lumbar transforaminal epidural steroid injection

[Tealadon58]

Can anyone give me some information on this type of injection.  My pain management doctor wants to do a series of 3 injections and I am scared to death.  I have read some horror stories online.  Any information or experience would be helpful.

Thanks

[Tuckamore]

Of course - but I don't think that applies in this instance.

[Teresa101959]

if you are a diabetic...steriods will cause an increase in your sugar!

[Tuckamore]

If you are frightened a bit by this procedure I encourage you to request some sedation.

I know some physicians don't use fluoroscopy to guide the needles to the correct location - if your physician does not utilize this great tool ask why - have him/her explain it.

My PMP didn't have a fluoroscope. She said she "could" do it without fluoroscope but said why should she. She said she was taught that - just because you can doesn't mean you should.

She sent me "out"  to another PMP that did have the fluoroscope to assure the needle went into the right location. Because of the light sedation I had absolutely no pain - or at least I don't remember it - which to me is the same thing.

So ask lots of questions but as Abbey said, these steroid injections can be awesome in controlling or at least reducing your pain level. Sadly the effects of mine only lasted several weeks. I was giddy those few weeks, danced and laughed - couldn't believe I had so little pain. In my opinion it was worth even those several weeks.  Indeed I had it repeated but sadly each time the effects lasted less and less time.

I'll look forward to learning about your outcome. If you have additional questions or concerns please do ask.

My Best to You,
~Tuck

[abbeyjustcuz2924]

Dear Teal,

Like Tuck, I have a great deal of experience with these injections. Before I was with my current doctor, I had a wonderful anesthetist as my doc (he regretfully retired at the age of 82 and the man never had one lawsuit in his entire career!).  He performed the injections himself on me and I won't lie to you, unlike Tuck, I was never sedated. I was given numbing shots in all the areas he was performing the injections (he would do 8 at a time on the days with the most injections as he did 4 on each side...and just like Tuck said he injected me with a steroid and a pain medication at each injection site which again, like Tuck said is very deep in the spine next to the nerve roots, etc.) The numbing agent only went so far so once the actual injections were placed past that point it was very painful, but I got through each one by just letting out some sighs (without moving...be sure not to move!) and ripping the paper on the exam/procedure table. He always laughed and told the nurse to get me more paper!...but to get serious, it depends how the doc will do them. I was not sedated, just numbed and he did not use x-ray technology, the injections were guided by his hand alone. I must say that at first, they worked very well.....after about 2-3 days (depending on how many injections I received that day) the pain of the procedure would subside and the injection medication seemed to "kick in" and worked very well for pain.....the longest they ever lasted for me was 7 months. My doc stopped doing them on me before he retired for 2 reasons, 1 was that they were not working very well in that they were only lasting 30-60 days as opposed to the 7 months and he also took some sort of further education (yes, in his late 70's he was still furthering his education!) were he found (and then did independent study for himself) that patients that received more than 4 rounds of these injections were much more susceptible to hip disintegration due to some sort of virus that the holes left from the procedure allows in the body and in turn it affects the patients hips. He said patients that received more than 4 rounds of these procedures were 62% more susceptible to hip replacements due to this type of disintegration and the only thing they had in common were more than 4 rounds of epidural injections.

Now, I had no less than 12 rounds of this treatment with this wonderful man and have had no problems with my hips that are not related to my physical injuries. With that said, please know it just depends on how your doc will perform the procedure. As I said, unlike Tuck, I was not sedated only numbed and I must admit that they were very painful but well worth that pain for what they took away when they did work well. So, I would say find out exactly how your procedure will be performed and go for it. Anything within certain reason is worth a try when dealing with chronic pain like we do. Also, don't be afraid of all of the machines you will see around you as they will monitor all your vital signs and how your body is responding to the procedure just as if it were a "real surgery". I think the "horror stories" may be because the docs performing the procedure are the ones that look at us as their commission check rather than the human in desperate need of their medical abilities.

I hope this helped you. I wanted to be very honest about my experience which ultimately was always worth the procedure until they began to not work anymore. I look forward to reading about your decision and how your doc will perform the procedure.

Best To You and Yours,
Abbey

[Tuckamore]

Hi Tealadon,

Welcome to our Pain Management Community. I'm glad you found us and took the time to begin a new thread - however I'm sorry to read that you are in pain.

If it's any comfort to you these procedures are preformed when we are  sedated but awake. I didn't even remember having mine done. My injection was not in the lumbar area - but other than location that's about the only real difference in these injections.

For our members that may not know a transforaminal injection is an injection of long acting steroid into the opening at the side of the spine where a nerve roots exits.

What part of the procedure causes you the most fear?

I won't get too technical but basically as I said you'll be sedated and won't recall the procedure and won't feel it. They also use a numbing agent. The procedure is performed with you lying prone (on your tummy). They use a fluoroscope (real-time x-ray)  to guide the needle into the correct location. They inject a "dye" to enhance the fluoroscopic images and they inject. It takes maybe 10 minutes,

I had some increased pain after the meds wore off for about 36hrs  - then the steroid kicked in and the pain relief began. Unfortunately in my case my condition went too long undiagnosed and untreated - the results of the steroids didn't last long enough to make it worth while.

I've know many ppl that swear my these injections. They can be very effective in reducing and controlling pain. I hope that will be true for you also.    

I hope something I've said has been helpful. If you have a specific question or questions or comment please do ask. I hope to hear from you again soon - and please keep us posted.

My Best to You,
~Tuck