Lumbar injections?

Discussions relating to Lower Back Pain.

Lumbar injections?

Postby Chris A. » Thu Mar 19, 2009 4:02 pm

I wanted to get some of your opinions on whether this should be kept up, or should I stop? So far, I have recieved injections twice, and they seem to help, but only for about 4-6 months.
Now, for the reason that I am asking. I must have pinched a nerve, pulled a muscle, of done something unknown, on Feb. 16 of this year, but was I in BAD shape. Let me give you the rundown:
I was getting into my company vehicle, and sat in the drivers seat, when suddenly, I felt a really bad, shocking pain in my lower back. As the day progressed, the pain got much worse. When I got back home, I am sort of an OTR driver, The pain was so severe that I was getting shooting pains down both legs. There was little to no sleep that night. The next morning, I started calling everyone that I thought could help me. I called and scheduled an appt. with my PCP, and my pain mgmt. Dr. Long story short, my PCP advised that I have Sciatica, and prescribed me Prednisone to lower the inflammation. The following day, I went to see my Pain Mgmt Dr., and he scheduled me for lumbar injections(Haven't had them for about 6 months). In between my visit to Pain Mgmt, and now, I have found the RYB website and forum, and have ordered the books. I have started doing the stretches, no excersises yet, and am feeling A LOT better. I no longer have the, lightning bolt type of pain going down my legs, but rather the pain is now centralized, if that makes any sense, in the middle of my back. The pain is moving. So, now back to the original question. Do you all think that I should just stick with this system, stretches and exercises, and work the pain out? Or should I get the injections, and continue with the exercises? I guess you can say that I am wits end, because this injury ocurred over a month ago. I am starting to lose patience, and am worried about my job, since I haven't worked since 2-16-09.
Wow! This was long, that is my story. What is your suggestion? What would you do in my shoes? Thanks for reading :lol:

Chris
Chris A.
 
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Joined: Thu Feb 19, 2009 8:28 pm

Postby randolph 2 » Sat Mar 21, 2009 1:16 pm

Hi Chris

My responses to your condition are based on my experiences healing from sciatica that exploded on my scene 3 1/2 years ago and some study of the orthopaedic treatments used today to treat sciatica. I'm also an OTR driver the last 10 years.

I'm somewhat surprised that prednisone was the first anti-inflammatory med your PCP prescribed; usually they try the OTC NSAIDs like naproxen first. Or perhaps this wasn't your first sciatica attack and they had tried the OTC meds with your previous sciatica attacks? At any rate, I hope they were prescribing prednisone for just a short time, until the worst of the pain was over.

The pain of sciatica is brutal; but, thankfully, the worst of it usually only lasts a month or two. Some folks are OK with taking NSAIDs whenever the pain flares, or if necessary (usually time constraints - gotta get back to work!), submitting to epidural injections. Problem here is that the pain most likely will return if there are no lifestyle modifications or no stretching/exercsing done to compensate for work/life stresses that can't be changed (like our having to sit 10-15 hrs each day working).

So my assumption is that after your first epidurals, you just jumped back in your truck and didn't add any stretching or exercising (of your core muscles around your lumbar spine) to your daily routine. And thus, the latest sciatica attack. It's the old infallible law: you keep on doing the same thing, you get the same results.

That's the key to not having sciatica attacks anymore. You can't change your work environment - you've got to sit for hours each day to work. But you can add stretching and exercises (like RYB) to your day to counteract the job stresses.

But what to do now. If you can afford to be off work to rehab, doing just RYB and taking NSAIDs to control pain should have you up and working in a few months (took me four months). But if you've got to get working ASAP, another epidural might help (docs are usually reluctant to do these more than a few times); or you could get a microdiscectomy. You'll be working sooner with the heavier duty drugs or operation.

In any case, however, to KEEP working, you'll have to strenthen your core with physical rehab (like RYB) to prevent further flare-ups. Your body is doing its best to heal the sciatic nerve that's being inflamed by the bulging or herniatied disc, but that's a slow process. Strengthening and increasing flexibility to the muscles around the spine seems to tend to reduce further inflammation of the nerve, and enable the body to keep up with the demands for healing you put on your body with your job stresses.

When I was in your shoes, I had savings enough to rehab without too many financial stresses so I could be comfortable spending several months doing RYB and not working. If I had to be to work ASAP I wouldn't be afraid to try heavier duty drugs like the epidurals, or even submit to a microdiscectomy, but I'd promise myself to faithfully do RYB each day. I'm convinced the biggest reason I haven't had a sciatica attack the last 2 1/2 years is my persistent work to make sure my strengthened and more flexible core is taking the stresses, and not my aging lumbar discs.

You're a month into your latest sciatica attack, so you're still in the acute stage of the illness. There are no guarantees, of coarse, but it's my guess that in a few months, you'll probably get back to working condition with just the RYB and taking a few NSAIDs to keep the pain down enough to do the exercises.

A good orthopaedic surgeon can tell you all this and a whole lot more; but finding a good orthopaedist (like at the Texas Back Institute) can be difficult; too many just want to do the microdiscectomy and won't take the time to explain the current state of the art in treatment options. Hope this helps.

Randolph
randolph 2
 
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