Those patients who still have some residual pain after the first injection should receive a second and third injection and patients who did not get any benefit from the first injection should not receive another one. Patient selection is very important in deciding on the type of injections patients should receive. Transforaminal injections (different approach to the epidural space) may produce longer pain relief and may also predict whether a patient might benefit from surgery or not (for details, see review McLain et al, Spine Journal 2005). For patients with the diagnosis of lumbar canal stenosis, improvement after such injections may be longer lasting than it was initially thought (Kapural et al., 2005).
The steroid medication begins to take effect in one to two days at which point you should start to see some benefit. The steroid effect continues to get stronger and stronger such that the peak effect occurs at about two weeks. Thereafter, the effect will stabilize and should last several weeks to months. Typically, the pain relief experienced from this procedure lasts 3-6 months, but there is significant variability from patient to patient and from one procedure to another. If and when the pain starts to return, this procedure can be repeated to try and attain some pain relief once again. Keep in mind that this injection may work very well for pain certain areas but may not help with others. This is normal. Areas of pain that do not respond may need other treatments, which you can discuss with your doctor.
Hello, my name is Rachael I’m 36 and I’ve suffered from chronic sciatica for almost 10yrs now. We think it’s due to a car accident at 19yrs old and pregnancy. Over the past year Iv e had a series of injections…4lumbar, si joint, nerve blocker, racet injection and rhizotomy, some worked better than others but not any longer than a couple weeks. Also, my emg says radiculopothy at l4 l5 and s1 but I have no significant bulging or herniated disc. I do show arthritis as well as facet arthropathy. The last lumbar epidural seems to lasting and gave me more relief than any others. So I’d say my pain decreased about 50% and it’s been about 2months now. The pinching around my si joint area is better too. I have pain in my whole lose back and numbness, I have groin, hip, buttocks, thigh, calf, knee and foot pain. I have numbness and needles in my foot and thigh on a daily basis. Also I’ve seem 3 neurosurgeons who say I have nerve damage and there isn t anything the can due surgically so back to pain management I go. In my experience it won t be long before all the pain comes back. My pain management doc wants me to get another emg (8 months ago emg showed moderate radiculopothy l4, l5, s1) my question is…will my new emg (scheduled next week) still show radiculopothy even though I just had lumbar epidural 2 months and pain not back completely? I guess I’m asking..does lumbar epidural sure radiculopothy not caused but disc issue or does epidural just mask the pain? Thank you and sorry, I tried to make as much sense as possible. My doctor is being gauge and my guess is waiting for new emg, but could it have drastically changed in 8 months?