problem, and need to deal with it. There are limited choices with the spine, and most of them have some risk involved (bats aren't one of them). The best way to make those choices is through communication with your health care providers.
  • I'll just tell you my experience. When I started having lower back pain a few months after my ACDF, my surgeon did an MRI and found a bulging disc at L4/5, facet swelling and inflamation, and stenosis.

    My symptoms were lower back pain, hip pain and pain shooting down my legs to my calves in both legs. I had an ESI that helped a little then was put on a medrol steroid 5-day dose. After that, the pain down the legs stopped, then came back, but it was different (difficult to explain), but it felt wider and shorter, only down to just above my knees.

    It turned out that the ESI and medrol pack helped my bulging disc and its symptoms, but the other pain was coming from my facet joints, stenosis and spondylolisthesis. They tried facet joint injections, which didn't help, then tried a diagnostic nerve block to see if a rhizotomy would help. Those didn't help so my only option was a TLIF to open up space for the nerves (fixing the stenosis), fusing the facet joints and adding rods and screws to stabilize everything.

    So, with all that said, I think trying the ESI would be a good idea if that's what the doc suggests. Sometimes it's also considered necessary for insurance purposes before a doctor can take more aggressive measures.

    Take care and please keep us posted.
  • I just had my 2nd ESI today and for me they have helped lower my pain level. If you do go ahead with an ESI just make sure it's a guided one, no blind ESI.
  • I'm an overanalyzer when it comes to making medical decisions, so similar to you I really thought through whether to give ESIs a shot. It really has to be your own call, but for me it was worth it to have them because:

    1) I felt better, if only for a short period of time. It was a relief to know there was *something* out there to help.

    2) It gave my doctor more info about what was going on. My positive response to the ESIs provided further confirmation for exactly what was causing the pain and the location of the pain generator.

    3) Although they are not practical to do on a regular basis because in my case the pain relief doesn't last super long, it's good to know that if there is ever anything important where I absolutely have to have pain relief I can go in for an ESI to get some temporary relief. I think of it as a tool in my pain management arsenal- now we know ESIs work.

    4) There is the possibility for longer term pain relief. The amount of time they last varies from person to person, but for me the chance of something providing lasting relief was worth a shot.

    You just need to be aware of the risks to make an informed decision that you can be comfortable with. As others have said, communicating with your doctor about your reservations will probably help you make the decision. Good luck :)

    P.S. The procedure itself is not bad (if things like that don't bother you). Someone mentioned they had sedation for theirs, but I've had 3 now and have never been sedated. It's a fast procedure and relatively painless. So, sedation is basically just a personal preference thing.
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