texasspondy

I had my first ESI one week ago today, Wednesday, and my follow up appointment today.

I don’t have the report but pain management doc showed me the pictures of the needle under xray. If I understand right he did a shot of anesthetic (numbing) and steroid to both sides of the L5 area, I believe to the pars area, and also he said he put some in the canal.

What I experienced was this….. I woke up from procedure, groggy, but got home and took a nap, and I would say that day, no real pain/aggrivation to the L5 area.
Next few days were very sore, but like I was bruised and it was tender just to walk, don’t know if that might of overshadowed the original pain but original pain was not on my focus. After about 5 days, the shot tenderness/bruise feeling wore off and the cycle of aggrivated type pain returned then muscle tightness/spasm tight pain returned on right low back, then today on left low back.
So it’s kind of back where it was before I went to have injection.

PMS doctor, said he would recommend another injection due to the fact the first roughly 24 hours the original pain had subsided. He said, at least some of the medication hit the area aggrivating me. He would this time injection the pars again but also put some in the central canal as opposed to the side to see if that hit the area better.

Anyrate, I had put for a promotion to an supervisory type of position with my current skill set and unfortunately found out that I was turned down due partially to my sick occurances last year, which was because of my back. One of the reasons I was looking for this promotion is to get away from the physical aspect my job can entail sometimes as a mechanic. Although honestly right now sitting aggrivates the area so not sure which is worse.

The question I am facing Dr. Corenman, if these shots don’t work, and I have to have surgery, is the pars repair, due to my age of 40, pretty much out of the question? If I do indeed have to have a TLIF, L5-S1, in your experience, have some of your patients been able to return to some physical labor work? And if so, my surgeon had said minimum 3 weeks for an office job, and I would guess 6 months for a physica type job if at all?

Hi Dr. Corenman. Since I last replied, I had an office visit with my neurosurgeons PA. Very nice guy and seemed very informative as well to my questions.
He was pleased and impressed I had done much research on my condition and was asking questions, he said he wished more patients did so.
Anyrate, as we talked he did mention one thing which I found interesting/confusing.
In the topic of when does one decide to have surgery, I said to him I will deal with it as long as I can tolerate the pain/symptoms conservatively, and when I can’t bear it any more, I will give in to surgery. He responded with, you really should consider having surgery when or if your quality of life has degraded to a point that you no longer enjoy much of the things you use to enjoy, so have surgery to give yourself a quality of life back.
Then he said, you should not have surgery due to pain, because we can give you quality of life back, but can’t guarantee pain removal. I guess I thought they went hand in hand but it kind of took the wind out of my sails, your thoughts??

He was all for setting up a Epidural spinal injection with a Pain Management Specialist. So they referred me to a doctor. I got into see him and he had my images and report. He also did a few tests of holding my hips and having me try to bend over to touch my toes (which was poor and difficult) benc back (which was easy), and try to turn to the sides, he concluded that he felt my spondy had not slipped yet, there was enough holding things in place, and has me scheduled for next wed a epidural I believe around the area of minor disk bulge L5 and one or two other nearby locations.

I should also add some information I note that you mention in a number of other posts. I really can’t say I have leg or foot pain/tingling. It’s mainly left low back/si/QL area. I do have couple lipomas (so I’m told) around this L5 area that feel sometimes bruised from sitting but I’m guessing that’s referral pain. Honestly sitting seems to aggrivate it worse. Walking feels better, and just standing doesn’t seem to aggrivate it as bad. My P/T generally makes it feel less aggrivated but that’s usually short lived.
I actually yesterday purchased your new book, I don’t expect my symptoms go away with your book, but maybe I can get an even better visual as to what is happening when. One of my biggest dilemmas with this problem is knowing how to do the correct excercises to not aggrivate it. My P/T folks gave me a number of things for core work, I’ve worked on that 3 months now. My chiropractor took a couple things out, said he didn’t like em and added a couple other things (superman and back extension raises 30deg only), then I read online superman is the worst thing one can do for foramen problems. It so frustrating to know what to do and not with all the information out there. The neurosurgeon said yoga was great and really only prohibited me from squats and axially loading the spine from above the shoulders.