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Thread: Corticosteroid Injections to spine, consider if suggested

  1. #1
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    Corticosteroid Injections to spine, consider if suggested

    I just had my third R L4 corticosteroid and lidocaine injection yesterday morning and I am a new woman! My problem was Right L4 stenosis. I had severe lower back, buttocks, and anterior thigh pain. I was taking 2 Dilaudid every 4-6 hour and 3 Motrin every 6 hours. Meds didn't help. This is my third inj and I understand that one cannot have more than three inj in a year. My first was in July, second in September. Linda posted about steroid having an effect on vertebral bone integrity. I know that it is a likely possibility, but the pain was so disabling [I did re-consider having the inj for 30 seconds...but I was totally useless and DEPRESSED by my deteriorating condition]! I could not stand for more than 3-5 minutes without sitting or lying down on the floor. I even laid on the floor awaiting loading of an international flight in Fiji [there was a 45 minute wait to load after everyone was in line!].

    My Oswety [is that how you spell it?] score was 78 before the inj, which is an awful score [think that one is called major severe disability or somethng like that.]

    So-o-o-o-o-o, if your problem is vertebral stenosis you might consider a sterid inj. It is a bandaid therapy. I am leaving shortly to go to the DMV to re-register my car. I wouldn't have even think about the lines last week! Today, it's OK. I feel awesome and even put on some cute earrings, perfume, and new clothes today!

    Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

  2. #2
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    My second steroid shot prior to my surgery gave me about 7 months of relief. After that, I only got about 2 months of relief. Some people get good results forever, and some do not, so yes it is a temporary measure for some and it basically is a crap shoot. I am glad you are getting relief for now Susan and I hope it lasts a long time. I was thinking of you when I heard of a bad storm that hit Fiji. Were you home when that happened?
    Take care, Sally
    Diagnosed with severe lumbar scoliosis at age 65.
    Posterior Fusion L2-S1 on 12/4/2007. age 67
    Anterior Fusion L3-L4,L4-L5,L5-S1 on 12/19/2007
    Additional bone removed to decompress right side of L3-L4 & L4-L5 on 4/19/2010
    New England Baptist Hospital, Boston, MA
    Dr. Frank F. Rands735.photobucket.com/albums/ww360/butterflyfive/

    "In God We Trust" Happy moments, praise God. Difficult moments, seek God. Quiet moments, worship God. Painful moments, trust God. Every moment, thank God.

  3. #3
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    a very real danger of steroid shots...which i did not know...
    is that it can crash your cortisol level if too much is given...
    happened to me from too much steroid last January....
    very very scary....no cortisol equals feeling like you have very
    bad mono...zero energy...took all my energy to lay in bed and
    breathe...feels like you were run over by a truck!
    my level went down to .39...doctor said cortisol should never be
    below 5.0
    i am very lucky that my level came back...took a full 6 months...

    never heard of the "oswestry" score before....
    found out it is just another way of measuring pain...and the impact
    it has on daily life

    jess...& Sparky
    Last edited by jrnyc; 12-21-2012 at 07:46 PM.

  4. #4
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    The Oswestry instrument is meant to measure lower back pain, and is sort of the industry standard, despite the fact that most patients absolutely hate answering it. Max score is 80, but pain is so subjective that it really can't be used to compare one patient to others.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  5. #5
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    Angry

    Quote Originally Posted by jrnyc View Post
    a very real danger of steroid shots...which i did not know...
    is that it can crash your cortisol level if too much is given...
    happened to me from too much steroid last January....
    very very scary....no cortisol equals feeling like you have very
    bad mono...zero energy...took all my energy to lay in bed and
    breathe...feels like you were run over by a truck!
    my level went down to .39...doctor said cortisol should never be
    below 5.0
    i am very lucky that my level came back...took a full 6 months...

    never heard of the "oswestry" score before....
    found out it is just another way of measuring pain...and the impact
    it has on daily life

    jess...& Sparky
    Unsure physiologically how a very localized small amount of corticosteroid into the inner foramenal vertebral space changes systemic cortisol. I don't think so.
    Susan
    Last edited by susancook; 11-30-2013 at 02:36 AM.
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

  6. #6
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    well, depends how often one gets the shots...and how much
    is given at a time...
    i did not get much relief with a small amount of the steroid...
    i complained about it...
    so i think the pain doctor was so determined to give me pain
    relief that he went overboard January 2012...
    i do not know exactly how much it takes to cause the cortisol
    reaction...
    but i do know how very real it is...
    and some doctors do NOT know about the connection between
    steroids and cortisol drop....
    scary, but that is the truth...

    the "localized" thing is NOT true...we had a discussion here on forum
    after i suffered the cortisol drop and wrote about it...
    people made clear to me that the stuff DOES indeed...ALWAYS get out
    into one's blood stream...or as my GP finally got thru to me, there is
    really NO such thing as truly "localized"
    i learned that the hard way!!!
    ask anyone here on forum about it!!!

    jess....& Sparky
    Last edited by jrnyc; 12-21-2012 at 10:30 PM.

  7. #7
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    Quote Originally Posted by LindaRacine View Post
    The Oswestry instrument is meant to measure lower back pain, and is sort of the industry standard, despite the fact that most patients absolutely hate answering it. Max score is 80, but pain is so subjective that it really can't be used to compare one patient to others.
    Linda, I always hated to fill out the Oswestry form because it only takes into account how you feel at that moment. For me, the answers would be totally different at different times of the day, so it always seemed like a waste of time.
    Sally
    Diagnosed with severe lumbar scoliosis at age 65.
    Posterior Fusion L2-S1 on 12/4/2007. age 67
    Anterior Fusion L3-L4,L4-L5,L5-S1 on 12/19/2007
    Additional bone removed to decompress right side of L3-L4 & L4-L5 on 4/19/2010
    New England Baptist Hospital, Boston, MA
    Dr. Frank F. Rands735.photobucket.com/albums/ww360/butterflyfive/

    "In God We Trust" Happy moments, praise God. Difficult moments, seek God. Quiet moments, worship God. Painful moments, trust God. Every moment, thank God.

  8. #8
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    I totally agree with Jess. I always had some degree of flushing in my face after a "localized" shot and get foot and ankle cramping after cortisone shots in the spine and in the SI joints. When you get too much cortisone from shots, the adrenals detect that there is already cortisone in the system and therefore shut down. How any Doctor giving cortisone shots would not know that connection is beyond my comprehension. That is why you are only allowed three shots per year.
    Sally
    Diagnosed with severe lumbar scoliosis at age 65.
    Posterior Fusion L2-S1 on 12/4/2007. age 67
    Anterior Fusion L3-L4,L4-L5,L5-S1 on 12/19/2007
    Additional bone removed to decompress right side of L3-L4 & L4-L5 on 4/19/2010
    New England Baptist Hospital, Boston, MA
    Dr. Frank F. Rands735.photobucket.com/albums/ww360/butterflyfive/

    "In God We Trust" Happy moments, praise God. Difficult moments, seek God. Quiet moments, worship God. Painful moments, trust God. Every moment, thank God.

  9. #9
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    Quote Originally Posted by susancook View Post
    Unsure physiologically how a very localized small amount of corticosteroid into the inner foramenal vertebral space changes systemic cortisol. I don't this so.
    Susan
    Definitely can be absorbed into the blood stream and redistributed.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  10. #10
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    i know, Sally
    i think the doctor who gave me the shots lost site of that
    when he was determined to give me some pain relief...
    but he absolutely should have known better...and told
    me why he might not be able to give me enough to alleviate
    my pain!
    but the endocrinologist i was sent to for consult after my cortisol dropped
    did NOT know steroids and cortisol were connected...at least, that
    is what he told me...i was appalled.

    i filled out that silly Oswestry survey several times without ever
    realizing that is what it is called.

    jess
    Last edited by jrnyc; 12-22-2012 at 12:39 PM.

  11. #11
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    My doctor told me that he has to keep track of my lifetime intake of steroids. He is aware of this problem. My last L5/S1 epidural didn't work. I've been suffering ever since. The last two weeks have been a living nightmare. Some days I don't want to get out of bed, although laying down causes the most pain. Lately, standing is causing pain to the point that I can't stand the pain long enough to fix dinner. I would like to get another injection, but I think my doc is stalling me for the reason of getting too much steroid.

    Susan, I know it's hard to think that such a good bandaid could be so dangerous. I know how good it feels when the shots work! I have a hard time not asking for more. I'm really afraid of what happened to Jess happening to me. I'm a low energy person to begin with (until I get going at least). It's a real danger and if your cortisol drops too low, you won't be able to even have the surgery until it comes up again (unless there is a way to give you supportive hormone therapy). It's one more reason to put on the pro side of your pro's and con's for surgery. Take care and I wish you all the best.
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  12. #12
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    From a physiological point of view, anything that is injected into the body will come into contact with cells that can absorb the substance. Blood cells carry oxygen and nutrients to the cells and carry away carbon dioxide and waste from the cells. The cells will get rid of the "substance" into the blood and it goes systemic. I get very woozy from local lidocaine injections when I have my trigger point injections. That came as a total shock to me and scared the hair off the doctor that gave me the injections for the first time, especially since it seemed mostly one sided. My left leg went numb and the injections were in my upper and lower trapezius muscles.
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  13. #13
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    Sorry that so many of you had problems. For me, it was a life saver and permitted me to do a 3 month international health project. Without it, I would have spent the last 3 monts on the sofa with a heating pad sucking up the Dilaudid. Not every treatment works on every person.

    Just sayin' that it is a possibility and just consider it. You have crusified it enough. Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

  14. #14
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    no one is crucifying anything!
    i do not even understand why you would write that

    what i was trying to do...and i think others, as well...
    was warn of the risks...

    i got TREMENDOUS pain relief from my SI joint injections...
    til i got too much steroid...

    i think you MISSED the point!!!
    you may not appreciate the warning...
    but others might

    jess

  15. #15
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    Quote Originally Posted by jrnyc View Post
    no one is crucifying anything!
    i do not even understand why you would write that

    what i was trying to do...and i think others, as well...
    was warn of the risks...

    i got TREMENDOUS pain relief from my SI joint injections...
    til i got too much steroid...

    i think you MISSED the point!!!
    you may not appreciate the warning...
    but others might

    jess
    I do get the warnings, I have counseled women for 23 years on risk and benefit of various medical procedures. I have perform medical procedures and have had a few bad side effects or untoward effects for my patients. All were fortunately minimal. I get it. I had neck surgery and the surgeon cut the terminal part of a nerve and I can't more one arm in a certain direction. I would still have the neck surgery again because I needed a diagnosis. I get it, honestly I do. You can let go of this one. Let go.......
    Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

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