Epidural for back pain

[challny]

Has anyone ever had one? Did it work? Was it painful? I think my orthopedic doc wants to give me one. On my very first visit he mentioned that, along with an MRI and possible surgery. Have not heard anything since. I would welcome an epidural if it would relieve this 24/7 pain and allow me to walk around the block. Surgery is something else. I'm very wary.

[Hacienda]

Hi Hun, I have had Epidurals, First for a Foot op, then my next for when I had a Hip replacement, The actual injection did hurt a bit, but worth it as I didn't feel the operations ( only a twinge with the Hip), Hope you make the right Choice for you. Love n Hugs xxxxx

[sassy59]

Pete had injections but they didn’t work so do your research. I think surgery is a last resort. Good luck challny.

Love and gentle hugs. Xxx 🥰

[Hidden]

My partner had one in the past for back pain and he said it worked really well. As for whether or not it hurt, I can't really say- he seems to have quite a high pain threshold and he wouldn't have said if it hurt anyway! If you have any more specific questions, I can ask him for you and report back. I really hope you find something that brings relief. xxx

[challny]

Thanks for all you advice. I really need to do something because I'm in constant pain and can't even walk around the block.

[Sandyeggo]

Hi yes I just had one last week, it was my 3rd in a 9 month period. Mine is for my C5-6. They want to operate but I’m trying to keep putting it off. The epidural does help... somewhat. It takes 7-10 days to kick in an it’s aomeqhat short lived. But it’s different for everybody. My friend had one a couple years ago and she’s been fine ever since. I’m just never that lucky. It’s a little painful but not a lot. I wouldn’t let that be a detourent good luck w/it. Do get on the schedule as it famously takes forever to get on their calendar. Nobody’s gonna drag you in by your hair, you can always change your mind.

[Danielmystar]

Hi challny I get a spinal epidural 2 to 3 times a year it does help I've got spinal stenosis yes some times you feel the stuff going down your leg but they put stuff in first to freeze it so it's not to bad they do say it dosnt work for everyone but I find it works for me it take up to 2weeks to kick in but mine normally takes a few days sometimes a bit longer as for the opp I wouldn't get it done myself it's also not guaranteed to work from what I've heard it needs doing again after 5 years but it will be explained to you like it was me so i chose the eperduril it's safer hope this helps you ..

[Lizzyblue]

i had one done yesterday it started to work straight away

i had about 10 injections They were not painful just a bit uncomfortable Go for it if your offered good luck

[anng18]

Hi Challny,

My husband was told to see a pain specialist to get the best options and before he was given an epidural etc. He had been involved in a very nasty cycling accident that had affected the discs in his back and was giving him a lot of pain.

[Mooka]

Yes I’ve had one. Mine worked straight away and was absolutely bliss for a week. The back pain came back and during the next few months the shooting pains down the leg came back. Was quite uncomfortable at the time as it touches the nerves and shoots the pain down the legs but waving your legs around helps. We are all different though I met a lady last week who had one a couple of years ago and has been fine since. I would push for the mri. As unpleasant as they are you need to know the cause of your sciatica to see if the injection is going to help.

[Kristicats]

Hi challny

My husband has suffered severe back pain which also radiates down one side into his knee. He has walked leaning to one side with the pain for the past 3 years min. He cannot walk far at all.He has tried EVerything including epidural, steroid injections, acupuncture ... you name it.

Last Thursday he had a new treatment and OMG finally something has really helped. He went to the hospital in a very negative mood . But the day after he’s been ‘ living again’ I’ve sent some reading on the procedure below. No chemicals or steroids involved. Good luck hope you get some relief soon.

Oxford University Hospitals NHS Trust

Outpatient Pain Service

Radiofrequency Denervation

of the lumbar facet joints Information for patients

What is radiofrequency denervation of the lumbar facet joints?

Radiofrequency denervation is a specialised injection, which uses heat to alter the function of the nerves that supply the facet joints in your back. These nerves transmit the pain signals from these joints to your brain. The procedure is carried out using X-rays to guide the injection, in a similar way to the diagnostic tests.

Radiofrequency denervation of the nerves is performed by placing special needles alongside the nerves to the facet joints, then passing an electrical current through each needle. This creates heat at the needle tip, which results in a change to the structure and function of the nerve. This can lead to a reduction of pain.

What are the risks and side effects of radiofrequency denervation?

The risks most commonly encountered with this procedure are:

1. pain after the procedure

2. no reduction in your pain

3. the risk of nerve injury – this is rare (a less than 1 in 10,000 chance).

4. a small risk of feeling faint during or after the procedure. We will be monitoring your heart rate and blood pressure throughout the treatment and, if necessary, we will give you intravenous fluids to help with this.

5. infection.

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What to do on the morning of your radiofrequency denervation

You will need to have someone to bring you to hospital and take you home from the appointment. You should not go home on public transport after this procedure. You will need to be taken home by car. This will be more comfortable for you and also quicker for you to return to the hospital if there are any complications on the journey home. If you do not have someone to drive you home, we will need to cancel the appointment.

You will be at the pain clinic for about 3 hours in total. You will not be staying overnight in the hospital.

Please do not wear any jewellery, as this can affect the X-ray images that we see on the screen.

It is important that you arrive at the pain clinic at the appointment time. Due to the number of people we need to see each day, if you are late we will not be able to carry out the treatment. Please allow plenty of time for your journey and to park, as the hospital car parks can be very busy.

It is possible that you will need to take time off work after the procedure, to recover. We will let you know how long you may need to take off work when you come for the procedure.

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What happens during the radiofrequency denervation?

When you arrive at the department you will be taken upstairs to the treatment area by one of the nursing staff. The person who has accompanied you won’t be allowed in the treatment area, but they can wait in the waiting area.

One of the nurses will complete the pre-procedure assessment documentation with you. You will need to let the nurse or doctor know if:

• you are allergic to anything (e.g. local anaesthetic, steroids, iodine or sticking plasters)

• you are taking or have recently taken antibiotics for an infection

• you are taking any medicines to thin your blood, such as warfarin, aspirin, ticlopidine, sinthrone or clopidogrel

• you feel unwell on the day

• you have any other serious medical conditions

• you have had surgery for any other medical problems in the last 3 months

• you have any metalwork or electrical devices implanted in your body (e.g. joint replacement or pacemaker).

If you are a woman aged between 12 and 55 years old we will need you to fill in a form to confirm that you are not likely to be pregnant. This is because X-rays can harm unborn children.

One of the nurses will ask you to change into a theatre gown. When you are changed, you will be shown into the treatment room.

The doctor will ask you to sign a consent form to confirm you are happy with the procedure going ahead. If there is anything you are unsure about, or if you have any questions, please ask the doctor or nurse before signing the consent form.

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We will put a cannula (small tube) into your hand, which will be used if we need to give you fluids or medication during the procedure. We will also connect you to monitors to check your heart rate and blood pressure throughout the procedure.

You will be asked to lie on your front on the treatment bed. The doctor will inject local anaesthetic into the area of your back that is to be treated, to numb your skin. You may feel a slight stinging when this is done, but your skin will soon go numb.

Once your skin has gone numb, the doctor will place the needles in position, close to the facet joints, using the X-ray images

to guide them. When the needles are in place, the nerves to

the facet joints will be stimulated by a light electrical current; this makes sure the needles are in the right place. You will feel

a tingling sensation or a deep ache in your back when this is carried out. For this reason you need to be awake during the procedure, as you will need to tell the doctor when you can feel this sensation.

When the doctor is confident that the needles are in the

right position, they will give you more local anaesthetic. The radiofrequency denervation will then be carried out. You may feel a little pain when this is done. Your pain will be assessed throughout the procedure, and we can give you additional pain relief if needed.

How long will the procedure take?

The procedure will take approximately 45 minutes. However, the total time you will be in the department will be approximately

3 hours. This allows us to book you in, check your details and for you to rest afterwards.

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What happens after the procedure?

You may experience some pain in your back after the procedure. Take your usual painkillers and use an ice pack. Ice packs should not be placed directly in contact with your skin as this can cause a ‘burn’. Place a flannel or towel between the ice pack and

your skin. Please check the colour of your skin 5 minutes after applying the ice pack. If it is bright pink or red, remove the ice pack. If it is not pink, the ice pack can be applied for a further 5-10 minutes. This can be repeated every 2-3 hours. Please do not use an ice pack for more than 20 minutes at a time, as it is unlikely to have any benefit and may cause damage to your skin.

Do not be concerned if the pain continues for up to 2 weeks after the procedure, this is normal. There is a small chance that your original back pain may increase for this period of time.

Although this treatment can give you a good level of pain relief, it is not likely to completely relieve your pain. If the treatment

is successful, you are likely to experience a 50-80% reduction

in your pain. The success rate for this procedure is between 60-65% (60-65 people out of 100 will have a good level of pain relief).

We will arrange a telephone appointment with one of the nurses, approximately 8 weeks after the procedure. They will ask you a series of questions to work out how effective the procedure has been.

Signs and symptoms to look out for

If you notice any redness or swelling around the area where the needles were inserted, or you have any other concerns after you return home, please contact your GP.

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What if my pain improves?

The effects of the procedure can last from 8 to 24 months.

If, after this time, your pain returns, we may be able to repeat the procedure.

If you start to experience pain relief, you can gradually increase your activities.

Please note:

• If you experience pain relief, it is important to remember that you still have the underlying problem that caused the pain. We have treated many people who have felt better and have returned to activities such as moving furniture, painting the house, etc. These people have had their pain return very quickly – sometimes within days of feeling better.

• Do not start off by doing all of the activities that you have been unable to do because of the pain. It is important to take part in a physiotherapy and/or gradual exercise program, to strengthen the surrounding and supporting muscles that have not been used while you have had pain.

What if the procedure does not help my pain?

Unfortunately, this procedure does not work for everyone, despite the diagnostic testing procedures carried out beforehand. If the procedure doesn’t work for you, we will have to think carefully of the next step, but it may be there is nothing more that we can offer you. The doctor who referred you for this procedure will be notified of the results, and you will be reviewed by one of the consultants in clinic.

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How to contact us

If you have any questions or need any further information, please contact:

Pain Relief Unit Nurse Advice voicemail

Tel: [phone]

Please leave a message and one of the nursing staff will return your call within two working days. For urgent advice please contact your GP or NHS 111 (dial 111 freephone from mobiles and landlines).

Email: [e-mail] For appointment enquiries

Tel: [phone]

(Monday to Friday, 8.30am to 5.00pm)

If you have a specific requirement, need an interpreter, a document in Easy Read, another language, large print, Braille or audio version, please call 01865 221 473

or email [e-mail]

Author: Oxford Pain Team 2015 August 2015

Review: August 2018

Oxford University Hospitals NHS Trust Oxford OX3 9DU ouh.nhs.uk/information

OMI 12421P

[challny]

Kristicats Wow! What a reply. And what's amazing is I just heard on another forum of a guy who was going in for the exact same thing. Thanks for the info.