Epidural steroid injection (ESI) for bulging disc

[UbonEagle]

Hi,

Been suffering upper back + sciatic pain for nearly 20yrs, not debilitating but annoying for sport especially.

 

Now over 50 it's becoming a bit more persistent unless I manage very carefully. Obviously thai massage is great and helps but still come/go OS for work so not always available.

 

Had CT/mri few yrs back showed issues at C4/5 likely impinging on nerve.

 

Has anyone had the epidural injections to neck ?  if so how did you find it and looking for doctor recommendations likely in BKK and rough cost ?

Cheers 

Doug

 

 

 

[Sheryl]

Bulging discs in the normal course of events retract with time  time. In other words what showed on your MRI a few years ago may not be the issue now and you are going to need a new MRI before any doctor will consider an epidural.

 

People are very individual in their responses to epidural and it also depends on to what extent the pain experienced is due to inflammation as that is what the injection addresses.

 

Cost of epidural in private hospitals is about 35k. Might be slightly less at Bangkok Christian hospital and there is a very good US trained spinal specialist there. I'll post 5he link in a bit.

[Sheryl]

https://www.bch.in.th/find-doctor/doctor-profile/?smid=4548

 

Is the doctor at Bangkok Christian Hospital

 

Depending on what the problem proves to be, doctors sometimes treat with a short course of oral steroids plus Lyrica. A skilled spinal specialist will know, based on a new MRI, if that is likely to help in your case or if you should proceed to an epidural.

 

Since massage is helpful, you might benefit from physical therapy/exercises. Lots of videos online fr this, just google exercise + cervical spine

 

See

[Lorry]

9 hours ago, UbonEagle said:

 

Has anyone had the epidural injections to neck ?

I had it in Bangkok Pattaya Hospital.

If you want the doctor's name I need to search a bit.

Cost were about what Sheryl said, but that was before covid (prices have skyrocketed since then), and it was the resident rate.

My problem was not chronic like yours. And of course,  I had an MRI done first. 

The procedure helped,  but I had a relapse about 4  months later. 

What solved the problem was 6 months  daily 1-2 hours of physical therapy, plus daily exercise (2-3 hours: swimming, gym)

 

 

[UbonEagle]

Thanks Sheryl and Lorry for your intel.

And yes i agree good therapy/exercise along with looking after yourself (sleep,food etc) goes a long way to managing these things, however with a few years more offshore work/travel than ain't always possible.

And given its been getting slowly worse for 10+yrs i'm not too optimistic of it fixing itself.

Hoping a treatment like this can at least be a circuit breaker, not expecting a silver bullet cure.

Cheers

Doug

[Sheryl]

Epidural (if needed) can be repeated once every 6 months. For some people that is enough. Even if there is break through pain after 4-5 months, some don't mind tolerating that until the next injection. Cost of twice a year injections will, within 4-5 few years, equal that of surgery (and beyond that time, exceed it).  IF your problem is amenable to a permanent surgical solution and IF you are a good surgical candidate (you probably are, as fit enough to  still be working) and IF epidural does nto give lasting relief, then might be worth considering that. There have been a lot of advances in minimally invasive spinal surgery.

 

These "ifs", to be answered, will need a new MRI and consultation with a good spinal specialist.

 

Some lucky people (a minority) get permanent relief, or at least relief for several years, from a single injection.  This reason is one reason why, if surgery is contemplated, it is usual to try an epidural first. the other reason is that  it helps confirm the diagnosis/planned surgical approach. (Problems seen on MRI are nto always the cause of the pain - things that turn up on MRI can sometimes  just be incidental findings unrelated to a person's pain).

 

If you have insurance that covers hospitalization in Thailand, epidural may be covered under day surgery provision (it was for me).

[1happykamper]

Old post I know. 35k? That's a crazy high price... Unless it was image guided floroscopy? 

 

I need one now... But 35k. Give me a break 

[Sheryl]

It is indeed done under guided fluroscopy, and in the OR.

 

No other safe way to do it. They are positioning a needle into your spinal column.

 

I had it done on my cervical spine just last June, that was 29K. Lumbar a year prior was a bit over 30K.

 

 

[Lorry]

10 hours ago, 1happykamper said:

Old post I know. 35k? That's a crazy high price... Unless it was image guided floroscopy? 

 

I need one now... But 35k. Give me a break 

Normal price here.

In Germany,  6500 THB. Under fluoroscopy, of cause.  No, this is not a government-subsidized price. This is the price if you pay out of pocket. Subsidized price is 0 THB.