# Received my second "Lumbar Epidural Steroid Injection" today



## Turmoyl (Aug 1, 2008)

(You can read about this procedure here.)

Like many people I have lower back problems, specifically at L5-S1. Mine stem from a few injuries, some dating back as early as my teenage years.

In 2002 things had progressed to a debilitating point and in lieu of a full surgical option (which are not exactly great things in today's medical arts) I was sent to a Pain Management Specialist who tried some trigger point steroid injections (into the main muscles of my lower back) while I was under general anesthesia to little effect. Early in 2003 the Specialist decided to inject directly into my spinal column instead, at the caudal (tail bone) space as well as laterally at L5-S1, L5-L4 and L4-L3, while I was under general anesthesia. While I have since learned that this is considered overkill it totally did the trick of stopping the spasms in my lower back muscles and taking away that constant and maddening hot clamp feeling at L5-S1.

This allowed me to go through 2.5 years of physical therapy where the main focus was strengthening my trans abdominal muscles, and lots of massage and ultrasound therapy which helped break up some of the scar tissue and "floating" calcium fragments in the area of L5-S1 (to make a long story short that junk was from an auto-defused auto-fusion; pretty ugly stuff).

After almost two more years of protecting my back from re-injury and also moving to a new city I was cleared by each of my new primary Doctor, his chosen Radiologist and my new Chiropractor to become physically active again. As such I started roller blading last Summer, learned how to snowboard last Fall at the age of 35 and continued with it through the Winter, and then got into mountain biking starting in May of this year. I also started mixing in some road biking for running errands in July.

Things were going better than I expected until I started getting to a point with the mountain biking that I could do some of the bigger climbs. This started strengthening my core like nothing had before and while this will be a good thing for my back in the end as having large muscles helping to support the damaged area at L5-S1 will be a great benefit it also caused a more immediate problem in that it began to pull on that area and move things around and generally irritate the crap out of it.

I loathe narcotics so I dealt with it the best I could using the stretching exercises I've been taught along with some homeopathic medicines such as Arnica Montana and Kali Carbonicum, but the issue continued to worsen as I continued to bike. This manifested in a self-defeating loop where the irritation to the damaged area would cause the large muscle groups in my lower back to spasm, and because the muscles are stronger now so are the spasms, which irritates the damaged area even more, which makes the spasms that much stronger, ad nauseum. By the beginning of August it had progressed to a point that a full 10 minutes of stretching and Yoga exercises would only offer 3-4 minutes of relief until the spasms returned and locked everything up. I haven't had a decent night's sleep in about 2 weeks.

As such I knew it was time for some more steroid injections. My health insurance is excellent but is in an HMO format so I went to my primary for a referral to a local Pain Management Specialist. We met and he sent me for an MRI and then got me onto his surgical schedule for today.

He does business much differently than the last fellow. He only injects one site at a time, which is apparently the way everyone in this part of the country does it, and he also does it only using local anesthesia. This was a totally new experience for me and while the thought of it made me nervous I used some light breathing and meditation exercises to calm myself down, and declined the offer of an intravenous sedative. My pain management Doctor is also a mountain biker (we plan to hit some trails together once I'm all taken care of) and the Surgical Nurse assisting him today likes to run the trails so while my naked butt is up in the air and they've got a catheter in my spinal column and are verifying placement with fluoroscopy and injecting a cocktail of contrast dye, local anesthetic and corticosteroids we all had a conversation about the trails in the area of town that we all live in. It was quite surreal, and the whole event was over in just a few minutes.

The relief so far is equivalent to what I experienced the first time I had this done. The spasms have stopped for the first time in over a month and the range of motion throughout my spine has returned, allowing me to self-manipulate things like my cervical spine and hips once again. The one difference is that I have a bit of discomfort in the area of my spine where the work was performed today, but it definitely feels more like a local irritation than the joint-type issue I'm used to. I hope this sensation will pass over the next few days, leaving me as near 100% as I can be.

My Doctor has ordered me to take it easy through tomorrow, but says that I can do the grocery run using a bicycle this weekend as with one small exception the route is fairly flat. However, I am to stay off of my MTB until a week from Saturday (8 days) in order to give the steroids a chance to run their full course and do what they are meant to do.

I've already been off the MTB for about a week in order to avoid any tertiary injuries that would require taking a medication or treatment that would have disqualified me from today's procedure, but rather than be upset about this "outage" I try to look at it as a small price to pay to keep my lower back going along without a major surgery, and consider myself lucky to be able to participate in these sports at all.

For those curious about the financial costs of this it has been minimal on my part due to our excellent insurance (for which I thank my employer once again). I have been able to keep everything within the HMO so my only out of pocket costs so far have been a $5 copay with my primary Doctor, and a $5 copay with my Pain Management Specialist, for a total of $10. The MRI was covered at 100% as was today's procedure, and I have taken no prescription nor other synthetic medicines. I expect to have follow up appointments with both of my Physicians over the next week or two so my total expenses will come to about $20.

I'm heading off to what I anticipate will be a good night's sleep now.


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