lumbar-epidural-steroid-injection

[Jaggg88]

From my experience with my spinal surgery and ongoing lumbar back pain I can completely concur with Sheryl's advice. I also have had good success with mckenzie exercises - google it. chok dee

[pseudorabies]

2 hours ago, rumak said:

If i knew my pain was going to be gone for even 3 years i would be in the hospital tomorrow !

btw :  Nobody has said whether the actual shot was VERY painful or not too bad .  

Good luck going forward ..... maybe surgery time .    but gotta see a specialist

For me the most painful part was when the doctor delivered the steroid which was a volume of a few milliliters.  If she or he is in the right location I would feel crushing pain down my leg that lasted for 5-10 seconds.  Pain when the doctor was positioning the needle wasn't too bad since local anesthetic is injected ahead of the needle that delivers the medicine.  Injections done by one doctor in the US gave me considerable pain later that evening.  Injections by other doctors, including the pain doctor that I see at Bangkok Hospital, have been relatively pain free.

[Teacher Robert]

On 9/23/2023 at 11:23 PM, rumak said:

I have had an MRI .... but a couple of years ago .  At that time my pain  (lower back) would come and go , and I did see a specialist here in CM .  He suggested to live with it ( being that it was not at a serious stage) ,  with occasional use of anti-inflamatories.  As time passes, and maybe you also know from personal experience,  there can come a time when the pain or discomfort becomes a problem that needs addressing.   Probably soon .

Of course if i were to get the ESI  it would be with a specialist ,  and I am seeking some personal cases such as yours to inform myself first .  The fact that you needed surgery on the lower back, but also injections in the cervical spine is informative .   My pain is mostly lower back,  but i am now getting more pain in upper regions at times ( and my neck ).  Reading about the facet joints also aroused my suspicions that I could be having problems associated with that . 

Surgery is something many people want to avoid (myself included) ..... as a surgery gone wrong is not unheard of .  That is why my first choice would be to try ESI (as you did) .   The second area you did which has worked sounds encouraging,   and thanks for the info about the facet joints . Gives me some good info for when i go to the specialist . 

Out of curiosity ,  which hospital did you use in BKK .   Also,  doesn't that doctor , or you,  have a recommendation for CM ?   Thank you for your posting ...       rumak

Had this done twice in the cervical spine under fluoroscopy. Doc said that if it didn't take i could either get surgery or "move somewhere warm and get a massage every day." She had no way of knowing I was moving to Thailand but that was 8 years ago! Massage, the genuine kind, and occasional acupuncture have forestalled the surgeon's scalpel all this time, knock on wood. But I will never forget that the relief I felt from the constant pain was immediate. It slowly returned after the first injection but after the second dose it never came back and I was able to pitch the neurontin I was taking. It is an excellent non-narcotic pain killer but, for me, it had the side effect of slowing down my thought processes and I was still working. Funny thing happened when I stopped taking eat I stopped being able to amaze my Thai girlfriend by eating food spicief than hers!  Good luck and remember to obey the nurse's guidance regarding your positioning in the time post procedurally to avoid a cerebrospinal fluid leak from the epidural site and the corresponding headache that'll cause if it happens. And tell them to properly sedate you with some Ativan beforehand. Savages did my retinal surgery and thought paracetamol alone was sufficient. 

[Sheryl]

6 hours ago, rumak said:

If i knew my pain was going to be gone for even 3 years i would be in the hospital tomorrow !

btw :  Nobody has said whether the actual shot was VERY painful or not too bad .  

Good luck going forward ..... maybe surgery time .    but gotta see a specialist

My lumbar injection was not edpecially painful. They numb the skin with lidicaine first and then the dolution they inject is a mixture of strroud and lidicaine.

 

The one in the neck area was extremely painful as needle first went in, so much tgat fictor had to stop and inject ludicaine jnto fhe underlying tissue just to be able to oass fhe needle jnto fhe epudural soace. . After that it was bearabke. Momentary pain wgwn he dud one facet joint none on the other side. 

 

You are still a ling wqy from both epudural and hodpitalization/syrgerg as your last MRI wasn't bad abd has nor yet been repeated.

 

Yoy can get MRI and an initial exam up in CM but if these suggest the pain is from the found I stringly advice coming to Bangkok for next steps. 

[The Old Bull]

On 9/23/2023 at 2:34 AM, Lacessit said:

I have found occasional use of kratom to be quite effective in eliminating lower back pain, about 2-3 times a week.

I had steroid injections for carpal tunnel syndrome, eventually they destroy nerve conduits.

Has the cause of your pain been identified? There is a big difference between osteoarthritis and a pinched nerve.

Apologies if not quite on topic.

What do you do with kratom? smoke it? or boil it up and drink the juice? I would like to try it seems to be the less invasive fix.

[Lacessit]

3 minutes ago, The Old Bull said:

What do you do with kratom? smoke it? or boil it up and drink the juice? I would like to try it seems to be the less invasive fix.

It is made as an infusion, by boiling in water. I understand the ratio is ten leaves to one litre of water.

Refrigerate after cooling down.

It may or may not work for you, everyone is different. Half a cup is enough for me. It is addictive, which is why I only use it occasionally.

I take it on an empty stomach, eat something sweet

( e.g. mango ) afterwards as it is somewhat bitter.

I have a supplier, kratom can also be bought on Lazada.

[mania]

16 hours ago, Dirk Z said:

We also know that many conditions have spontaneous remission without specific treatment as my own experience in occasional back pain shows. That means that the last therapist always has the best result because the patient is getting better by himself. We having the saying that "nature takes care of the disease while the doctor/therapist entertains the patient".

That is brilliant & in my experience so true!

 

Many times in my life my back has gotten so damaged & it was usually always 6-8 weeks before it got better

During that time of course I tried things like Chiropractor, Acupuncture, pain meds etc etc

Nothing really cured it but as you said the last therapist always has the best result ????

 

But in recent years I have really come to realize the prevention is what works for me & although I always thought I was in shape truthfully I was getting tighter & tighter in places & my body just compensated for it till it couldn't then it lets go & takes time to recover

 

Thanks again for that great quote!

"nature takes care of the disease while the doctor/therapist entertains the patient". ????

[mania]

On 9/24/2023 at 5:08 AM, rumak said:

but......... before, for many years now,  when my back hurt I did not have pain or weakness in my

Yes & I think mostof us  "older" folks can say the same ????

 

But..... "before, for many years now" you were younger, you didn't have a broken hip with titanium parts, etc etc We age & don't realize how we are stiffening & while yes you said you always had tight hamstrings your body may have been able to overcome it before by using other muscles

 

But it does creep up on you & the main difference IMHO between young & old is in reality flexibility. The older stiffer folks have a very tough time & become ever more fragile. They do not survive any simple falls well at all.

 

Of course it all does not rule out a actual breakage or disc problem etc but by the way your describing things it sounds like you have just gotten very tight. The cure/repair will not come overnight but give it your best shot as it sure beats spinal surgery or meds that will only ever disguise the injury/ hide the pain. That in itself only leads to worse damages trust me I know as I lived on them awhile as it allowed me to continue the heavy lifting of my job at that time ????

Good Luck!

[Cory1848]

I didn't read through all the responses, so sorry if I'm repeating anything. I just had a cortisone (steroid) injection yesterday morning in my neck (upper spine) for a pinched nerve that was causing pain in my right arm; arm feels better today, but it will take a few days for the full effect (if it works) to take place. Did it at Chiang Mai Ram, which has been my regular hospital for years.

 

Since the cortisone injection typically lasts about six months and patients go back for injections (no more than twice a year), I also intend to travel to the spinal surgery center at Bumrungrad in Bangkok to see if they have a noninvasive (laser) technique to take care of the problem once and for all. Chiang Mai Ram does have a surgical solution to my specific problem, but it's invasive (they go in through the neck). The laser procedure sounds more appealing, if available.

 

Hope that helps; good luck. I'd consider traveling to Bumrungrad for a longer-term solution, if you're looking for that; steroid injections are easily done at Chiang Mai Ram.

[rumak]

2 hours ago, mania said:

Yes & I think mostof us  "older" folks can say the same ????

Your comments are well taken .   If i may opine :    the one variable ( and its a biggie ! )  is how each person manages and diagnoses health matters for their bodies , and minds.   Not much different than all things in life .... as i am sure you would not think that all contracters have the same capabilities or work ethics .  

I won't go into my life story ( thank god) ...... but in the matter of health,  i have had ups and downs, and yet have continued to stay active and improve my already good diet .  My recent development may actually be from trying to even further my activities by frequent swimming ,  gently and for fairly short periods of time.  I felt great .  Till,  i didn't .   Those much heralded benefits often recommended for elders probably aggravated something in my spinal condition . ( and yes, i did try to follow the "how to swim"  protocols .     Sometimes,  sh** just happens .   

As stated,  i am FIRST going to give it some time.  I am right now going for an easy stroll around a lake here in Doi Saket .   And , doing one or two exercises .  (soon to start the one you sent me)

Thanks for your help .... i will post from time to time ...... 

Note:  i am not giving up the idea of ESI ....... but that is just one idea i am checking out 

[rumak]

1 hour ago, Cory1848 said:

I didn't read through all the responses, so sorry if I'm repeating anything. I just had a cortisone (steroid) injection yesterday morning in my neck (upper spine) for a pinched nerve that was causing pain in my right arm; arm feels better today, but it will take a few days for the full effect (if it works) to take place. Did it at Chiang Mai Ram, which has been my regular hospital for years.

 

Since the cortisone injection typically lasts about six months and patients go back for injections (no more than twice a year), I also intend to travel to the spinal surgery center at Bumrungrad in Bangkok to see if they have a noninvasive (laser) technique to take care of the problem once and for all. Chiang Mai Ram does have a surgical solution to my specific problem, but it's invasive (they go in through the neck). The laser procedure sounds more appealing, if available.

 

Hope that helps; good luck. I'd consider traveling to Bumrungrad for a longer-term solution, if you're looking for that; steroid injections are easily done at Chiang Mai Ram.

thanks for that info ....... cost ?   and recommendation for doctor if possible  

Edited September 26, 2023 by rumak

[Cory1848]

1 hour ago, rumak said:

thanks for that info ....... cost ?   and recommendation for doctor if possible  

Total cost of the cortisone injection was about THB 16,000. But you’ll need an MRI before that to pinpoint exactly where the problem is; not sure if you’ve had an MRI yet, but that cost about THB 13,000. If you have international insurance, both procedures can possibly be direct-paid by the insurance company (at Chiang Mai Ram), depending on what insurance company it is and pending pre-approval by the company (I have Blue Cross, which worked, but had to pay a copay of about 15%).

 

My issues are in the upper spine, neck area; if you’re lower back, costs of course may differ, I have no idea.

 

The doctor at Chiang Mai Ram who administered the injection is Dr. Prasong Khunsongkiet; he was great. You’d need to talk with someone on the first floor of the hospital (surgery desk) to arrange an initial consultation, and the injection is administered in the operating theater on the second floor. The nurse held my hand throughout the injection (about a minute), which was a nice touch ...

[rumak]

16 hours ago, Teacher Robert said:

. But I will never forget that the relief I felt from the constant pain was immediate. It slowly returned after the first injection but after the second dose it never came back

good info in your post.   thanks.  (before others comment I KNOW  that different people have different results...etc etc)   .      

I am doing due diligence, and research .  I personally find anecdotal experiences very helpful .  SO thanks again to those contributing theirs .    

[rumak]

1 hour ago, Cory1848 said:

The nurse held my hand throughout the injection (about a minute), which was a nice touch ...

What did she do when you screamed ??    lol     seriously,  thanks for taking the time to tell me your experience .    In my many years I have been to Ram ,  Ram 2,  Bangkok hospital,  Rajawet (hip surgery) ,  Sripat,  McCormack (mri ) ,  and of course a few clinics.  

No,  i hardly ever get sick !    This is over an almost 30 year period.    I have had good and not so good experiences... nothing horrible .   But the 2 procedures i had were with very good doctors .  Dr. Suthee fixed my frozen shoulder without surgery ( called manipulation) ... something very few surgeons can do .    Broken hip also done very well .  ( no pain like when one breaks their hip in a fall !   still, i kinda dread that big needle used for ESI ... and the area involved )

Edited September 26, 2023 by rumak

[owl sees all]

Very slightly off topic.

 

I would suggest a natural remedy. It means a lot of rest. and a fast. Could try it for 14 days.

 

Having the right state of mind is important.

 

A bit more to it. But not hard.

[rumak]

5 hours ago, mania said:

Thanks again for that great quote!

"nature takes care of the disease while the doctor/therapist entertains the patient". ????

Actually,  i am someone ( not that many of us)  who does not run to "go see a doctor, you idiot" .

As you have found out , many times they do NOT offer the cure .   I won't get into a long rant, but will just say I have done well and corrected many issues by research,  and mostly by following "natural remedies"  .   nuff said  

 

I looked,  and my previous MRI  was 6 years ago !    Only an occasional anti-inflamatory at times since then.   Now, as we know,  age brings another episode .... to the back .  I am going to give it some time to heal.   But....... about an ESI  ?    hmmm  we'll see ,   First an MRI  ,  if no improvement .

[Cory1848]

49 minutes ago, rumak said:

What did she do when you screamed ??    lol     seriously,  thanks for taking the time to tell me your experience .    In my many years I have been to Ram ,  Ram 2,  Bangkok hospital,  Rajawet (hip surgery) ,  Sripat,  McCormack (mri ) ,  and of course a few clinics.  

No,  i hardly ever get sick !    This is over an almost 30 year period.    I have had good and not so good experiences... nothing horrible .   But the 2 procedures i had were with very good doctors .  Dr. Suthee fixed my frozen shoulder without surgery ( called manipulation) ... something very few surgeons can do .    Broken hip also done very well .  ( no pain like when one breaks their hip in a fall !   still, i kinda dread that big needle used for ESI ... and the area involved )

I did yelp twice, during a few moments of very brief discomfort, and it was nice having something to grip onto! But I got an initial shot of local anesthesia, which helped, and because of that I hardly felt the cortisone injection at all. I did not see the size of the needle used; I was on my side, facing away from it, and I wasn’t in the least bit interested! I really don’t enjoy getting shots of any kind, but the overall experience here was quite good.

 

Again, not sure how it would differ for something in the lower back. Best of luck --

[UbonEagle]

Great post

i have constant thoracic pain from C5-7 bulging disc, not debilitating but requires work to maintain for 10yrs+.

 

Have long considered ESI, at age 53 and still very sportingly active it might help, but I imagine having soon after injury would have provided more benefits.

I think healthy lifestyle, stretching and quality massage are key for me, something that will be a lot easier once retired and not travelling for work in few yrs time 

[rumak]

2 hours ago, UbonEagle said:

Great post

i have constant thoracic pain from C5-7 bulging disc, not debilitating but requires work to maintain for 10yrs+.

 

Have long considered ESI, at age 53 and still very sportingly active it might help, but I imagine having soon after injury would have provided more benefits.

I think healthy lifestyle, stretching and quality massage are key for me, something that will be a lot easier once retired and not travelling for work in few yrs time 

 

2 hours ago, UbonEagle said:

Great post

i have constant thoracic pain from C5-7 bulging disc, not debilitating but requires work to maintain for 10yrs+.

 

Have long considered ESI, at age 53 and still very sportingly active it might help, but I imagine having soon after injury would have provided more benefits.

I think healthy lifestyle, stretching and quality massage are key for me, something that will be a lot easier once retired and not travelling for work in few yrs time 

Yep... you are not alone .  Good to hear from the members here who are dealing with back pain (and nerve related) .   My main take-away is the fact that everyone's issue is unique  (and, yes, has to be diagnosed properly  ,    I am pretty sure you have done research as well.   There of course are ways to deal with bulging discs... some less invasive ones but i am not up to date on that.

Hang in there.   Stay active and careful ..

Edited September 26, 2023 by rumak

[Sheryl]

@rumak

Is the tingling/numbness in the leg on ssme side as your hip surgery? 

[rumak]

1 hour ago, Sheryl said:

@rumak

Is the tingling/numbness in the leg on ssme side as your hip surgery? 

i do not have any tingling .  I occasionally feel a very small degree of numbness in a few toes. usually on the opposite side of the surgery .   Before i started taking 25 mg (smallest dose) of diclofenac in the morning , and one  after dinner ...... and started this post .... my legs were feeling weak , and once or twice my knees hurt .   I have now improved ( it has been about 5 days) ... no more weakness in legs or hips today .    I am walking ,  light stretches (2 very basic ones) ,  and getting some relief .  BUT......... how much is do to the meds ?  ( they definitely help) 

I never was in sharp pain,  but the weakness and tiredness at times in the legs is what had me most concerned.   Also dull ache in lower back .   I plan to keep this up (taking the anti-inflamatories and current protocol )  for at least a few more days before stopping the pills and seeing how much improvement i have made.   

So basically i am following many suggestions here... also hope to start the stretches for the quadratus lomborum ...maybe see how that feels.  My MRI  I see was 6 years ago !  quite a while but Dr Chanagan said it was not bad for someone my age.      Of course i will do another if this persists.

NOTE :  i went last week to the surgeon/hospital where i had the surgery and took xrays of that area and he examined me .  All showed up extremely well.     It was my initial concern..... but really i do not seem to have any worries from that .   ( it was a REAL RELIEF ,  as if there was a problem with the pin moving or something..... it would have meant an operation to remove ! )

Edited September 26, 2023 by rumak

[mania]

4 hours ago, rumak said:

also hope to start the stretches for the quadratus lomborum ...maybe see how that feels. 

I actually found & started that video while I was in great pain. I was shocked at how it helped.

Hope it does help you too!

 

The video of those can be done very gently. But seemed to elongate that & I felt instant relief

Of course as you said I appreciate we're all different & of course this is just an online talk with others

with bad backs ???? Which may or may not be similar

 

Good Luck back pain can be such a problem I know.... for me it even got to a point mentally that I wondered if this is now how life will be. Hang in there????

 

 

[rumak]

On 9/25/2023 at 3:14 PM, Dirk Z said:

I am a retired neurosurgeon having done thousands of spinal operations and treatments. Around 40 years of practice have taught me that - unless there is clear-cut pathology, like a herniated disc, a tumor, cyst etc. - a lot of treatments are trial and error with very little evidence to support the effectiveness of one treatment over another. We also know that many conditions have spontaneous remission without specific treatment as my own experience in occasional back pain shows. That means that the last therapist always has the best result because the patient is getting better by himself. We having the saying that "nature takes care of the disease while the doctor/therapist entertains the patient".

As for lumbar epidural: I have seen the best results in acute lumbar pain and varying results in the more chronic forms. But as far as I know there is still no solid evidence for it's effectiveness. It is not easy to set up a study with matching patient groups over a longer period of time.

thanks.....  i have just read this post  ( missed it as did not see a notification) .    Question:  as i also agree that a lot comes down to trial and error .   I have had back pain before... and it did go away, though I am always careful now,  due to advancing age and stiffness.   

Do you suggest stretching ?   And ,  i just got a pull bar which i will hang from ( feet on ground) . It will take a while, i'm sure,  as my shoulders and lats really need to strengthen up .   When i was a kid i could do 20 chin ups,  even one arm chinups.   Now..... I probably could do one or two ( and really screw myself up ! )

[Dirk Z]

19 hours ago, rumak said:

Do you suggest stretching ? 

As I said, it's trial and error. But it won't hurt. Quit anything that doesn't work after 1-2 weeks.