Lumbar Cortisone Injections…

Citroënbender · 04-01-2023, 08:59 PM

I have been “prescribed” this for improved mobility and pain relief by a local doctor, after having my back scanned. Guess it’s a big positive that nothing is broken.

Sure that others here have been down the same road. Naturally I’m a little apprehensive (isn’t everyone about their first time?

). So - curious to hear from anyone with similar experiences, what sort of initial discomfort to expect, how long until any benefits are felt?

FERG_51 · 04-01-2023, 10:18 PM

Hi Citroenbender, I had a really bad bout of sciatica down my left leg that almost brang me to tears for about six weeks where scans showed I have damage to L5 and L6 discs in my lower back, I had the lumbar injection and within a couple of days I was much better. The physio gave me some excercises to help when the pain comes back which I don't do as regularly as I should, I don't have the sciatica pain but my back gives a bit of grief at the end of the day. I also get spasms down the left leg at nights which wakes me up until I can shake it off and my left big toe is numb which is due to the damaged discs. Short answer is the injection helped for sure, was quiet painful but didn't take long to be done.

Citroënbender · 04-01-2023, 10:21 PM

That’s really helpful, thank you.

prktkljokr · 04-01-2023, 10:46 PM

I have a herniated L2, did it 23 years ago, I have good days and bad days, but I have realised that the bad days are my own doing, I have never taken any medication for it but as I am getting older its taking longer to recover, so I might start looking into either having injections, or going on some medication that I can take on the bad days, so I am very interested in what other people have done to cope also.

CFOUR · 04-01-2023, 10:58 PM

cortisone injections will almost certainly negatively affect your eyesight.

Citroënbender · 04-01-2023, 11:10 PM

C4: I’ve honestly never heard that before - but I don’t generally Google medical stuff. Where did you hear about this?

PJ: Doctors used to throw around pregabalin (correct name of Lyrica) for a lot of nerve type pain but I think this is now less recommended. I’ve personally seen a family member become slightly addicted to it, and experience mild withdrawal symptoms.

arm79 · 04-01-2023, 11:38 PM

Have you had Cortisone or Prednisone before? Even in oral or cream form?

Only ask because some people are rather allergic to it. Creams and oral are easily stopped if you have adverse reactions, but once its injected your stuck with it for a bit.

Dad is allergic to both, they are from the same family. Will cause a nasty red itchy rash over his whole body that takes days to get relief. Pills and cream take a day or 2 to show up. Injections cause redness within 6 hours.

Adverse reactions can be much more severe too.

There have been a couple of times Dad decided to weather the side effects and have cortisone injections in a shoulder and knee. To him it was almost an instant night and day recovery while the injection lasted.

prktkljokr · 04-01-2023, 11:55 PM

Quote:

Originally Posted by Citroënbender

PJ: Doctors used to throw around pregabalin (correct name of Lyrica) for a lot of nerve type pain but I think this is now less recommended. I’ve personally seen a family member become slightly addicted to it, and experience mild withdrawal symptoms.

Yeah got a mate with a bad back also, he's on whatever the doctor has prescribed, I tried 2 once they made me nauseous, 1 is not bad, but probably still a bit strong for me or I am not as used to them as he is, he throws them down like peanuts but he is no better than me pain wise.

I find if I spend a bit of time in the pool it loosens me up so I try to do that as much as I can.

Citroënbender · 05-01-2023, 03:28 AM

Quote:

Originally Posted by arm79

Have you had Cortisone or Prednisone before? Even in oral or cream form?

Only ask because some people are rather allergic to it. Creams and oral are easily stopped if you have adverse reactions, but once it’s injected you’re stuck with it for a bit.

Fair point, apart from hayfever I don’t have a predisposition to allergies. At this stage I think your father’s idea is where I’m probably sitting - even a reaction is OK if the pain is reduced. Can work with a rash, whereas now I struggle to check the mailbox.

LG17 · 05-01-2023, 08:02 AM

I only have 91/2 fingers due to being on a high dose of Lyrica - horrible stuff.
I have CRPS (Complex Regional Pain Syndrome) because of a bad crush injury to my left foot and my pain specialist suggested lumbar injections as a way to cope and lessen the pain. From memory I had 5 of them over a period of months. Each one did help but the assistance lessened as time wore on. I had no side affects.
I was apprehensive before my first one, despite my specialist saying it would be ok. After the first one it was just another step in my possible recovery.

PooDog · 05-01-2023, 08:29 AM

Hey CB ,I've had a bad back for years , got about 3 munted discs I've had a few injuries and had a cortisone injection a couple of years back I was told by the doctor some people it can last for up to a month but others only a couple of days it was almost instant relief but unfortunately for me it only lasted a couple of days , so I haven't bothered again

I was offered one in a damaged shoulder years ago and decided not to as I was told that the cortisone weakens ligaments because I do a lot of physical work ....so I presume it wouldn't be good for the ligaments in your back either

Your call , I sympathize with your position I just suck it up but it's getting harder the older you get

Good luck

PooDog · 05-01-2023, 09:36 AM

Oh ,forgot to say the injection did not hurt really at all ....I was expecting worse

Itsme · 05-01-2023, 11:43 AM

I have only had two Cortisone shots in my life, one for back ailment and the other for shoulder problems, Cortisone should only be used as a last resort if other remedies fail.
Your treating physician should explain the pros & cons especially if you have other ailments or health issues.

tbro4123 · 05-01-2023, 09:20 PM

After having 2 disc fractured L1 & L2 and 7 herniated disc after an industrial accident in April 2020 my specialist recommended this treatment purely as a pain control. As you can imagine it was a bit scary, but after he explained that they would do an MRI and locate the areas for injection and then mark the spots and then inject the spinal area.

It worked after a couple of days and lasted probably 3 or 4 days but that was far better than taking the painkillers I was on (oxycodeine) 4 or 5 times a day and it allowed me to do some physio to help recovery.

If your in pain go for it. I also have had both knees and shoulder injected and my previous doctor told me that 3 times is pretty well all you should have the injections, if you need it more than that you need to see a specialist for treatment ( I had knee and shoulder ops to repair damage)

Terry

Citroënbender · 05-01-2023, 10:02 PM

Good information, thanks for all replies so far. It’s disappointing to hear how quickly this wears off but encouraging to hear of so few side-effects. My dearest is waiting on a new right hip (August, with the left one an estimated eighteen months later) and rips through painkillers - it’s not my preferred MO.

One of the companion issues I’ve apparently got is narrowing of the “bore” in one’s spine such that it slowly constricts the spinal cord over time. Eventually surgery to ream it out, will be required. Hopefully the current condition will taper off with time, injections, gentle exercise and return to near this baseline.

prydey · 06-01-2023, 07:13 AM

Quote:

Originally Posted by Citroënbender

Good information, thanks for all replies so far. It’s disappointing to hear how quickly this wears off but encouraging to hear of so few side-effects. .

I was led to believe that the interval between injections would continue to grow. The effect may only last months the first time but 2nd time might be a year and 3rd time longer and so on, until no longer required that often at all.

I suffered from a badly bulging disc that was impacting the sciatic nerve early last year. Physio wasn't able to improve it and eventually I had an injection in May. 2 weeks later I was able to sit down again having got to a point where I could barely sit.

For me though the specialist determined that surgery was my best path forward as scans showed the bulging disc was large, so I went under the knife in July(L5S1 microdiscectomy). I'm 5 months in to recovery and while I'm still sore if I do too much I am expected to make a full recovery eventually.

I would definitely say that surgery should be a last resort though.

Depending on the severity of the inflammation, injections should give reasonable relief and can last many years eventually. It's more about accepting that it's not a magic quick fix or wonder drug and working with the specialist and doc and physio to reach a suitable outcome.

prydey · 06-01-2023, 07:18 AM

Quote:

Originally Posted by LG17

I only have 91/2 fingers due to being on a high dose of Lyrica - horrible stuff.
.

Sorry to hear that. Lyrica worked well for me. I was on the max dose of 300mg twice a day in the months leading up to surgery and couldn't have got through without it. It was used as a nerve blocker. I'm still on it but only 50mg now, twice a day and gradually weaning off.

I've had no side effects during the time I've been using it but everyone reacts to medication differently.

LG17 · 06-01-2023, 01:07 PM

Quote:

Originally Posted by prydey

Sorry to hear that. Lyrica worked well for me. I was on the max dose of 300mg twice a day in the months leading up to surgery and couldn't have got through without it. It was used as a nerve blocker. I'm still on it but only 50mg now, twice a day and gradually weaning off.

I've had no side effects during the time I've been using it but everyone reacts to medication differently.

I too was on 600mg per day for months.
I spent the entire time as high as a kite and just floating through the days. After I lost my finger they decided to get me off Lyrica and on to Gabapentin as it's side effects were supposedly not as bad.

asagaai · 07-01-2023, 12:02 AM

Hey CB

A LOT of my work involves reading peoples medical files and injuries, common cervical and lumbar injuries,

Over many years of observing people get cortisone injections for back/neck/shoulder my observations is that it provides some people relief, some people little relief, some people no relief.

The duration of relief if achieved ranges from days to weeks.

It is anti inflammatory and so it really depends on what the underlying pathology is.

The common advice with back injuries is reduce weight, increase cardio vascular fitness, cut smoking and do exercises like swimming etc.

I crush wedge fractured my T11 and 12 thoracic vertebra in a rock climbing fall in Thailand when a bolt snapped and I fell some 6 metres onto a ledge.

When hunched over a desk working on a big file for a day, my thoracic spine gets really painful.

My remedy THAT WORKS- I get a black rubber exercise roller, place under my back on floor, and with feet on ground only and my back and body supported fully by roller underneath I roll my back up and down the roller, and my body weight cracks the spine as it rolls over the thoracic area. I can feel the crack and the release of pain is instant.

I get immediate instantaneous relief- no further pain until another day of flogging and flagellating myself with folders on the desk.

Guess what I am saying is cortisone injections is a questionable modality relief that it only temporary and depending on your pathology there may be other better more natural relief modalities.

Good luck

Citroënbender · 07-01-2023, 11:42 PM

Good to have your seasoned perspective, too - thanks.

I’m really hoping for some relief via injections, a reset of the baseline. When it hurts whether standing, lying or sitting, you’re kind of low on options for comfort/relaxation.

Took Oxycodone again at 2AM and it removed 85% of the pain for about six hours (paracetamol and ibuprofen weren’t doing much). Things are improving though, a fortnight ago the same barely made an impression. I wouldn’t double up because I can feel it suppressing my breathing at the single dose.

prydey · 08-01-2023, 05:09 PM

Quote:

Originally Posted by asagaai

It is anti inflammatory and so it really depends on what the underlying pathology is.

Very true. If the pain is being caused by something that is unable to reduce back to its normal size, then anti inflammatory won't help and definitely not long term.

prydey · 08-01-2023, 05:11 PM

Quote:

Originally Posted by Citroënbender

Took Oxycodone again at 2AM and it removed 85% of the pain for about six hours (paracetamol and ibuprofen weren’t doing much). Things are improving though, a fortnight ago the same barely made an impression. I wouldn’t double up because I can feel it suppressing my breathing at the single dose.

I was on palexia slow release for pain relief. It's still a narcotic but I don't think it's as addictive as oxy.

Citroënbender · 08-01-2023, 05:37 PM

I’m not a fan of opiates, some seem blunter than others in how they work, but I don’t feel it’s consciable to drive while they’re still working on me. The bulk-billed GP I saw last week was not really interested in discussing pain management before firstly a scan (I get that part) and secondly not before the recommended injections. If I can’t get that done early in the week I’ll probably go around him to a different doctor.

It’s ironic that the 1m breaker bar I ordered just before this broke loose, makes a good walking stick.

arm79 · 08-01-2023, 06:03 PM

Quote:

Originally Posted by Citroënbender

I’m not a fan of opiates, some seem blunter than others in how they work, but I don’t feel it’s consciable to drive while they’re still working on me.

Avoid at all costs. They screw with you and are hard to get off.

Dad has been on Tramadol for years. Even after getting his knee replacement it's been insanely difficult to get him off this medication, best we've done is lower his dosage 25% over the last 2 years. Doesn't help his GP is a useless ****wit douche who has no interest in helping making happen.

Your body does get used to the medication and you can act 100% normal when on it, providing you don't miss a dose. Missing a dose turns you into a 2yo having a tantrum. But it does screw with your breathing. Dad has oxygen saturation levels that drop into the high 70's to low 80's regularly and that is all attributed the long term use of this pain killed and another med he is on.

My understanding of them is all they do is increase the ability to mask pain and decrease the pain threshold.

For a more realistic explanation, you to your GP and say "I have pain level 2" and the GP gives you a low dose of opioid pain meds. You take them and get instant relief.

Sometime down the track, we're probably talking months here, your brain is still registering pain level 2 but recognises you are "ignoring" it by virtue of the medications masking the pain. So the brain goes "this idiot doesn't realise they are in pain" so it starts to artificially increase the pain level until you start to notice it.

So at this point your brain is signalling pain level 4, but in reality is remains an actual pain level 2. So off to the GP you go and say "but it still hurts, what do I do" and the GP ups the dose... Rinse and repeat, the cycle starts again.

And that's where the danger lies. You end up feeling pain level 10 for an actual pain level 2, on a max dose of opioid that your body has now become addicted to and is incredibly hard to stop using. Even on max dosage Dad is still popping anti-inflammatories and paracetamol like lollies and still complained of pain. His GP then tried to move him to Targin with poor results.

The Feds have really cracked down on opioid scripts these days too. Getting on them are difficult, you must have regular pain reviews and if you do get a script then the best you can get is a 20 day supply without a special authorisation. Goes to 30 days with special authorisation. Used to be a straight up 60 day supply. So you are forever at the GP organising repeat scripts.

So you'll probably find the GP is going through the moral, ethical and legislated motions before considering putting you on the hard stuff.

prydey · 08-01-2023, 07:32 PM

I was on palexia for approx 4-6months, starting at 50mg twice a day and working up to 150mg twice a day over the space of a couple of weeks before the pain was managed. After surgery, once I was released from hospital, I stopped. Cold turkey. No side effects. No withdrawal symptoms. There was some side effects while on the drug, mainly with little things like not recalling words etc, or not being able to get the right words out etc. I'm sure there were other minor things but nothing serious.

I agree they should be used only if absolutely necessary however. I was being seen by the head of pain management at Flinders hospital here in Adelaide.

Regardless of any advice myself and others give, only use medication under the guidance of your own doctor and specialist. Everyone reacts differently.

Citroënbender · 10-01-2023, 02:55 PM

Friday 13th I get pinged, hope they recognise the date and add some carbon black as a tracer.

Pain levels are diminishing but still not close to fit for my normal work tasks.

HIPO · 10-01-2023, 04:38 PM

Good luck! had a disc replaced with a carbon fibre one many yrs ago... also suffer with sciatica.... had many meds - opiates since.... as much as i enjoy some opiates they can mask pain, allowing you to stuff yourself up more before realizing it..... NOT fun to come off of either!

LG17 · 10-01-2023, 04:57 PM

Quote:

Originally Posted by prydey

I was on palexia slow release for pain relief. It's still a narcotic but I don't think it's as addictive as oxy.

I have been on oxycontin, oxycodone, palexia and am now on morphine for severe pain. Fortunately I have never had any signs of addiction.

Even the morphine doesn't seem to work that well. My doctors are starting to look at cannabis oil. I just have to work out the driving thing as I live in a rural area where obviously there's no other form of transport.

HIPO · 10-01-2023, 05:46 PM

I found the Buprenorphine 7 day patch to have the least side affects, but after several yrs stopped lasting the 7days, so would be withdrawing regularly..... dropped that recently & am trying to go just 20 Endone per month, which were meant for break through pain with the patches.....ok so far.
Oxycontin IR was my fave, euphoria & wire me for action, but does no good in the long run..... terrible withdrawals. Beware of this stuff!

prydey · 10-01-2023, 07:23 PM

Quote:

Originally Posted by HIPO

Good luck! had a disc replaced with a carbon fibre one many yrs ago... also suffer with sciatica.... had many meds - opiates since.... as much as i enjoy some opiates they can mask pain, allowing you to stuff yourself up more before realizing it..... NOT fun to come off of either!

For myself, the medication was simply to help with the pain. It was never administered as a solution so that I could continue my day to day life. Dr and surgeon made sure that I understood I still had to take it easy and not do things just because the pain had eased.