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Spinal Stenosis and cortisone injection

Started by spine_issues_112233 on 10/06/2018 7:18pm

Hi, my mom who is 78 years old has lately been diagnosed with spinal stenosis. Her symptoms are extreme pain in the right leg (pain level 9) which goes all the way to her right foot and some pain in the left side.

X-RAY imporession:
1. Moderate degenerative changes visualized portions of the lower thoracic spine. L1-2 and L2-3. Multilevel facet athrosis throughout the lumbar spine particularly L4-5 and L5-S1.

MRI impression:
1. Stress injury of the right-sided L5 pedicle with asymmetric edema within the pedicle.
2. At the L4-5 level, there is moderate right-sided neural foraminal narrowing.
3. At the L5-S1 level, there is moderate left-sided and mild-moderate right-sided lateral recess encroachment. There is moderate to severe left-sided and moderate right-sided neural foraminal narrowing. There is a small 2 to 3 mm right-sided facet joint cyst associated with the right ligamentum flavum wich contributes to the mild-moderate right lateral recess encroachment at L5-S1.

3 weeks ago she had a steroid injection into S1. The doctor spoke positively about the injection because according to him he had seen a swollen nerve and injected in an area to make sure the cortisone gets to that place. Right after the injection she was feeling a lot of relief, most likely due to the anesthesia. The very next day she had even more pain than before the injection and the pain has not gone away ever since. I have read that the injection causes a flareup, but it usually lasts a few days. According to her doctor the medication did not get where it was supposed to and the reason for increased pain is due to the flareup caused by the injection.

The next step was suggested to do an EMG test to find out if there is any nerve damage. According to the doctor who did the EMG test there were some damaged nerves and based on her report the doctor should be able to fine-tune the 2nd injection so that it will actually be helpful.

The doctor upon the last visit said that the next time he's going to inject into L5, after he has the EMG results.

Do you think this all makes sense and should we proceed with the 2nd injection, or we should do other tests and possibly see another doctor for a 2nd opinion? Why would the flareup last so long, and what can be done to get rid of this flareup? Will the 2nd injection also take care of the flareup that was caused by the 1st injection?

Thank you all for taking the time to read. Any advice/help/information will be greatly appreciated.

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