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Has anyone tried epidural shots? your take on them? I need help with pain

Started by MrsZingers on 08/03/2011 7:22pm

First of all, I am a 59 yo nonsmoking female, been suffering with back pain for about 10 years. First my L3-4 got herniated. I tried chiropractors, PT, pain meds but my rheumatologist won't give me anything stronger than gabapentin, celebrex and Ultracet. I'm currently on all 3. (I also have fibromyalgia) Last yr my L2-3 disc ruptured and I also have a bulging disc at L5-S1 from what I remember the MRI says. I've had 2 rounds of Epidural shots. The pain relief only lasts approx 2 months. I am now in a lot of pain - hips, legs, low back, burning sensations in my rt leg, etc. I like the epidural shots except they raise my blood sugar for 2 weeks to really scary levels (I am a diabetic also). I've tried PT but can't continue as I can't afford the co-pays. I'm doing excercises at home and aqua class every week. I'm afraid of surgery - It would involve a fusion and replacing a disc with an artificial one. The neurosurgeon said I wouldn't be able to bend down for 6 mo's because I'd have on a hard brace! I have pets at home to feed and housework that has to be done -how can I not bend down! Then, I'm afraid of the scar tissue after surgery causing even more pain. Anyway, are there other people in my shoes and what are you doing about your back pain? Oh, by the way, there is some spinal stenosis in the lumbar spine and I also have severe DDD in my cervical spine.

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They did nothing for me. After the shot I started having electric shock like pain in my calves. My left hip started giving me more trouble to the point that I now limp and my left leg is weak. And the hot flashes were aweful. It does help some people and I only had one. I gave it a chance and it didn't do what I hoped.

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They did nothing for me. After the shot I started having electric shock like pain in my calves. My left hip started giving me more trouble to the point that I now limp and my left leg is weak. And the hot flashes were aweful. It does help some people and I only had one. I gave it a chance and it didn't do what I hoped.

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I have tried the ESI and I did not have good luck. The injection only last for a few weeks each time I had them. My doctor has now discontinued the injections because he said for some it works and some it does not. I guess I was the one it did not. I am in the same boat with you and I am 42. I have DDD in cervical also and bulging disc L3-L4 and Spondylolisthesis L5-S1. I have more issues with the Spondylolisthesis because the vertabrae moves when it wants to and hits nerves and I am down for the count. I have not worked in about 4 months and now worried about job. I have had the same type job for over 25 years. I do not see me getting into a car and driving a 100 miles a day and doin the phyical work I once did . My job has always been who I am and I am so afraid to lose that in my life. If no shot and no surgery, then what the heck to do? I can't live on pills all my life. I will follow your stream. I also need the same advise. Thanks for sharing and I hope you get some relief soon.

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I have tried the ESI and I did not have good luck. The injection only last for a few weeks each time I had them. My doctor has now discontinued the injections because he said for some it works and some it does not. I guess I was the one it did not. I am in the same boat with you and I am 42. I have DDD in cervical also and bulging disc L3-L4 and Spondylolisthesis L5-S1. I have more issues with the Spondylolisthesis because the vertabrae moves when it wants to and hits nerves and I am down for the count. I have not worked in about 4 months and now worried about job. I have had the same type job for over 25 years. I do not see me getting into a car and driving a 100 miles a day and doin the phyical work I once did . My job has always been who I am and I am so afraid to lose that in my life. If no shot and no surgery, then what the heck to do? I can't live on pills all my life. I will follow your stream. I also need the same advise. Thanks for sharing and I hope you get some relief soon.

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I am a 46 year old, non-smoker. I have had back pain for about 6 years. My pain was severe while sitting, standing in one place for more than a couple of minutes and laying. I too have tried chiropractors, several different ones, purchased two new beds over 6 years, medication, and physical therapy. Nothing worked. I had the epidural on Tuesday. I had immediate relief. The injection wasn't painful at all. The side affects that I am suffering are moderate hot flashes and sleeplessness, probably from the hot flashes. But, even with those side affects, it was well worth it.

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I too had the hot flashes with the epidurals, they were doozies. I drank ice water and kept the A/C on in the bedroom. The biggest issue was my blood sugar, my fasting was 215 in the morning! I ate salads and lean chicken because I couldn't eat many carbs with that kind of sugar reading.. Lost a few lbs but it all came back because I can't exercise like I want to.

In my case I quit my job a few years back and with the help of an attorney filed for SSDI. In my last job I worked for a real estate lawyer and had a lot of running around to do in downtown offices. I have other issues too, such as fibromyalgia and severe migraines. With the help of medications my migraines seem to be under control now. I am not sure when and if I can ever return to work. I am pushing 60 and can barely get out of bed in the morning.

I guess my next step will be to get a second opionion on surgery. Maybe they can do one disc at a time? I also thought that discs heal themselves after a while, they shrink and the pain isn't so bad. I'm still waiting for this.

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hi i have DDD i had 3 epidurals in a space of a year up to july 2010,they were ok but the longest time without pain was 2 wks,i also have steven johnstone syndrome which means i can"t take any pain relief of any kind,so i try to keep active ,daily for about 30 mins and just be carefull i cant work anymore,so i concentrate on what i can do not what i cant do im starting swimming tomorrow hope that helps

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hi i have DDD i had 3 epidurals in a space of a year up to july 2010,they were ok but the longest time without pain was 2 wks,i also have steven johnstone syndrome which means i can"t take any pain relief of any kind,so i try to keep active ,daily for about 30 mins and just be carefull i cant work anymore,so i concentrate on what i can do not what i cant do im starting swimming tomorrow hope that helps

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Hi MrsZingers
I have both ruptured discs at L3-4. L4-5 and a Spondylolisthesis and now progressive Degenerative Disc Disease. My doctor referred me to a Specialist for an Epidural Steroid Injection. I attended the appointment, but they were unable to get the needle into the epidural space and after almost an hour of trying, they decided to give up. As it was becoming more and more painful as time went on, I wasn't sorry on one hand but disappointed on the other as I had heard that they can be very effective. However, they are not generally meant to be a permanent solution when it is not acute back pain and people have to return often 6 monthly for repeat injection. As others have said above, they work better for some than others. Having had previous steroid injections in my shoulder, elbows and since then knees, I generally respond reasonably well.
As a diabetic myself (now on oral steroids for Rheumatoid Arthritis) I understand the effect they cab have on blood sugar levels.

When I suffered with my first ruptured disc I was also told that the majority of discs reabsorb themselves and no further treatment is needed - however I'm one of the 'lucky' one that this did not happen for.
When I sought advice first from an orthopaedic surgeon, he wanted to do a 'multi-level fusion' on my lumbar spine. Knowing that it was a serious operation I asked if he minded me getting a second opinion. So I consulted a very experenced neurosurgeon who said that said that unless there was a serious concern related to for example, severe compression of the spinal cord due to disc material, spinal fusion for a ruptured disc, or Degenerative Disc Disease was not usually a recommended treatment particularly when considering multi-level fusion as all it achieves in many cases is simply to transfer the pressure to the next un-fused disc above. However you mention Spinal Stenosis too. If surgery is required for that - it may not be a fusion that they look at.

I don't know whether you have read the information that Spine Universe sent out a short time ago, but here is the link if you want to have a read:.
ISASS issues new lumbar fusion policy on degenerative disc disease
Good Luck with your decision, it's definitely more complicated by the fact that you have diabetes, as healing can be delayed due to this. At the very least do get more than one opinion though before jumping in particularly as my neurosurgeon was insistent that 'Spinal Fusion' was not the ideal choice for DDD

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I recommend you to go to a neurosurgeon first.

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MrsZingers: I am a veteran of five back surgeries. I originally hurt my back by lifting boxes with my knees locked which was a stupid mistake. I spent the next 14 years going to a chiropractor for back adjustments which turned out to be a HUGE mistake because all he was doing was wearing out the discs in my back with each adjustment which resulted in degenerative disc disease. At the time I was naive and did not know any better. As the pain got worse I eventually ended up going to a neurosurgeon who told me my L5-S1 was degerated. First I went through physical therapy and then I had epidural injections which helped for a short time but then quit. Epidural injections are not a cure-all and you are limited as to how many you can get per year by your insurance company. Going through physical therapy and getting epidurals is the standard procedure for insurance companies. One day I noticed the pain going down my left leg making it difficult for me to walk and I knew I was in trouble. I made an appointment with my Neurosurgeon and he told me it was time for surgery. Trust me when I tell you that fusion surgery IS NO BIG DEAL! I agree with your doctor when he says you can't bend down for six months, but you CAN squat which is exactly what I did. As for the brace, it is a hard shell and only fits around the back (at least all of mine did) with velcro straps that secure in the front and it actually feels good to wear it because it stabilizes your back while it is healing. I have four cats and had no problem feeding them. My case was different in that within a year of surgery to repair my L5-S1, my L4 slipped and I had to have a second fusion. Then less than a year later I had problems with my L3 which included spinal stenosis and this time the surgeon went it and put a cage around my spinal cord and added morphagenic gel (or at least that's what he told me), and then as my luck would have it, a year later my L2 slipped and had to be repaired. All of this happened between 2003 and 2008. Then in 2009 I went back to my surgeon because I was still in pain and I could not stand up straight. He looked at my MRI's and said he did not understand what the problem was because everything looked great. It was then that he referred me to a doctor at UC San Francisco here in California. That doctor looked at the xrays looked at me and told me my spine looked like the Leaning Tower of Pisa. He said "you have adult scoliosis and there is a 70% chance I can fix it". It involved two more surgeries, the first one was through my abdomen to prepare my spinal cord for the second one. That surgery was a piece of cake and I healed quickly. The second surgery was scheduled for two months later and that was when he put two titanium rods in my back from the L5-S1 to my T12. He promised me 70% and I got 100%. I just had my 2 year post op and I am doing great. I am walking without a cane and I am standing up straight. The only time I need pain meds is if I stand too long or do too much around the house. Now I'm not saying all of these surgeries will happen to you. Hopefully you will get lucky and only have the one but the best part is that when you wake up from surgery all of the pain in your hips and legs will be gone and the pain in your low back from the surgery will be manageable with the drugs they send you home with. To me, having the surgery is far better than spending my life in constant pain. I no longer work and I will be on Social Security Disability for the rest of my life but hey, at least I now have a life!

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Hi MrsZingers,

I have had so many procedures on my lower back and neck, but just thought I'd let you know what I found out after a few years of epidural injections for my neck and arm pain. For the most part, they would last around 2 months, I'd have to wait out one more month, and then at the 3 month mark, I was able to get another injection. This went on, as I stated, for about 4 years, every 3 months. I also had a spinal cord stimulator implanted for the neck and right arm pain. The epidurals were for left arm pain which began a few months after I had the stimulator implanted. It finally got to where the epidurals were only lasting a week or two, and my pain Dr sent me to a neurosurgeon, stating he felt I was at the point of needing surgery because there was really nothing else he could do for the pain. The neurosurgeon agreed and I had a 4-level fusion in my neck, which only lasted 6 weeks. The x-rays showed that some of the screws had loosened from the plate, so I was back in surgery within 2 days of their finding this, and ended up with anterior and posterior incisions and a 6-level fusion in my neck.

The whole point of this is to advise you that my neurosurgeon told my husband after the second surgery that my bones were so soft, hence the need for the 2nd surgery to fix the problem. He also stated that he felt the bone softness was from having so many epidurals done.

In my case, I really didn't have much of a choice but to have surgery, but ended up with several complications due to the surgeries. I wish I hadn't had either surgery, yet I was out of options for pain relief, other than raising my pain med intake. I also have an intrathecal pain pump implanted for failed back syndrome, which was what I ended up with after an L5/S1 fusion.

I believe each person has to arrive at their own decision for any treatment they choose for their pain. I happen to be one of those people who ends up with any and all of the rare effects of every treatment I have, but yet there are so many others out there who have had excellent success with their surgeries. As for the epidural injections, I do believe they also are an excellent way to treat pain, but if it comes to the point that a person needs to continue on with injection after injection, then there could be a problem with softening bones. I am no professional, and only speaking from my experiences, and wish you the very best. My intent was not to scare you, but just to let you know what may happen with too many epidural injections; and I have no idea where "too many" come into play. My best to you in your decisions and your pain. I hope you are able to find whatever works best and can get the relief you need.

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Thanks Betty for your lenghty input. It's good you're without major pain now and able to walk ok. You mentioned a person wouldn't be able to bend after the fusion but can squat. I have a problem with squatting. I can squat but have difficulty getting up. I also have difficulty walking up stairs. I think this is due to quadricep or leg weakness and I've had this for many years, even before I had spinal issues. Being overweight may be contributing to it. I'm not looking forward to the golden age with these problems.

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MrsZingers: I really wish I could meet you in person. All of those problems you mentioned with squating and with your legs will be gone after you have surgery. You will have a walker after surgery which you can use as long as you need to help you get up from your squats and you will need a cane if you don't already have one. We were renting a place that had an upstairs to it and had to move because of the stairs. I don't know if you own or rent but if you own, the stairs are going to be a problem unless you live with someone because you should not be going up and down those stairs even now. It is true you will not be able to "bendover" for six months after surgery but I promise as God is my witness, the only pain you will have left will be centralized to just the surgical area and that pain will be managable (since all the other pain will be gone) and it will get a little better each day. If you have a really good surgeon, there is nothing to worry about. Ask around, go into his office when you don't have an appointment and talk to the people in his waiting room, ask any of those people if they have had surgery and how they are doing. You mentioned you have Quadricep weakness, have you ever googled this on the computer? What does your primary doctor say about this? I looked it up on Google and what I found was quite scary but very treatable. If you are not getting treatment for this, you need to be because you may be going through unneccessary pain. Anyway, back to your other situation, you said you are overweight, well so was I. I had been on Weight Watchers and lost a lot of weight before my surgeries and gained it all back over the course of all of the surgeries so don't worry about that. The best part about that is they won't consider taking any of your hip bone to use to repair your back. When they do that it hurts more and it makes recovery harder so if they suggest that tell them "NO!". I have since lost 30 pounds again on Weight Watchers and things are going great. I know the back is a scary thing to mess with and there are a lot of horror stories out there but the key to your success is your Neurosurgeon. A Neurosurgeon only specializes in the spinal cord and the brain so like I said, secretly check him out and if several patients in his office tell you they are happy with their surgeries then you can relax and go for it. If not, find another doctor. Good luck and keep in touch.

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Dear MrsZingers

As I mentioned in my post - this time yesterday, once your spine is fused 'what occurs is that the stress is shifted to the unfused disc/discs above' or words to that effect. I note that one person who posted shortly after me explained that this was exactly what happened to her, She had one level fused then the next and the next and so on.
I'm not here to judge anyone or their pain, or to recommend treatment when outcomes can be hugely varied for different people. However, to say that a spinal fusion is 'no big deal' especially when the only experience a person has is their own, I would certainly NOT take that approach. Or to explain exactly how you will feel is taking a huge guess.
No surgeon would tell you how you will feel - a decent and honest surgeon should only be able to offer you a percentage chance of success eg mine said 'I would only expect a 10-15% chance that a spinal fusion would be a success for you' as he was looking at my specific situation. Just because someone has the same/similar treatment does not mean that the outcome will be the same for you.
The best approach is to read through different people's experiences and formulate different questions based on what people have described as their experiences.
As one lady said seek a neurosurgeon (be aware that the spine is frequently claimed as their specialty by both orthopaedic surgeons and neurosurgeons as it obviously has both bone and nerves involved you can't get a bigger nerve than the spinal cord) - have these questions ready for them as again surgeons even use different braces post surgery. But importantly read what different people have posted - no-one's experience is ever exactly the same.

One thing I want to add (which I don't regularly post) is that as well as personal experience of severe back problems, I am also a Registered Nurse and have been for 27 years. I am not claiming to be an expert in any way, but it does give me a bit more experience and I have seen both good and not so good outcomes from many treatments and surgeries and a lot in between.
I'm not advising you on what you should do, just recommending that you talk to a good Neurosurgeon before deciding on which course of treatment you opt for. If necessary get a 2nd opinion and even a 3rd if it helps.
The lady who describes 'bone softening' after multiple epidural steroid injections most certainly would not be alone, as Prednisone (a steroid) taken long term can without question can cause Osteoporosis. This site is a really good resource for hearing about others experience, but whatever you decide - please remember that everyone is an individual and if you had 100 people with the same/similar diagnosis all having the same operation, it is highly likely that you would be lucky to find 2 people with exactly the same outcome. Wishing you well for whichever treatment you opt for - and remember that NO surgery should be taken lightly and always weigh up the risks and benefits. Best wishes

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I'm 65 and had fusions 45 years ago which lasted perfectly for 40 years. Developed spinal stenosis and couldn't walk. Had about 8-10 epidurals over 6 years which gave me complete relief and allowed me to maintain 100% mobility and play tennis at high level. Eventually spine wore out and required fusing rest of lumbar spine. I've had many problems with surgeries and will have 8th surgery next week. Been through it all but remain hopefull.

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Thank you Backman66!!! Someone else who supports me and the fact that all back surgeries are not the end of the world! After reading the last posting from Tippysnail I also want to say that I did ask my surgeon before my third surgery if the repeated surgeries happen to everyone and he told me he could count on one hand the number of people that happens to. Remember, I had 14 years of chiropractic adjustments prior to my first surgery so my discs were very weak and probably worn out to begin with. Tippysnail said it was also highly unlikely to find 2 people with the same outcome and again I disagree with her because I have a friend here in the same town who had polio as a child and now has post polio syndrome so her body is a mess in more ways than one. To make a long story short, Sheryl has also had multiple back surgeries by the same doctor I go to and she is doing great and she is still walking at the age of 66.. I still maintain the success of your surgery lies in the hands of your Neurosurgeon and his abilities!

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THANK YOU BACKMAN 66!! Finally someone else who supports me that back surgery is not as bad as eveyone is making it out to be.

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Thanks. I will get a second opinion on the surgery. One thing I wasn't happy about with the first opinion is the choice of hospitals. I have a PPO plan, a Medicare advantage plan. The hospitals the neurosurgeon was on were not my choice top. In fact the best hospitals are NOT in my PPO plan, unfortunately. I will have to get a second opinion with a dr. from another hospital but it again will not be a top hospital for neurosurgeries. I am not 100% sure my insurance pays for anesthesia. The anesthesiologists - as far as I know, bill separately. There's no telling who will take my Medicare advantage PPO, many will only take BC/BS now or medicare. I won't know if the anesthesia is covered or not until after surgery! How scary is that!

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The shots only relieved the pain for a very short period of time. I have a bulging disc at c3-4, a torn disc at l4-l5 and at l5-s1. I ran someting called a discogram and it determined the pain was coming from l5-s1. I am a workcomp case and when I saw several spine surgeons and all stated I needed fusion surgery. I fused l5-s1 on March of 2011. I won't lie it was a bit rough but honestly you will beable to get thru it. I am currently off almost all narcotics and only taking ultram( pain med and antiinflammatory). I do not regret doing it and mine was done minimal evasivly. I did not have to wear a brace at all either. I have ddd as well. My conditon worsened due to the heavy lifting I have been doing at my job for 8yrs. Think about it, I have had a positive experience. Good luck to you, any questions please just ask!!!

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MrsZingers: This is your lucky day. Not only do I have a history of back surgeries but when I was working before I became disabled, I was a medical biller and I can answer your question about the anesthesia. Your Medicare Advantage Plan (also known as Plan C) is the same as Medicare A & B except it also includes a drug plan which A&B does not. The secret to getting all of your bill paid with the exception of any deductables is to follow the guidelines in your plan booklet. Be sure to use a Neurosurgeon listed in the booklet and go to a hospital listed in the booklet. Also make sure the anesthesiologist is in the booklet. This is called being in the "network". As long as you use their "network" of physicians your bill will be paid. If necessary go to the hospital admissions a few days before surgery to make sure they use an anesthesiologist on your plan and make note of the date and time you were in there as well as who you spoke to. If your anesthesia doesn't get paid this will help you when you appeal the bill. Don't worry too much if the hospital is not your first choice because you are putting your faith in your neurosurgeon not the hospital. Hope this help...

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Have you tried radio frequency ablation? This has helped me in the past. I have many of the same problems as you have described.

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to bnlandry- I am not very familiar with radio frequency ablation. Is that where they zap out the nerves? I was told that nerves grow back. In my case I have 3 discs that are compressing nerves...I guess that would be a lot of ablation?!

Did you have this procedure done? What was it for and did it help?

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Yes, I have tried them and they do really work. They did for me anyway. It lasted for about 3-4 months then I have to go back and get it done again. It does not take long to have it done and my doctor puts me to sleep so I do not feel a thing. Try it if you have not done so you will be glad you did.

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I am a 37 year old who was in a car accedent due to a stupid driver tring to cross to many lanes of traffic to get onto the highway from a gas station. I have lumbar spndolosis, 2 bulging disc with tears(L4-L5 and L5-S1) amoung other things. My symtoms are pain in lower back, hip, knee, and shin on the right side. I have weakness on my right side from not being able to have a normal life. Trying to do any normal activity thatI use to take for granted was extremely difficult for me. I was a very active and in shape person before the accident. The more I did in a day the worse the pain was. Sometimes It was even hard to get up off the couch while in the laying position. I would have to roll off and use a chair to put myself in the upright posistion. Last summer I was walking along stepped down and my back gave totally out. It affected everything from the beltline down. I could not get out of bed by myself. I had to have help getting dressed and doing any normal activitiy what so ever. I had a 7 year old and a 3 year old to care for at the time so thank god for my support system as they really pulled through for me.

Anyway, I just went through a RF ablation two months ago. The proceedure worked for me. Most of the time I am completely pain free. When I over due it I have muscle spasms which is managable pain considering what I went through before. I would do it again with out even thinking twice.

The procedure is quite simple. I think the whole procedure|recovery took about 45 minutes.They put sedation in an iv. They use a flouroscopy machine to locate the correct nerves. Tested the nerves to insure that no pain didn't go bellow the buttocks. Then ran the radio waves through. The testing of the nervers was uncomfortable but didn't last long and was nothing compared to the pain that I felt before. The burning of the nerves with the radiofrequancy was not painfull at all. It felt like a tens unit that is barely on. (slight vibration) When I got up to go home my knees felt extremely week, and I almost fell as nobody told me that would happen and was completely normal. It went away within a hour. I spent the next day in bed, but after that was doing pretty well. I was told to ease back into my "normal" life before the accendent and just listen to my body. The procedure could last 3 months to a year. I have read on the internet that some peoples have lasted over two years while others lasted two months or did not work at all.. I have also read that some people have less pain when it does come back while others have more. every person is different so just hope for the best right?

Before I got this treatment my Doctor insisted on doing a nerve block to make sure that the procedure would work and that he was targeting the correct nerve. I had a total of 6 shots at once in the area where they did the rhizatomy. The shots lasted somewhere around two weeks.

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Hi I am 34 non smoker very active in good health have been in pain for about a year an a half. My condition is work related i have been in the same line of work for almost 15 years. I have since cut back on hours but I am still working. I have herniated and bulging disks, muscle spasms, and severe migraine headaches. my pain is neck, scapular and shoulder. I have been treated by Chiro, Physical therapist, pain management, pain meds, anti inflamatories, muscle relaxers, trigger point injections, epidural steriod injections, and finally botox injections. Results vary for everyone but sadly none of the above have worked for my situation and actually the botox (very expensive) made me alot worse. I do get slight relief from deep tissue massage (which hurts during treatment )and I also use a Flector patch and meds daily for pain. I walk do water exercises an Physical therapy 3x a week. I have gained 20 lbs and am not able to do the things i used to but was told I will just have to deal with chornic pain. Personally I would not go thru surgery but It can work for some. I do believe that all the injections and meds are really just a temp fix. I hope you soon find relief. Best of luck.

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HI, I also have similar medical conditions. Spinal stenosis, I had a Cervical Foraminotomy in Jan 2010.
My main condition is called DISH from Wikipedia, "Diffuse idiopathic skeletal hyperostosis (DISH) is a spondyloarthropathy also known as Forestier's disease and ankylosing Hyperostosis. It is a noninflammatory disease, with the principal manifestation being calcification and ossification of spinal ligaments and the regions where tendons and ligaments attach to bone (entheses). the most common abnormality is bilateral calcification seen on both side of the thoracic spine[1][2]

So to answer your question yes I had Epidural shots. I had two sessions about two weeks apart. They seem to work for a while. I also had it in the Lumbar as well.

Before I had my surgery on my neck the prep nurse said to my living space "back friendly." Mine was minor non evasive surgery. I would suggest that you work something out with a friend or family member. Tell the doctor your living status. Maybe your insurance provides coverage would provide and aid or a nurse to check up on you. If you have high enough medical bills you might be able to get some help.
If your afraid of surgery, you should find a pain group in your area that you might find someone that have same or similar problems, but the other options you might want to go to a pain management doctor. They have give you the necessary medicines to help relieve your pain. I would make a list of my questions and ask the Doctor about the surgery, what is it going involve, when will I be able to resume my life style, ect.
what are the advantages & disadvantages.

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