lumber epidural steroid injection
I also go in for lumbar epidural steroid injections as well. I have had 7 rounds thus far and scheduled to go back in Aug. I have on several occassions experienced intense shooting pains down my legs when the steroid is injected. This is typically normal. I unfortunately experience that type of pain periodically at home or at work so for me, the sensation is very familiar. The sensation is caused by the medication rushing up against the nerve roots to "bathe" them. Did they use fluroscopy or X-ray when they performed your injection?
Not everyone gets meaningful relief from epidural injections. The injections for me, help a lot with the low back pain but only help the sciatica for a couple of days to a week and the sciatica slowly starts to build back up.
I truly believe I am getting beneficial results from these injections because of the other medications that I am taking for pain: long-acting/short-acting opioid medications, cyclobenzaprine, valium, gabapentin, 4-5 OTC naproxen sodium tablets, and an anti-depressant. I most certainly believe the medications you are taking are helping you and also helping the injections work more effectively. The Gabapentin and the meloxicam are medications that significantly help reduce sciatica. As when a nerve is compressed in the low back, the resultant sciatica is due to nerve inflammation and the meloxicam directly helps reduces that inflammation. Gabapentin works by increasing a chemical in the brain, called Gaba. This helps block the pain signals sent by the inflammed/pinched nerve from reaching the brain. Gabapentin is much more helpful at relieving nerve pain than the most strongest opioid pain killers. Cymbalta is also good for this type of pain as well and it is a SNRI anti-depressant.
So in summary, you are on a good mix of medications. Asking your doctor for an increase in Gabapentin would be a good step to take if you are still experiencing severe sciatica. Doses of Gabapentin go up to 3600 mg per day so you are on the very low end of dosing. You are maxed out on the cyclobenzoprine. An increase in the meloxicam would be the other recommendation if your stomach can tolerate the higher dosage.
The epidural steroid injections take 1-2 weeks to become effective and before this takes effect, increased pain is normal. However, if you see pus or swelling at the injection site, get to a local ER asap as this is a sign of a serious infection. The ESIs are generally effective for 6-8 weeks. So the effectiveness is not very long lived.
I experience my worse leg pain in the morning when I wake up so upon waking I take 600 mg of Gabapentin, 2 Aleve (naproxen), and 10 mg of oxycodone IR. This combo helps me to be able to at least get dressed in the morning but the pain begins creeping back after 2-3 hours. I am also on the Fentanyl patch which as you probably know is the strongest opioid medication on the market and it still leaves me with a large amount of nerve pain. So take my word as bond when I tell you opioids are not very effective on nerve pain.
My diagnosis is discussed in detail on my profile page. In short, I have a ruptured disc at L4-L5 that is pressing on the spinal cord and right/left nerve roots. At L4-L5 there are bone spurs, osteoarthritis, spinal stenosis, and thickening of the ligamentum flavum. I also have problems at the L5-S1 level. Been told I need a 2 level lumbar fusion but I would never agree to it as it is only 50% successful at relieving pain and many times makes it worse...much worse. I have contacted the Laser Spine Institute and hopefully will get a minimally evasive discectomy soon. I recommend looking into laser spine surgery. They can fix issue with the discs, nerve roots, and bone by making a very small incision and using a laser. Typically, general anesthesia is not needed and there is no hospital stay and you can go home the next day.
Good luck to you. I am a mom of a 6 year old son so I know what you are talking about when you say that your kids need you. I haven't been mommy for awhile and I am ready to be mommy again too. I hope this helps. Take care.
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