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understanding the different types of injections

PostPosted: Sat Dec 30, 2006 1:49 pm
by cygnet
Hey all,

I have a couple of questions - maybe someone out there has some insight. Your feedback really helps keep me going.

After three weeks of severe sciatic pain (ie, not able to walk more than a few yards), I saw an osteopath last week. He gave me a cortisone injection, but it was not an epidural. The injection was done just to the left of the affected disc, and I think it was into the muscle or the area where the nerve exits from the spine. The shot contained cortisone and anesthetic. The anesthetic worked immediately to dramatically reduce my leg pain, but it only lasted for an hour. Had the shot on Thursday afternoon...as of now, Saturday afternoon, I haven't noticed any real change. I'm hoping that will change in the next 24 hours.

How long does it usually take for the cortisone to have an effect? I've heard 2-3 days, or up to a week before there is a noticeable decrease in the inflammation. I know it doesn't work for everyone, either.

What I had wasn't an epidural, trigger point, or facet joint injection...does anyone know what it was? I will see the doctor again next week and can ask more then, but would like to know more about cortisone injections generally. Are epidural injections more effective than the type I had?

OK, here's another question for you. I've had intense sciatic pain for three and a half weeks now making it difficult to walk or stand for long. It has completely wiped out my normal life. I've been very anxious and upset that the sciatica hasn't healed yet. Reading about it in different sources, I see that sciatica can take 4-6 weeks, 4-8 weeks, a couple of weeks, or 12-18 weeks to heal - these are quotes from different sources. What is a realistic timeframe in which to expect enough improvement that you can resume your life, walk around and stand normally? If I knew that it's not that unusual to still be in a lot of pain after three weeks, I would feel less scared about it. I do realize that everyone heals at a different pace. Just knowing that my situation is relatively typical and that most likely it will eventually improve would be reassuring.

Finally, one more question for you...I've tried doing the Cobra pose, and just can't do it without flaring up bad leg pain - nerve pain. I can't even lie flat on the floor without having bad muscle cramps in the buttock and leg pain. Arching my lower back is difficult except in the Cat and Camel exercise. Has this happened to anyone else? When standing or walking, my lower back becomes rigid and stuck in an abnormal C shape.

Before the sciatica I was able to stand upright with the correct pelvic tilt.

Anyone able to provide insight into any of these questions? Has this happened to you?

Know what you mean...

PostPosted: Sat Dec 30, 2006 4:28 pm
by krd
Hey Cygnet

I can only speak of my experience with an epidural injection. My injections was done under what is called "guided fluroscopy". They actually use an xray type monitor and place a large needle into the specific area where the nerve is being irritated. My first one gave me instant relief; however, I had a 2nd one 3 weeks later and that took almost all of the pain away. That was on September 21. I went to a PT (McKenzie Certified) for 8 weeks, 3 times a week and the change is remarkable.

I now do my exercises everyday and I have no pain at all and I am living a normal life again. I too could not lay flat on the floor prior to the epidurals. I now do the cobra 2 to 4 times a day with no discomfort. As for me, I was in severe pain on and off for a period of approximately 4 months. I tried to do it on my own, but the epidurals gave me the ability to seek PT and to aggressively exercise and strengthen the core muscles around my lower back.

I know that epidurals do not work for everyone, but an easy way to tell is to have your GP give you a prescription for a steriod pak (take 6 pills day one, 5 day 2, 4 day 3, etc until they are gone). If you notice that the pain decreases, even slightly, than most likely, an epidural will work for you. Remember that the epidural does not heal anything. It only eliminates the inflammation. It is important that once the pain is gone that you work hard and daily to maintain a healthy back.

Good luck, and I hope that you have a great new year!!!!!!!

Ken

PostPosted: Sat Dec 30, 2006 6:42 pm
by cygnet
Hi Ken,

It's very good to hear a success story like yours. You must be so happy about this! I hope I will be as lucky.

My doctor - an osteopath - wrote me a prescription for a Medrol dose pack, but he advised me to wait a while and see if the cortisone shot has any effect first. I guess the Medrol dose pack is the next step if the shot doesn't work.

It seems to me that the hardest part about sciatica is that doctors tell you to start walking and moving normally when it's just not physically possible due to the pain. I feel like a failure because even though the doctors tell me to walk, I just can't. I wonder if I am slowing the healing process by not moving and walking enough. If cortisone shots or dose packs can interrupt the inflammation, even though they don't cure the disc problem, the reprieve from pain would allow me to start moving more normally and start PT.

So from what I'm reading & hearing, sciatic pain won't go away, and the disc won't heal on its own, without physical therapy and exercise? Anyone want to answer that one?

Thanks again for your post Ken, and congratulations on your recovery!