Epidural for low back pain

[Bateman54199]

I need to go get an Epidural shot for my low back pain. I have tried to research this on the internet but all I can find is information on Epidurals for pregnancy. Does anyone have any information about this type of shot, my general questions are:

Does the shot hurt?
What are the benefits?
Are there any cons?
What is the general procedure?
Why do doctors generally want you to get this shot for low back pain?

Thank you!

[LorTabitha]

Here's my thread on epidurals from a while back. It should answer some of your questions, at least:

http://forum.opiophile.org/showthread.php?t=17405&highlight=epidural

[Poppylvr]

An orthopedic surgeon, neurosurgeon or anesthesiologist would be the kind of doc to do this.
You can find them at a legit pain clinic.
The general procedure is for you to be curled in a ball either lying on your side or sitting up. The doc washes an area of your back where the needle will go in. I'm assuming they do these at different levels for different sources of pain - but the childbirth one is put in right where your waistband and your underwear would touch your back. An epidural done at this level given good relief from about the waistline down.
The doc injects some lidocaine - that will burn but only for about 60 seconds. The s/he will insert a needle with a plastic catheter (tube) in it. They'll given you a test dose. My understanding (remember mine only comes from childbirth epis) is they use a mix of narcotic a numbing med.
I think the reason doc's like epidurals is they are easy to do ( and redo), and fairly inexpensive, and provide excellent pain relief with minimal addiction risk bevcause the doses are so low.
Best bet - find a pain clinic tell then you want this but you have lots of questions. Good docs will try to answer all your questions.
Good luck, hope this helps.

[oxy kid]

I had a buddy of mine that got one a few years back. He said it worked excellently.

[WhyCatsPaint]

I need to go get an Epidural shot for my low back pain. I have tried to research this on the internet but all I can find is information on Epidurals for pregnancy. Does anyone have any information about this type of shot, my general questions are:

Does the shot hurt?
What are the benefits?
Are there any cons?
What is the general procedure?
Why do doctors generally want you to get this shot for low back pain?

Thank you!


I myself have not had one but my husband has them from time to time (the doctor allows me to be in the procedure room while he perfroms them) so I will try my best to answer everything.

Does the shot hurt?
It depends if they will sedate you before the procedure not all doctors use sedation if they do then no you won't feel anything during the procedure, but you may be tender 24-48 hours after and they will have you apply ice to the injection site to help reduce any swelling that may occur.

What are the benefits?
Pain relief in your lower back

Are there any cons?
Yes there is always risk associated anytime you insert a needle into the spinal column. These procedure's are performed day in and day out and most people suffer no ill effects.

What is the general procedure?
A Block is performed under fluroscopy. A spinal needle is inserted into the epidural space of the lumbar or caudal spine. An anesthetic and steroids are injected into the epidural space.

Why do doctors generally want you to get this shot for low back pain?
They do the in conjunction of other modalities to bring your pain to a manageable level. Not all doctor like to rely solo on medication due to tolerance and side effects so they will often use medication along with other modalities Trigger Point Inj. Physical Therapy, RF's, Tens Unit and many other to help you achieve the relief that both you and your doctor are satisfied with.

If your doctor performs it under fluro sometimes they will print out the pictures (before and after contrast) and you can ask if they can make a copy for you if you want to see what they did.

Here is a great link to a video that shows the injection and explains what you are asking:
http://scrubtv.com/pharmacy/epidural-steroid-injection-video_bc0befd38.html
(Note: your doctor may vary in performing his procedure)

[samsong]

Epidurals are generally less painful than Selective Nerve Root Injections (SNRI)--the epidural is shot right into your epidural space, whereas the SNRI is shot directly onto the major nerve roots that travel to your lower extremities. When I get the SNRI, they have two nurses hold me down as the pain is fucking nuts, but only last about 30-60 seconds which is why they don't sedate me, but when I have done the epidurals, it is just a bit unformtable, but not crazy pain like the SNRI.

The steroid medication is intened to reduce the amount of inflammation and therefore reduce the pain. The risks are very minimal with either procedure. Ihave done maybe 6 epidurals and about 20 SNRI's over the past three years, all up and down my spine. Sometimes they work, sometimes they don't. Sometimes the pain goes away for months, sometimes it only lasts 2 days. It is very much a hit and miss procedure. However, the upside is that more injections you agree to do, generally the doctor will be more willing to write you scripts for narcotics.

[sweet pea]

An orthopedic surgeon, neurosurgeon or anesthesiologist would be the kind of doc to do this.
You can find them at a legit pain clinic.
The general procedure is for you to be curled in a ball either lying on your side or sitting up. The doc washes an area of your back where the needle will go in. I'm assuming they do these at different levels for different sources of pain - but the childbirth one is put in right where your waistband and your underwear would touch your back. An epidural done at this level given good relief from about the waistline down.
The doc injects some lidocaine - that will burn but only for about 60 seconds. The s/he will insert a needle with a plastic catheter (tube) in it. They'll given you a test dose. My understanding (remember mine only comes from childbirth epis) is they use a mix of narcotic a numbing med.
I think the reason doc's like epidurals is they are easy to do ( and redo), and fairly inexpensive, and provide excellent pain relief with minimal addiction risk bevcause the doses are so low.
Best bet - find a pain clinic tell then you want this but you have lots of questions. Good docs will try to answer all your questions.
Good luck, hope this helps.

what you said there about where they put it. when i had my kid, mine was more like in the middle/upper part of my back. it was kind of a blur, but i definitely don't remember it being down towards my waist area. is this normal for me to have had it up that high?? also, it had worn off for the most part by the time i had her (16 hours later) and now i'm wondering if this had something to do with it.

sorry, that was kind of off topic since the op isn't having a child! lol. but, fwiw, it really didn't hurt that bad at all. and i had a great deal of pain relief (from labor pains & insane pressure) for about 12 hours.

[samsong]

epidurals for childbirth are completley different from steroid epidural injections. The term epidural refers to an area of the spinal canal that runs the entire lenth of your spine. For childbirth, they inject narcotics/anasthesia into the epidural space to block the pain. For back/neck problems, they inject steroid medication into the epidural space to reduce local disc and nerve inflammation. The epidural injection for childbirth is supposed to wear off relatively qucikly because it is only used to temporarily block pain sensations.

The epidural injection of steroids for back/neck problems is supposed to reduce inflammation within 48 hours, but once the inflammation is reduced, the pain releif can then last for a long time, or not, in many cases. But you can't compare childbrith epidural injections to back/neck steroid epidurals--two compeltley different things, it is just that for both injections, they are injecting the meds into the epidural "space" of your spine, hence the procudures are called "epidurals" because of the location.

[RobOC]

I have had 3 of em. They didnt really help me but for some they work really well. They put me in a twilight with versed and gave me alot of fent so it didn't hurt much. Atleast not the parts i remember.

[stymie]

One thing to be aware of is that there is the possibility of the procedure puncturing the dura causing arachnoiditis. I suffer from this disease and it can be caused by trauma to the spine, poor outcomes from spine surgery, or epidurals (both the steroid kind and the childbirth kind). It is a rare complication, but real nonetheless. There are at least four women in my support group who had no other procedure or risk factor other than oNE epidural. A couple of them had immediate spinal headache and CSF leak, along with a long stint in ICU.
Not trying to scare you, and it may be rare though underdiagnosed, arachnoiditis is real, painful, and incurable. I had trauma to spine, a laminectomy, and three epidurals, so I can't be sure which of these or all three factors gave me this wretched condition. I try to warn all young women I meet to NOT have the epidural for childbirth for obvious reasons if they can possibly have the baby without it.

[stymie]

The 3 epidurals I had did nothing for my pain, which lead to surgery.

[Bateman54199]

Thanks for all the help, especially WhyCatsPaint.

I have decided to go through with the shot but I am going to have it done at the hospital instead of my PM clinic.