Cortisone to the lumbar.

[Headshot]

OK folks, I am considering the cortisone shots to the L4, L5 area. Who has had them, and what are your experiences with it? Does it help/not help, recovery time, etc.?

For the rest who have only heard about them, I really don't care about your neighbors second cousin twice removed from her uncles side's, best friends hairdressers nephew, who has a friend in Seattle with a mother-in-law that plays bunco with some old bat whose husband got a cortisone shot in the elbow, back in '62. Please keep this to first hand experiences to keep me from having to sift through the BS. I need to get them soon (as in Monday) if they are worth it, or else go ahead and get the mylogram and prep for surgery. Thanks in advance for the help.

 

[Florida173]

Temporary fix. I had cortisone shots under both of my knees and it helped for a bit while I was able to address the real issue. When I had a herniated L4 and L5 I chose to do physical therapy with a lot of twists and strengthening exercises with deep tissue massages and ultrasound. Within a few months I was better and running half marathons.

 

[surgicalcric]

Temporary fix...

What he said.

I have had a couple in my L5-S1 and while they help for a couple weeks I found them to be more troublesome than helpful in the long term.

Have you tried phys therapy? Is it an ortho doc or neuro doc who is going to do the surgery?

Crip

 

[Diamondback 2/2]

The injection its self is not too bad, I have had them in the C & T spine in multi levels. If the doc uses local the pain is minimal, but have some soreness for about two days and then I am normally GTG for roughly 3 weeks and then it starts to wear off. About the 5th to 6th week after I am in a good amount of pain and having to start taking pain meds again…

The big issue with me is that I start feeling better and start doing more activities then I normally would be. This has a reverse effect long term and basically causes more damage to the problem area in the long run… Personally unless you are planning to lie around the house and take an easy in life, I would only use them when the pain is beyond controllable. Get through that particular bad point and then drive on with out it as long as you can, try and keep active as much as you can but learn (and follow) your limitations…

Best of luck bro!

 

[Frank S.]

Left shoulder, and the doc who did it knew what he was doing. Worked fast too in my case. I'll echo what the other guys said as well.

 

[Matthew D]

I had them it was a temp fix but mine only last a few days not the weeks most do...

 

[RackMaster]

I have problems in the same area of my back. Had a corto shot a few years ago for break through pain relief and it did that but only in the short term. Ended up having surgery (the first time) and I regret it to this day. If you need it to get you to see/think clearly to move onto some other type of therapy, then sure thing but not as a long term therapy. There are studies now that show physio therapy (if done right and consistently) can have better results for back pain than surgery; I wish I would have had a better physio therapist years ago before I headed down the surgery path. That is if you don't have any serious symptoms; ie. loss of motor control, loss of sensation, bowel/bladder control, etc. Then surgery may be your only option. There are some new meds out there that help with chronic nerve pain as well; ask your Ortho or Neurologist, your family Doc might not have the knowledge about them.

 

[Chopstick]

T, Ive never had cortisone injections in my lumbar spine but I had bulging and herniated discs for which I had 8 weeks of PT many years ago instead of going for surgery and its served me very well..no problems at all ever since doing the PT. Ive had the cortisone/lidocaine cocktail injections in my knees and in my foot and ankle. It was a temporary fix for me..sure I felt good the second day after and Id go and do stuff like go back to the dojo...feel great.run..bike ect ect..until I actually ended up breaking a bone in my foot. For me, in the long term those injections were not good for me. I needed surgery followed by PT to adequately fix my problems. While our particular problems may be different, its my opinion that the cortisone thing is very temporary and as I said in my case the ones I had in my foot and ankle caused more damage than if I would have just rested and done the full course of PT from the beginning. The surgeon told me the cortisone injections the podiatrist did probably contributed to my fracture as well. Out of all of the injuries Ive had by far the worse was my lumbar spine. The pain was worse than having a baby..honestly. I dont envy your position trying to decide which course of treatment to pursue. As I said I opted for the PT and fortunately it worked for me. But then again our problems are most likely different. Im sorry I dont have a "pat" answer for you but I offer my experiences FWIW. Ill keep positive thoughts for you too. Good Luck with what ever course of treatment you pursue. Please keep us posted up on how you are doing.

 

[8'Duece]

I rec' a steady diet of Fenty patches and Johnnie Wallker blend. You'll be much happier and in good spirits (pun intended)

Did I tell you about my cousins friends mother fellow bingo player with an aunt that had a son who's daughters friends mother had the injections ??

 

[pardus]

My neighbors second cousin twice removed from her uncles side's, best friends hairdressers nephew, who has a friend in Seattle with a mother-in-law that plays bunco with some old bat whose husband got a cortisone shot in the elbow, back in '62, told me that beer was good, Works for me! :cool:

P.S. Headshot's a homo!

 

[Diamondback 2/2]

There are some new meds out there that help with chronic nerve pain as well; ask your Ortho or Neurologist, your family Doc might not have the knowledge about them.

Agreed, I am now on 3 meds that do really help control my pain and I am not all doped up on...

TRAMADOL (ULTRAM) for pain.
TYLENOL mixed with Ultram has a increased effect and longer relief.
BACLOFEN for spasms.

In the past I have been on Hydrocodon, Oxycodon, Oxycotton and Demeral. They did control the pain but left me high as a kite and border line addicted to my meds (found my self taking them when I was not in pain, just b/c I liked them). I have since been off them unless I get laid up for a few days and then I will take the Narc's, b ut for the most part the three I listed keeps me GTG durring the day.

I have had surgery on my arm, shoulder and knee. I'll be damn'd if they cut my neck or back! Once you get cut, you will be cut every 5 to 10 years after like clock work... Fuck that shit, I would rather lay in bed when it gets bad and take meds... Of course I am younger then T, but I still would hold off as long as possible even at his age!

 

[Headshot]

Aside form the fact that Pardus is a flamer of the first rate, I have a ruptured L4 and a bulgining L5, not to mention the bulge in my groin. My left leg goes numb and my L foot tries to involuntarily twist inward most nights and causes me to have to get up and move around, thereby losing assloads of sleep several nights a week. I'm GTG as long as I'm up and moving, but it's the sleep deprivation that's wreaking its havoc on my tood and general behavior. Thanks for all the above advice other the the fag they call "Pardus". I think I'm going to go ahead and get the surgery and be done with it.

Pardus is gay, and I don't mean happy!

 

[RackMaster]

Agreed, I am now on 3 meds that do really help control my pain and I am not all doped up on...

TRAMADOL (ULTRAM) for pain.
TYLENOL mixed with Ultram has a increased effect and longer relief.
BACLOFEN for spasms.

In the past I have been on Hydrocodon, Oxycodon, Oxycotton and Demeral. They did control the pain but left me high as a kite and border line addicted to my meds (found my self taking them when I was not in pain, just b/c I liked them). I have since been off them unless I get laid up for a few days and then I will take the Narc's, b ut for the most part the three I listed keeps me GTG durring the day.

I have had surgery on my arm, shoulder and knee. I'll be damn'd if they cut my neck or back! Once you get cut, you will be cut every 5 to 10 years after like clock work... Fuck that shit, I would rather lay in bed when it gets bad and take meds... Of course I am younger then T, but I still would hold off as long as possible even at his age!

I've heard good things about those meds. I've been on pretty much all those previous mind numbing meds you have but my med and pain tolerance is so high that my current elixer is hydromorphone and oxycodon. I'm in the process of switching to Lyrica and it's supposed to have great results for chronic nerve pain but I'll still have to take something else for the joint/muscle pain. But hell, at least I won't be a zombie all day.


HS,

I completely agree that sleep is the killer when it comes to pain. I have shitty sleep for multiple reasons and pain is just one of them. If you go the surgery route, don't let them fuse; once you go there, there is no other options. If you have problems with both disc's, make sure they do something for both. Good luck any way you go and I hope that they help you out.

Oh and I agree that Pardus is a giant faggy fruit!

 

[Diamondback 2/2]

Aside form the fact that Pardus is a flamer of the first rate, I have a ruptured L4 and a bulgining L5, not to mention the bulge in my groin. My left leg goes numb and my L foot tries to involuntarily twist inward most nights and causes me to have to get up and move around, thereby losing assloads of sleep several nights a week. I'm GTG as long as I'm up and moving, but it's the sleep deprivation that's wreaking its havoc on my tood and general behavior. Thanks for all the above advice other the the fag they call "Pardus". I think I'm going to go ahead and get the surgery and be done with it.

Pardus is gay, and I don't mean happy!

Yeah the injections wont do much for that brother, I would talk to them about nerve blocks for the nerve damage. I have the same stuff in both arms from my neck, the nerve blocks did not get rid of the numbness but it reduced it a little. Also talk to your doc about the meds I listed above when it's all said and done, those are the ones that have helped me along with most of the guys at the WTB with spine problems...

Just so you know and I am sure your doc has told you about it, the surgery will not fix all the nerve problems and will take 6 months to a year to recover from. I agree with gdamadg about not fusing, but if your going through the VA I doubt they will give you disc replacment. I feel for you bro!

 

[8'Duece]

Cocaine's a helluva drug !

 

[SF4ever]

I injured my L3-5 in a Freefall Jump and was unable to ruck, run, jump, dive, etc.... for a long time due (1+ years) to the pain in the low lumbar region. The medical board was even considering putting me out of the army due tot he injury even if they did surgery. I tried everything from topical ointments to include the shots with no lasting relief. I was avoiding surgery due to the horror stories of other SOF buddies having it done by the Army Surgeons. The pain felt like a buring hot sword being shoved sideways through my low back if I attempted to bend and pick things up or run for any length of time. I finally found a Physical Therapist that actually knew what they were doing and was put through a regimen of stretching, exercises to build strength in the stomach/low back - 6 months worth. I was 24 years old then - I am now 50 years old and just returned from AFG after 6 months on the ground. I also just ran 3 miles yesterday in 19:30 minutes.... not bad for a "old guy" that used to have a back injury! BTW - I still do the exercises each and everyday without fail - I have never had a minute of back pain after the Physical Therapy!!! :) I know that technology has improved some in the form of surgical procedures and drugs but I still hear of people/friends going through what I did and not being able to find true relief. I hope you find the cure for your injury very soon!!!

 

[medic1]

Hey Dude, I work in the OR and see many people come in for their Lumbur shots every 4-5 months, yes it works...until it losses effect and you need another shot BUT the cortisone is pretty corrosive to human tissue and will eat away at the structure and make the condition worse, resulting in surgery perminent handicap. I once asked a prominent Back Surgeon what the rate off success was for back Surgery and he told me frankley about 30%!
My advice, before you chose to go down the joint injection path...........find a good acupuncturist. I suffered from chronic back pain [from all those round chute landings], studied Trad. Chinese Medicine during my recovery period and booked my self into a TCM practitioner. Result, 100% pain free after 8 years of chronic pain, just need occasional top up treatment if I over do things.
Do the research, acupuncture for back pain has outstanding results....

 

[QC]

Couldn't agree more on the acupuncture. Backslammed onto a rock ledge and then bounced along said ledge or 25 metres trying to enter the sea & it worked fixing me up. I've had Chinese medicine in one form or another for most of my life and it works, fuck knows how but it does.

 

[Chopstick]

 

[Red Flag 1]

Epidural Steroid Injections (ESI)

This is a thread that touches almost everyone. Either you have back pain, or know folks impacted by severe back pain. My practice of anesthesia included epidural anesthesia, analgesia, labor & post-op pain management. Epidural Steroid Injections (ESI) are a valuable tool in dealing with documented lumbar back pain, especially with symptoms of nerve root irritation. It is not indicated in all cases of back pain, and is best seen as an invasive adjunct to care.

It is best if the area to be injected is identified by CT or MRI. I liked to see the studies myself to aid in treating the correct area. The meds injected, along with a local anesthetic, include Celestone, Depo-Medrol, or Aristopan. The best way to think of this is as if you were to place a "super" Motrin right along the nerve roots in the area involved. The steroids will reduce inflamation and reduce pain as a result. It requires a series of three injection spaced a couple of months apart. It may or may not stop all the pain. It should reduce the pain from what it was. The key here is to then engage in some serious Physical Therapy (PT), as SF4ever noted. To me, that is the key. The ESI will not "cure" the problem all itself, nor will oral Motrin or narcotics. At the direction of your physican, PT is likley the treatment that will get you better. Get return ESI as directed, it should make PT easier to tolerate. So what is the down side?

For isolated lumbar pain, it is not likely to respond well to ESI. I've had ESI (not all landings are soft, and knowlege does not confer immunity), and found my experience to be what I expected. For me the third was the most uncomfortable. It is an invasive procedure with a pretty big needle. Using local at the injection site pretty much makes the procedure painless, it was for me. Side effects/complications include: backache for 2-4 days, headache, infection, and nerve damage.

To recap, ESI works best if coupled with PT, at the direction/consult of your doc. ESI is not for all back pain symptoms. It is invasive and can lead to unwanted complications. If you remember nothing else, remember what SF4ever has said, he is right. PT alone can reduce, and even stop the pain, ESI can make PT a lot easier if indicated.

There are some measures for long term pain management, but that would be for another thread.

BE well

RF 1