When Should I get an ESI - Epidural Steroid Injection? | Dr. Sheena Bhuva, PMR in Plano explains.
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- Опубліковано 19 лип 2020
- When Should I get an ESI - Epidural Steroid Injection?
Dr. Sheena Bhuva, Physical Medicine & Rehabilitation specialist at Texas Back Institute talks about ESI (Epidural Steroid Injections) and when to have one as part of your spine treatment. Dr. Bhuva describes the treatment for radicular pain or sciatica, which is pain, numbness and tingling running down the arms or legs from a spinal nerve. Many people experience radicular pain from stenosis, disc herniation, or a pinched nerve.
An ESI is typically recommended after anti-inflammatory medications, nerve medication, followed by physical therapy. This injection helps patients find pain relief from radicular syndrome. In some more severe cases an ESI can be given to help relieve pain in order to maximize the ability to do physical therapy.
Epidural Steroid Injections help reduce inflammation and irritation of the nerve being pinched, it does not un-pinch the nerve.
#EpiduralSteroidInjection #Stenosis #PinchedNerve #eşi #backdoctor #spinecare
For more information about ESI - Epidural Steroid Injections visit: texasback.com/treatments/inje...
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Thank you Doctor!
Thank you for concise and to the point information and still telling every aspect 🙏
i have a dessicated l5 disc. Its black as the night. it hasnt lost its thickness yet. im 43 and always a physical hard laboring guy. I have constant ache and soreness. PT didnt do anything as this has been a long 20 year issue. Waiting to hear back from Dr about my next step since I just got this MRI finding
If I don't have the sciatica pain down the leg is it still an option?
I have failed hernia Mesh surgery that prevents me now from doing the physio that use to deal with my back issues and lost my core strength so now I'm in constant pain
Would you recommed a epidural for diagnosed cervicogenic headache (diagnosed by neurosurgeon)?
How to start testing
Hi Doctor, i have 2 epidural shot into low L4 (narrow) does epidural shot does not work
On me (2 days )
After all the shooting/tingling /numb is start back as it before . So does it mean I have to get surgery?
I have sciatica just recently both my legs have been going numb i have been to PT in the past im going to a chiropractor now the PT helped for a bit I was recommended to go see a chiropractor I've been going for a year now I been taking ibuprofen and Tylenol for the pain but recently it got worse and sometimes it's hard for me to walk cause my legs are to numb I'm running out of solutions and I don't want it to get any worse so would an ESI be my next step
Marko, Sorry to hear that, you will have to discuss this with your doctor. There are many options for patients, but each case is determined on your anatomy and condition. Our physicians are a great resource to discuss future treatment options. If you would like to schedule an appointment with a spine specialist give us a call at 972-608-5000, or visit www.texasback.com. Thanks
I still have sciatica for 2 years and i did physical therapy and now i still have it in 2023
sorry to hear that, if you would like a consultation with a specialist, call us at 972-608-5000 or visit texasback.com
Great video, is this something you do for osteoporosis pain? And how long does the injection last? Would it last for the whole month?
It should last more than that. If needed, three or four injections a year can be given
@@thecatatemyhomework Thanks for the info. It's something I may look into!! 😇🥰
Excellent information, my question is at what point does one skip the injection entirely and actually " fix" the problem at the source!
Jeff, thanks for the comment. Each patient is different depending on their anatomy and symptoms. Our spine specialists work with patients to find the treatment plan that fits their goals and condition.
Had a car accident. I'm supposed to get these shots. Does anybody have any feedback?
If someone suspects one particular disc is causing sciatic pain can an epidural steroid be shot in that disc "only" to see if that is the disc causing the pain? Also if someone has their pain masked by an epidural steroid and it keeps pressing on the nerve can that lead to permanent nerve damage instead of having a discectomy to fix the nerve sooner and allow the nerve to heal?
great question. i'm surprised this doctor hasn't replied.
I am due to have my first steroid injection. The doctor showed me on my MRI exactly where the nerve is being pinched and he said they inject the steroid exactly on the spot that is being pinched. They hook you up to a computer screen. Not sure of all the technical stuff but the doctor can look at the screen and know exactly where to inject the steroid.
As far as your second question, which is a great question, I don't know the answer to that.
@@thecatatemyhomework Let me answer my own question for you since the author of this video never did and the fact I have been dealing with the issue since 2017 now. I have tons of videos on my page following these 6 years in hopes of helping others. If you get an epidural steroid even at the L4/L5 disc if that is the one causing the pain or bulging or ruptured, it will or probably will still travel into the L5/S1 nerve root or discs above so that would not tell you which disc is bad. I actually had a doctor inject me with lidocaine at L5/S1 as a Diagnostic injection to see if that was the bad disc or was causing some of my pain. I knew going in it would only give me about 4 or 5 hours of relief if it worked but after the injection by the time I got home I was able to move around way better than before the shot. I have a video of the day before and an hour after the shot one above the other. This told me I do have some disc issues annular tears at L5/S1 not just L4/L5. As far as why they wait so long to do surgery like a discectomy is bulging disc will a lot of time, heal on their own if you take it easy. If you have a disc bulge that causes cauda equina compression or urine problems, sexual problems that is a ER emergency and they will operate right away. If you have muscle weakness from the nerve or trouble walking or standing they usually make you wait even though it can be excruciating. Luckily for me after my discectomy I was sciatic pain free and all my strength or most of it came back. Unfortunately I ended up rupturing the disc a couple of years later and had a fusion that did not fuse but that's a whole story I am dealing with now. Good luck to anyone dealing with back pain and I hope you find relief. All I can say is do anything before surgery you can do and if you are just in so much sciatic pain you can not sleep or walk or function then do the discectomy.
@@KBradAdams
Thank you for responding! I’m gonna go check out your channel
i went to a pain management doctor and he saw my mri and he said that my disc rip which means i don't have a bulging disc instead i have herniated disc. I asked him if the epidural injection only takes the pain away and he told me yes but that it also helps the disc shrink in size which means that it won't be touching the nerve anymore adnd said that it also helps repaid the disc. Is this true in all cases or just for some people? I am in severe pain all day even with strong pain medication!!
Were scheduled to have this injection. But i called and cancelled it. I haven't had a MRI yet so how will the doctor know where to inject. Plus if you are a diabetic having these kind of injections will spike you numbers up high and fast
It this also beneficial for back pain because of degenerative disc? I dont have too much problem with my legs but have pain in my back. My doctor told me its not because of herniation but mostly because of degenerative disc.
I like your question. I have the same issue.
I have swelling in my spinal cord d1 d2 and i cant walk is this injection is help full for me???
Hi Mhod, you need to speak with your spine specialist to find out the best treatment option for your condition. If you would like to schedule an appointment with the specialists at Texas Back Institute, give us a call at 972-608-5000. Thanks
I m 56 yrs old male n suffering from low back pain on n often. No herniation or bulge or anythng like that only schmrl’s nodes in L3 and L5. Otherwise ddd whick mri report says. Tried physio therapy n medication also but i m only little better, still can not do regular activities freely. Do you recommend ESI to me ?
I have bulged disc , but I have to go for physical test for police job can I go for this injection .plz reply
Sorry to hear that, if you would like to talk to a spine care specialist, give us a call at 972-608-5000, or visit www.texasback.com. Thanks
I have crippling sciatica and low back pain but my doctor said the MRI and xrays showed mild disk bulging and thecal sac flattening at L4 L5, and grade 1 spondylolisthesis at L5 S1 but its not bad enough to be causing my pain and injections are too risky but then said I need to go to a back surgeon. I took opioids, went to PT, chiropractor and did all the stretches and nothing helps. Is there anything else that can be causing the pain and anything outside of surgery that will help?
Sorry to hear that, if you would like to talk to a spine care specialist, give us a call at 972-608-5000, or visit www.texasback.com. Thanks
Welcome to hell buddy. I got the exact same diagnosis 13 years ago and its been nothing but a giant circle jerk with these doctors. I actually had grade 2 spondy same spot and the bulging disc.
13 years later my doctor thinks I am a junkie. Refuses to help manage my pain with anything but the garbage that doesn't work for nor is designed to deal with chronic pain.
Ill tell you, do not ever take gabapentin, tramadol, or an ssri for back pain.. Ever! These doctors, some of them, need to be taken out behind the hospital, beaten with a bat in their lower back, and then queried a few days later on their pain, then offered bs that doesn't work for pain.
The problem is most doctors I've come across are all healthy and intelligent in the sense they can spit back information they read somewhere, but none of them have ever felt an ounce of real pain in their life. I want a doctor who has and is dealing with chronic pain, because i'd bet my bottom dollar they aren't taking any of that bs they offer to us.
Its especially worse now after the whole opiate crisis, which has turned into a Chinese Fentanyl problem and much more disastrous. And I 100% blame ignorance on the whole thing because no one is over dosing on fkn 5mg percocet, and if they do, they deserve to be in the ground.
Swingblade, if you just got this diagnosis 6 months ago.. I will say one thing. Stay active! I basically did my best but with no pain relief, taking a walk become a challenge. Working, standing, sitting etc all became massive problems and now the pain is so bad I can't sleep on a normal routine as I will get into a normal day shift pattern of sleeping properly at night then boom! fkn Arthiritic pain and bull shit keeps me up till 9 AM!! and I am right back on this stupid night shift bull shit unable to compete in normal society, unable to work, unable to have a relationship, living on welfare and being denied disability because my doctor doesn't prescribe me .. wait for it... PAIN MEDICATION! haha.. Fkn circle jerk from hell.. Oh he's not getting an opiate pain medication so the pain can't be that bad, he can still work.. Fk off you cunts!.. Oh I must sound a little nutty?
Life with chronic pain is nothing less than torture. In fact, I'd rather be in a fkn pow camp in vietnam getting bamboo strips shoved up my finger nails..
take care.
How are you doing now?
Alot worse. 39 years old and have to use a cane most days. Now it is grade 2 spondylolisthesis and add scoliosis to the list. Ended up finding a pain management doctor in mid 2022, had several ESI shots, first one did wonders, after that none of them helped. Even got SI joints done, nothing. Got a spinal cord stimulator trial, helped the sciatica but not the back pain. Inability to work made me lose my job/insurance in late 2022 and have not been able to get help since. Still trying to get ssdi and medicaid but hard with no recent medical records. Catch 22.
@@swingblade1776 I am so sorry to hear that. I wish you speedy recovery. May I know where do you live ? Also, why are you not going for surgery ?
Will it get rid of disc desiccation? Basically a loss of fluid in the disc. (I subscribed).
Hi, thanks for the subscription. ESI injections are to help strengthen the area around the nerve, not for rehydrating the disc itself. If you would like to speak with a spine specialist, please call our office to schedule an appointment!
I dont want to cause anyone to make a different decision for their needs but I wanted to ask a very important question...... I already tried calling the doctor who performed my 2 injections about a week ago and im not getting a returned call so I'm asking here...
I had 2 injections at L5, and S1 for my SEVERE sciatic pain, my weakness, the numb foot and pins and needles all day long. If I drive a car for more than 2 to 3 minutes I'll be laid up for at least 10 to 20 minutes of ice and severe level 10 pain....
It's been a week and the injections have made my pain worse! I used to have good mornings and bad ones and now I go to bed in pain and wake up in pain.
My follow up isn't for another week and this hurts so bad. Is the discectomy a super serious invasive surgery that has any possibility of paralyzing me???
I would almost beg for surgery at this point and to be honest I ALWAYS would rather rehab before any kind of surgery.
I'm in so much pain that I can't even make a decision.....the pain forces my mouth.... Cut me open and slice the disc! But I don't know anything.... Im 39 years old. I can't work a job because of this. I have a 5 year old. My wife needs my help too.
Please.... what's the next step if the injections only made it worse?????
Can I know how you feel now because I have worse pain after the injection,
@karimaboston2461 my 2nd injection wasn't aimed correctly and that's why there was little to no relief. Even if they use the laser guidance it doesn't really matter if they "wing it" the 2nd time for a good spot.
My 3rd injection was the one way closer to the spine (it's def slightly more dangerous) and this time it worked and gave me enough time to work the pain out / build up muscle around the disc. I'm 100% better now and I really do owe it to that 3rd injection.
Will it make it week and break your spine the injection?
Too much steroids in short periods of time can deteriorate bone and slow or stop absorption of calcium. That is why this kind of injection is normally performed 3x a year at max.
Should I get one even though I have no pain? I just have left foot numbness when I walk or stand
There are many options for patients, but each case is determined on your anatomy and condition. Our surgeons are a great resource to discuss future treatment options. If you would like to schedule an appointment with a spine specialist give us a call at 972-608-5000, or visit www.texasback.com. Thanks
Why steroid when you have regenerative medicine
i have pinged nerved at L4 and S1 with unimaginable pain from lower back down to right ankle. All conservative measures were done, like pain & anti inflammatory medicines and therapy bit none of those relieve the pain, numbness and weakness. my doctors then advised me to have surgery, with this kind of pain i already say yes. good thing one of our friend who is a neurosurgeon told us not to proceed yet with surgery. she asked what treatment i already have and why need to jump to surgery. that’s were she told us about ESI. So i had an ESI instead of surgery. we’ll what i can say, it’s like magic. right after the injection the pain of 10 go down to less than 3. i was able to stand and walk right after but of course not for long as numbness and weakness of my right leg is still there, it will take sometime to recover. right now, with ongoing medication and therapy there’s already big improvement.
So why do you feel this is better than a discectomy? You might have nerve damage and numbness and pain the rest of your life or do more damage because you don't feel the pain because its masked by a steroid injection. I wish I could have found a surgeon that would have done the discectomy sooner so my left calf and foot would not be numb and painful every day now. Someone explained it to me like a parked car on a garden hose, if it sits there too long that hose will never allow water to go through it, if you move the car and let the hose open back up then you will be able to use it again. Good luck to anyone suffering from a real sciatic pain. Until you do you don't know how debilitating it can be.
@@KBradAdams i can’t say ESI is better than microdiscectomy, but there are certain cases that meets the criteria for ESI and for Surgery. in general, surgery will likely be adviced after all non invasive measures have been tried, like; pain and anti inflammatory medicines, therapy, ESI and combination of those. likewise, it can also jump immediately to surgery based on MRI result and symptoms. As for me, MRI result shows minor impingement, also it improves a lot after the ESI and continuous therapy. but if numbness and weakness won’t improvement in 6 weeks and pain returns, i will consider the surgery. though the procedure may look simple and hitech this time, i’m still afraid because it’s still spine.
@@mojaco3910 are you good now please reply back
How you feeling? Please reply thank you
How Many Injections Are Required For Complete Cure. Is There Any Side Effects. what will be the cost of this procedure. Dr recomended me these injections also but in my case I dnt have any pain only stiffness. I cant sit for long time and moreover I cant exert myself. pls do reply.
Such injections are a temporary solution that can last days, weeks, or months (maybe even years for some). That is just depends on the person and the source of their pain. Risk are possibility of bleeding and/or infection but that is said to be every 1 in 300,000 cases. Just based on my research. But if your issues is just stiffness and not any pain that maybe you need to look in doing some stretches with a professional rather than invasive injections.
My
My doctor said my nerves are in flames.(inflammation) and the steroid shot to my c7- t1 will probably fix it. I almost cant believe him but we will see. Update later
Any updates? Howd it go. Did you get sedation?
Any update???
@@mystery3494 I had an injection near the T1 region. I was not sedated and I didn't feel hardly anything! The placement of the needle on the spine can probably have drastic effects.
So are you better?
Did you die ?!
I got into a very small car accident, literally a tap and you know lets just say i wanna get payed lol … now the insurance paying for my chiropractor, x rays, MRI, everything… turns out i have 3, 2mm hernias on my lower back and neck. And they think its because of the car crash 😂 so now they want me to get this injection but i don’t know if i went to far with this or should i not get it? This could mean if i don’t get an injection i could get payed less, if i do then i could get payed more… should i do it? I mean will this even help me out ?
Yes
Yet another video promoting the use of these injections with no mention of them being used off-label and no mention of the possible side-effects, including the rare but very serious ones. You can do better!
Right, that's what I clicked on this video to see. I'm suffering back pain from car accidents and my attorneys said surgery would be good but I'm 😨terrified of surgery in my spine
What are the side effects? Every doctor is supposed to let you know the side affects though
@TemayaCurryAlston Hi.. did you get an MRI? What were your results? I was in an accident too and back pain fluctuates going in 3 months, not a day without the pain and my MRI results came back negative for 3 hernated disc. I watched a UA-cam video of a lawyer saying thr lawsuit won't get you much if you have a hernated disc unless injection or surgery is done..but no money is worth your health deteriorating.. do your research and from there make your decision. Good luck.
I mean positive for 3 hernated disc.. I just noticed you left that commen4 a year ago.. May I ask what happened? Are you still fighting?