Question. A friend of mine has a herniated disc which is causing a pinched nerve. A doctor very close to us suggested an epidural and if it doesn’t work then surgery. Has anyone else taken this route?
Thanks,
Mark
ESI (Epidural steriod injections) are a very typical treatment for a herniated disk. Sometimes one will help, sometimes they are performed in a series of three. If your friend gets relief from them, he can indeed avoid surgery. The fact that he has a physician that is recommending conservative treatment first says a lot about the care he is receiving. The most important thing is to make sure that the procedure is done with fluoroscopic guidance. Some surgeons just guess as to placement and if you can’t get it into the correct area, the injection is worthless. In my humble opinion, it is certainly worth a try rather than go under the knife.
IANAP. I run a surgery center and we perform these types of procedures on a regular basis.
I’ve had a couple series of epidural steroid injections over the years for a severely hernitated disk (L5S1) and no surgery so far. Physical therapy has also been very helpful.
I have been using epidural shots 2 or 3 times per year for the last 7 years, and find them to be successful about 2/3 of the time. My thoracic spine was fused in 1998- consequently my neck and lower back must take up the slack due to the loss in flexibility of my mid-spine. I am also very physically active and prone to injuries like herniated and ruptured disks and pinched nerves. These injuries escalate because the swelling at the site causes friction, which further aggravates the injury and increases pain. I use steroid shots (like Cortisone) to reduce swelling and inflammation and allow my body to heal the injury.
Steroid use can cause side effects like weakening of bone or infection, so advise your friend to listen well to her doctor. For me, epidural injections are far better than surgery, and since I have an aversion to narcotics, my only option to deal with pain. I agree with porcupine- once the injury has healed, physical therapy may help strengthen the muscles and prevent another herniated disk.
My mom got epidural blocks to rid her of sciatica. Very effective.
It cured my pinched sciatic nerve. One treatment.
This was after I had tried pain killers, physical therapy, steroid treatments, and prayer. I recall being a bit nervous about it because the neurologist warned me of possible dire consequences up to and including permanent paralysis and death. Those were unlikely, but the scariest one was the possibility of a headache comparable to migraine. I was told to call an ambulance if I got a headache because by the time I would get to the emergency room, I would need morphine.
Anyway, I never felt the needle enter. He did a lot of topical numbing before he stabbed. I was lying on my side faceing the wall when the needle’s tip touched my nerve. OOOOOOOOOUUUUUUUUUCH! Damn. My knees slammed into the brick. He apologized quietly, finished unloading the syringe, and cleaned me up.
Within a day or two, I was completely healed. No side effects.
Wow, Liberal that shit sounds scary but I guess it was worth it.
Foxy, are surgeons that bias to surgery that you could almost predict that they would surgery is the best option? Is that based on making money or the theory they were trained with.
Thank you for the replies. From what I’ve read, there isn’t much wrong with the epidural approach. The surgeon like always recommended surgery. However, a friend of mine, a neurologist, suggested the conservative approach. I’m happy the thread for the most part agrees.
In my experience, not necessarily. I went for a consult with the best orthopedic surgeon at a very reputable local teaching hospital (Northwestern); after hearing my story, he went through all the various surgical options and explained to me why he didn’t think they were a good choice for me. He said most of the time things will resolve on their own within six months, even without treatment, and that he only recommended surgery for patients with long-term intractable pain where other options did not work.
Great feedback. I’m glad I joined this message board.
Yea, it hasn’t been six months yet but she worried about the numbing. She had the shot yesterday. The doctor said it would take 3 days to take effect.
My MIL did it, finally.
She says she wishes she had done it years ago. She is not entirely pain-free, but better than before.