Anyone had injections for back pain?

[SADShooter]

I've had chronic back pain for several years, after a couple of car accidents and a nasty ladder fall back in early 2005 along with substandard maintenance. I've seen chiropractors, osteopaths, and had a couple of rounds of PT which have helped short term. I've been overweight and often sedentary throughout that time, with my exercise activity increasing in the last couple of years in conjunction with the PT.

An MRI suggests arthritis in the facet joints of the lumbar spine and some disk compression causing pain into my right low back and hip. No major damage, but the pain is severe and chronic enough that it's become a coping issue. I'm scheduled to go in for diagnostic injections in about a week. I'd like anyone who has had the procedure or similar experience to chime in and share your thoughts. Did it work for you? Other treatments you've tried, etc.

Thanks,

SADShooter

[Regolith]

My dad went that route.  Unfortunately, the clinic where he had it done failed to properly sanitize the needle used, and he acquired a fairly nasty staph infection which proceeded to eat away at his back bone and damn near paralyzed him.  He was in the hospital for several months, and still has some problems because of it.

It would probably be a good idea to make sure your hospital doesn't have a bad record when it comes to infections. 

[Monkeyleg]

I had it done by an excellent surgeon. He anesthetized the area before the injection, and I didn't feel a thing.

One weird thing that happened is that, when the cortisone hit the spinal cord, my right leg just shot up in the air.  The doctor yelled "don't move!", but it was a reflex action.

I had really severe pain, but one shot made it go away (as long as I didn't stress my back). He wanted to do two shots, but I convinced him to go with half a dose on the second, as I was leery about liver damage from steroids, given the amount I drank.

Make sure you have something to eat before you go. This is an invasive procedure, and you'll be woozy. I didn't eat before the first one, and just about passed out when I tried to stand.

You'll need to take it easy  the rest of the day, and after that it's back to life as normal.

It's a shame that Regolith's dad had the infection. I haven't heard of anyone having problems before this.

[vaskidmark]

I've had cortizone injections into the spinal cord.  They work, but as Monkeyleg mentioned you want the area numbed and perhaps a little Versed to keep you still.  Figure on not moving for at least 30 minutes afterwards.  (With Versed you will remain woozy and still for about 45 minutes.)  Do not drive yourself home.  Yes, relief can be almost instaneous or take a few days to kick in - all depends on how much swelling is going on.

(As regards swelling - one guage is if the needle gets stuck partway in.  That's an indication of moderrate swelling.  You do not want to know what goes on if the swelling is severe or extreme.)

But you mentioned "diagnostic injections".  That sounds more like a mylogram, where they inject x-ray opaque dye into the spinal cord.  Read the side effects at http://medical-dictionary.thefreedictionary.com/Mylogram - especially about headaches.  You want to have narcotic analgesic on hand for them - not saying you will get them but if you do it will make your worst hangover on top of a migraine feel like a breeze.  You also do not want to be moving around much with extra fluids in your spinal column/brainpan.  Thus the narcotics.  Do not try to be a "big boy" about this - use the drugs.

stay safe.

[Viking]

My dad went that route.  Unfortunately, the clinic where he had it done failed to properly sanitize the needle used, and he acquired a fairly nasty staph infection which proceeded to eat away at his back bone and damn near paralyzed him.  He was in the hospital for several months, and still has some problems because of it.

It would probably be a good idea to make sure your hospital doesn't have a bad record when it comes to infections. 

*blinks* Aren't needles meant to be single use, taken from sterilized packages?

[SADShooter]

Thanks for the input. Regolith, I'm sorry your dad went through such a mess.

skidmark, the way I understand the diagnostic element is that I will get lidocaine and cortisone, but dosed to assess if the injected locations are causing the pain, not necessarily as a long-term relief strategy, with possible additional injections depending on the outcome. There is radiologic dye/x-ray to verify injection sites, so thanks for the link.

[Regolith]

*blinks* Aren't needles meant to be single use, taken from sterilized packages?

I think so, but the needle can still be contaminated after it's removed from the package. For instance, the person using it could have failed to wash properly, or could have touched the needle to something that was contaminated. I don't know exactly what went wrong, only that the needle was the most likely source, since the infection started deep in the injection site.

These kinds of things are probably relatively rare, though, so it shouldn't be a problem for SADShooter, but it's something to be aware of.

[HeroHog]

They tried them on me but they didn't work. Don't let that discourage you though. Each case is different! They tried deadening the nerves, local injections of steroids and who knows what all else and none of them worked for me. Pain management is what I was left with. I just have to live with the pain and the meds that keep it at a level I can tolerate and I am VERY limited in what I am physically able to do these days. Because of all that, I am 100% disabled and lost everything. It took over a year to get my Social Security Disability approved and some income coming in again.

[MillCreek]

I think so, but the needle can still be contaminated after it's removed from the package. For instance, the person using it could have failed to wash properly, or could have touched the needle to something that was contaminated. I don't know exactly what went wrong, only that the needle was the most likely source, since the infection started deep in the injection site.

These kinds of things are probably relatively rare, though, so it shouldn't be a problem for SADShooter, but it's something to be aware of.

Actually, it is more likely that the infection could have been caused by contamination of the injected solutions, or that bacteria from the skin could have been carried into the injection site.  The fact that it was a staph infection makes me think about skin contamination. 

[dm1333]

SADShooter,

I've had cortisone injections into my shoulder for arthritis and into my lower back for pain from thrown hard against a 90 degree knife edge on a boat.  None of the three shots I had worked all that well but don't let that hold you back.  The two shots in my shoulder offered some temporary relief but I also had a torn rotator cuff, torn ligaments, etc.

Three things have really helped my back and shoulder pain, riding a bike, core exercises and body weight exercises like push ups, pull ups and dips.  If I stop any or all three of them within a week or two I start to feel creaky and have trouble bending over and sometimes even walking.  I don't know that cycling would help with your problem but if you have a bike or a membership at a gym it may be worth a try.  My back is a little sore right now from not riding at all this weekend (rain and fog) but if I ride to work tomorrow I can almost guarantee my back will feel a whole lot better. 

[Jim147]

I had a couple shots in my back. They stopped at two because they had no effect. I had one in my hip and it helped for about a month or two.

I had surgery in '01 on two disc's. It helped until last fall. The lower back and hip don't always hurt, but I've had a charlie horse in my calf since I reinjured it last year.

jim

[RoadKingLarry]

My wife has been getting it done for a couple of years now. I think she goes in either every 2 months or every 3. She claims it makes a huge difference for her.

[Pharmacology]

I think so, but the needle can still be contaminated after it's removed from the package. For instance, the person using it could have failed to wash properly, or could have touched the needle to something that was contaminated. I don't know exactly what went wrong, only that the needle was the most likely source, since the infection started deep in the injection site.

These kinds of things are probably relatively rare, though, so it shouldn't be a problem for SADShooter, but it's something to be aware of.

It most likely happened in their IV lab, if the person preparing the stuff didn't follow USP 797

[Grebnaws]

I believe you are talking about a different series of diagnostics and injections than I've had experience with. I am young and not very heavy but already suffering from a variety of back pain and injuries. Four weeks ago I received a toradol injection after dislocating my sacrum. The crushed nerve and corresponding inflation have caused severe pain and almost complete helplessness. The shot helped me briefly but the next few weeks of muscle relaxers, opiates, and steroids shave clouded my memory of how useful they were when judged individually. So far it's just been a few weeks of absolute misery and I dread the future knowing what pain lurks inside me.

Has a chiropractor been useful to you for any kind of long term pain relief or recovery of your back injuries? It is the only treatment I'm using right now and have felt improvement. My chiropractor has helped with the near total recovery of a damaged disc and crushed nerve between L5 and S1.

[SADShooter]

Thanks, all.

If the docs are correct and this is arthritis-induced, then obviously it isn't going away. Hopefully I'll get some luck and the injections will help. Anecdotally, though, the odds don't seem very good. I'll keep plugging away at the PT and core strength/flexibility regimen. Honestly, when I manage to avoid injuring myself, that's what seems to give me the most relief.

[vaskidmark]

Cortisone does not help much with arthritis because it does not address the causes of the symptoms.  Depending on whether it is osteo- or rhumatoid arthritis will indicate what treatment will provide the maximum possibility of relief.

If you are not hooked up with a rhumatologist, do so ASAP.  They will save you lots of time that you might spend with a GP or internist while they try other stuff instead of dealing with the arthritis.  And what works for one type can be anathema for the symptoms of the other type.

stay safe.

[roo_ster]

If you do get some relief from the injections, do your darnedest to get exercise & diet while the stuff is working.  When I tore up my leg, I would take the pain meds and after they were working, I would proceed to work it out.  Helped me recover most of my mobility.  If I had to do it through the pain, it would have taken longer or maybe I would not have recovered as fully.

[SADShooter]

Please cross any available digits on my behalf. I go "under the needle" tomorrow morning. With luck, I'll be writing more-than-usually incoherent posts by afternoon, or asleep at home.

[GigaBuist]

Good luck, man!

[AJ Dual]

Interesting read.

My father's had several cortisone shots into his shoulder and has found they work for him up to a year, and I suspect I'm going to find out soon. I'm only 37, but I've been having recurring problems in my fingers, wrists, neck and ankle that I assume are osteo-arthritis.

Mrs. Dual was having an epidural for the delivery of our second set of twins, and when the Anesth. hit her spine, both legs shot down ramrod straight, launching her off the bed.

"Keep Still!" is really Dr. code-speak for "OH MY GAWD! MY MALPRACTICE INSURANCE PREMIUMS!" 

[Lee]

I had it done once, several years ago.  It worked very well...too well maybe.  I never did the recommended PT, because I felt so well.  I've not had one since, but if the pain returns to the level it was back then, I would not hesitate.  I do have to admit though, the idea of someone sticking a needle deep into my back was scary then, and scary now.  Good luck.

[geronimotwo]

i hate needles, but the procedure did help with my lower back muscular pain.  i also felt woosy after, so they would let me sit and rest for a few minutes until i felt better.  i think the cortizone lowers your bp?

[SADShooter]

Back at home after a substantial brunch. No problems, no pain so far. Now we wait to see if the cortisone does its job.

Thanks very much for the feedback and support. 

[geronimotwo]

good luck, pain sucks.

[Viking]

Interesting read.

My father's had several cortisone shots into his shoulder and has found they work for him up to a year, and I suspect I'm going to find out soon. I'm only 37, but I've been having recurring problems in my fingers, wrists, neck and ankle that I assume are osteo-arthritis.

Mrs. Dual was having an epidural for the delivery of our second set of twins, and when the Anesth. hit her spine, both legs shot down ramrod straight, launching her off the bed.

"Keep Still!" is really Dr. code-speak for "OH MY GAWD! MY MALPRACTICE INSURANCE PREMIUMS!" 

I was talking to a guy at my job about that, he'd gotten cortisone injections in his elbow (tennis elbow). He'd gotten relief for over a year. Another guy he'd worked with had also gotten injections, for him it lasted just two months. He got another injection to see if it would help, otherwise he's in for surgery.