I would take the needle. I have a compressed and fragmented L5 with on and off spasms since '97. In Jan. 05 I had a cortizone injection and was back to running that very evening. I had sciatica along with my other symptoms and the only uncomfortable part of the shot was the injection of local before the real injection along with some pain down the leg from all the fluid from the shot compressing on the disc. Literally within an hour I was feeling better. I have had 1 episode of pain since and that’s when I found out that the fragmented piece was floating around the spinal canal. Good luck!
I would definitely recommend the epidural…it makes labor/delivery much more enjoyable…oh, uh, not that “Epidural”??
Do the ESI’s. They can be a godsend.
Cheers,
HC
You're talking about an epidural steroid injection, right? I had one for two (not quite) herniated discs last summer. It was like a miracle. My doc said I would see improvement in 48 hours and like clockwork, I felt fine in 2 days. It doesn't cure anything. It just clears up the inflammation so the body can recover. You'll still have bulging discs. That you'll have to control. Some people have to go back every four months. I was lucky, I had one shot and noW I do a short stretch and strength routine every morning to keep it under control. One thing that bothers me in you post; if my doctor wouldn't answer my questions, I'd find a new doctor, but that's up to you. Good luck with your back and good luck in IMC
There’s a reason he wont do the injection if you continue to run… corticosteroids not only reduce the inflammation, they weaken the tissue, thus predisposing your disks in this case to more serious complications like rupture. It’s not just a typical Dr. response to overuse injury: “Dont run then”. Corticosteroids are not a thing to play around with, if their use is unnecessary (medically speaking). First find the cause of the aggravation (bike fit, biomechanics) and get rid of the offending agent, rehab, try PT… Unless you cant handle daily life with your pain, or you are a pro whoe depends on making a living from a particular race, corticosteroids injections are not a good solution, nor are they a long-term solution.
Having said that, my L5 is shot, and I used to have continual sciatica every season for years when i was rowing, that would get progressively worse during the season…culminating in the worst pain right around the most important competitions. I attribute being completely pain free today to the fact that I treated it conservatively, looking at fit and technique, stretching, strengthening exercises. The people I know who had corticosteroid injections for the same thing, could row pain free immediately after their injection, while I was suffering, but it let to their progressive deterioration, most of them being unable today to participate in sports. Corticosteriods do reduce the inflammation, but the damage that caused the inflammation in the first place is still present, you just can’t feel it, leading to more problems down the road.
I have had two epidurals recently for a 2mm bulge at L4-L5 and a 5mm bulge at L-5 S-1. I asked a ton of questions and got on the web and searched the topic until I was satisfied that it would work for me. One thing the Dr did to see if I was a good candidate, was perscribe a 6 day medicine pack of pills- cant remember the name, but that worked very well, temporarily, and is similar to the medicine in the injections.
The suggested treatment plan consists of three shots. Based on how much improvement you see with the first, they may recommend that you come in every two weeks for a total of three. If you see no results with the first, they may or may not continue with that plan.
The first shot I had was very painful and even hurt more for 2 days. That is common. After the third day I noticed a huge difference and could stand up straight and sleep without much pain. The second shot was not successful at all and gradually the effects of the first shot wore off. My Dr did not think a 3rd would be any better so I did not get that one.
From what I understand, the shot is buying you time to correct your issues from a therapeutic standpoint without giving you so much pain. You need to use that time to do your work to improve the problem, or you might make it worse. For some, it is the magic cure, for others, it is just a short term solution.
I think of all three areas, running is the hardest on your back. I would be afraid that you might make those discs really mad if you put more pressure on them than they can handle. That is no fun. Sometimes I think that taking time off or readjusting your expectations is even harder than dealing with the pain itself. It is a mental adjustment ,but I think in the long run, it will be worth your while to get some strengthening type of therapy and see where that goes. I hate being injured and sitting out the season while all my friends are racing. But in the long run, I will be a better athlete for learning how to pay attention to my aging body and strengthening my weaknesses before they ruin my competitive career completely.
Hope all goes well for you.
To me, the size of your bulges is not too bad, its the nerve root compression. Are you having any radicular pain (pain radiating down the leg)? If so, which is worse, the leg pain or the lower back pain? On a scale from 0 to 10, 0= no pain 10=worst imaginable pain, how do you rate it?
Have you been given a Medrol Dosepak yet? Its a tapering dose of prednisone, usually take 5 pills the first day, 4 the next, etc. That would be a logical step before going down the epidural road. If you do end up doing epidurals, ask your Ortho or the anesthesioligist about “fluoroscopically guided” epidurals…I feel people get a better result with this procedure, because they’re more specific. Are you on any other medications for this? Tried any PT? McKenzie exercises?
January 17 - injured my back, turned out to be a herniated L4-L5 disk. I tried advil, pain meds and careful stretching for several weeks, got one nerve root injection around valentine day, one more 2 weeks later. since then pain much better, back to swimming and cycling. got a new bike, fits great and can ride all day (well, 3+ hrs anyway) in mostly aero position. a tiny bit of elliptical trainer time, one 15 min jog with the dog, stil waiting for all of the pain to go away so i can run.
i wish i’d had the two injections sooner, and maybe had the 3rd since i still have pain. it’s not nerve/sciatic pain, now seems to be muscular (piriformis maybe, from the off balance walking). Been going to PT 2-3 times a week but ins coverage limits about to stop me.
RANT: If i smoke and get lung cancer they will pay $1 million for treatment, if I go to PT to keep myself running and keep myself healthy, they pay max of $2,000 a year, and tha’ts the “executive” policy that’s way better than most of my employees have…