Epidoral-For Pain-Question?

[OhMari]

My mil has been receiving epidoral shots at least once every month for the last 6 months. She claims she has a cyatic nerve that travels from her back, to her hip and down her leg. The shot gives her about 3 weeks of relief and it eventually wears off the 4th week-hence she goes in for another shot.

Her sister claims it is probably her hip and she should have her hip replaced. During these 3 weeks she is able to walk about 1 mile on her tread mill for exercise. The week it wears off she is unable to walk again.

What exactly is an epidoral.

Anyhow, my mil has extremely huge mood swings-which is uncharistic of her. She retired 3 years ago and so did my fil. She laughs at things that are not funny, she called her 5 yr old granddaughter a terrible name the other day-she told her cousin how noone helped her when her daughter was a baby and had a birth defect and had surgeries and noone gave them any money. (Her cousins grandson is going to be 4 and has stomache cancer) - her cousin was so stupidfied and told her, "but he has cancer".

I guess this last episode was very upsetting to her cousin that she called me and asked me what is going on with my mil. I apologized to her and told her maybe it was this epidoral shot she was receiving. This cousin told me it is also considered a steroid-cortisone. She told me her cousin would have never ever said anything like that before. It was so out of line-that she didn't say anything back to her. And she felt something was going on.

So anyone have any info what these shots can do?

 

[C.Ann]

Personally I've never heard of anyone having an epidural for anything other than childbirth - and it wears off in a matter of hours.. Sounds more like some sort of steroid injections.. Whether or not they cause mood swings, I don't know, but I'm sure that Disney Doll (a nurse) or disneysteve (a doctor) might have more info for you.. Hopefully they will see this post - or perhaps you could send them a PM..

 

[4greatboys]

Epidural steriod injections are pretty common> I used to work at at Imaging facility that did a lot of them daily. Here is some info:

What is an epidural steroid injection?
How an epidural steroid injection work
An epidural is an injection that delivers steroids directly into the epidural space in the spine. Sometimes a flushing solution (either lidocaine or normal saline) is also used to help "flush out" inflammatory proteins from around the area that may be the source of pain.

The epidural space is the space between the dura mater (a membrane) and the vertebral wall and is filled with fat and small blood vessels. It is located just outside the dural sac. The dural sac surrounds the nerve roots and cerebrospinal fluid (the fluid that the nerve roots are bathed in).


Here are the risks and side effects:

What are potential risks and side effects of an epidural steroid injection?
Risks of an epidural steroid injection
As with all invasive medical procedures, there are potential risks associated with lumbar (lower back) epidural steroid injections. Generally, however, there are few risks associated with epidural steroid injections and they tend to be rare. Risks may include:

Infection. Minor infections occur in 1% to 2% of all injections. Severe infections are rare, occurring in 0.1% to 0.01% of injections.

Bleeding. Bleeding is a rare complication and is more common for patients with underlying bleeding disorders.

Nerve damage. While extremely rare, nerve damage can occur from direct trauma from the needle, or secondarily from infection or bleeding.

Dural puncture ("wet tap"). A dural puncture occurs in 0.5% of injections. It may cause a post-dural puncture headache (also called a spinal headache) that usually gets better within a few days. Although rare, a blood patch may be necessary to alleviate the headache.

Paralysis is not a risk since there is no spinal cord in the region of the epidural steroid injection.

Side effects of an epidural steroid injection
In addition to risks from the injection, there are also potential risks and side effects from the steroid medication. These side effects from an epidural steroid injection tend to be rare. Side effects from steroids are more common when taken daily for several months. Risks and side effects may include:

A transient decrease in immunity

High blood sugar

Stomach ulcers

Severe arthritis of the hips (avascular necrosis)

Cataracts

Transient flushing

Increased appetite.

Who should avoid epidural steroid injections
Lumbar epidural steroid injections should not be performed on patients who have a local or systemic bacterial infection, are pregnant (if fluoroscopy is used) or have bleeding problems. Epidural steroid injections should also not be performed on patients whose pain is from a tumor or infection, and if suspected, an MRI scan should be done prior to the injection to rule out these conditions.

Injections may be done, but with extreme caution, for patients with allergies to the injected solution, uncontrolled medical problems (such as congestive heart failure and diabetes), and those who are taking aspirin or other antiplatelet drugs (e.g. Ticlid, Plavix).

 

[barkley]

the is an epidural treatment for pain-it blocks just the nerves in a particular area (my brother has them done for neck pain).

as for sciatic pain-i can attest to it being very painful and can impact walking-i was in a car accident in the early 80's and stretched/tweaked mine. despite physical therapy and medical treatment it took a long time to heal.


as for the mood swings-this does'nt sound like anything the epidural would cause-could she also be taking pain meds? they can sometimes cause mood swings and confusion.

if she's the type that you (or maybe better yet-your dh) could talk to her about the changes in her behaviour and suggest she mention it to her doctor that would be something the dr. should know about. in absence of that (and i don't know how old your mil is-my mom is in her 80's) while the hiipa laws prevent her doctor from communicating with you about her medicaly-i've found that most doctor's of the elderly will take information from a close family member if they are concerned about something they are observing that the doctor should know about.

 

[TEENEE]

My dh has had those shots (or maybe his is something a little different.) His doctor told him he can only be given the shots three times per year.

 

[OhMari]

Thanks for the suggestions C.Ann and thanks for answering a lot of my questions "4greatboys".

My mil does worry when she gets the shot that they may be to close to a nerve and she worries about nerve damage.

Barkley-my mil is only 64 yrs old. I can't imagine living with this pain-it seems she stops over at our house right after she gets the shot to tell us she just received another one. I just can't imagine that she is going to endure that for the rest of her life. With her mood swings, we do know she is a diabetic-and has high blood pressure. Her weight is not a problem-she just carries a lot of weight in her waist-which is a classic sign of diabetes. She has been diabetic for over 20 yrs. Other than that-I don't know of no other medication she may be taking.


My dh has had those shots (or maybe his is something a little different.) His doctor told him he can only be given the shots three times per year.-That is what I thought too. I don't know how she is able to get this shot monthly.

 

[MrsKreamer]

The mood swings could be the start of demensia. My maternal great-grandmother went through it and now paternal grandmother is. The demensia makes them forgetful, but can also cause out of character meaness.
Or the meaness can also just be from getting old.

 

[minkydog]

Wow! I see a red flag! I think you have two different things going on. It sounds like you mom has injured or herniated a disc in her back which is irritating the nerves which go down her leg to her foot. An epidural injection would relieve it,but not cure the problem. That's why she keeps aving to go back for moreinjections. They aren't getting to the root of the problem. Has her doctor suggested a few weeks of physical therapy? I know it made a huge difference for me. i went from not even being able to dress myself to being able to walk around the mall.

The more concerning part of your post is her drastic personality change.Could she be mis-using some pain-relieving drugs? Steroids can cause mood swings, but not usually when they are given this way. I think something else is going on. She needs to see a doctor first and find out if it's some medicine reaction or a physical problem making her act this way. People, even old people, don't usually change so abruptly.

 

[OhMari]

Wow! I see a red flag! I think you have two different things going on. It sounds like you mom has injured or herniated a disc in her back which is irritating the nerves which go down her leg to her foot. An epidural injection would relieve it,but not cure the problem. That's why she keeps aving to go back for moreinjections. They aren't getting to the root of the problem. Has her doctor suggested a few weeks of physical therapy? I know it made a huge difference for me. i went from not even being able to dress myself to being able to walk around the mall.

The more concerning part of your post is her drastic personality change.Could she be mis-using some pain-relieving drugs? Steroids can cause mood swings, but not usually when they are given this way. I think something else is going on. She needs to see a doctor first and find out if it's some medicine reaction or a physical problem making her act this way. People, even old people, don't usually change so abruptly.

My mil just mentioned that she does go to physical therapy-thus she stated how proud she is that she is able to walk on the tread mill now for 1 mile. When I ask her what hurts her and why she is receiving these shots, she tells me it is a pinched nerve in her back that goes to her leg. But her hip is being affected by this pain. That is why her sister believes it is actually her hip that is giving her this pain.

Who knows.

 

[hiwaygal]

I think you (or someone) should really talk to your mil and get her to another doctor!

First of all, the injections should not be given that often!! One of the "side effects" (from my understanding) of steroid injections is that they can thin the tissue at the injection site...I know that's a pretty lame description, but I would guess if she's been getting THAT many steroid injections for THAT long, they may actually be CAUSING the problem now!

The mood swings could be caused by SOOO much (from something very easily treated and controlled to something not so easy to control/treat)...your mil needs to find out what is causing her pain and what is causing the mood swings!

 

[hiwaygal]

she tells me it is a pinched nerve in her back that goes to her leg. But her hip is being affected by this pain. That is why her sister believes it is actually her hip that is giving her this pain.

Who knows.

when the sciatic nerve is being somehow "hurt" the pain is in the hip, even though the nerve is kinda sorta in the back.

She could also have herniated discs putting pressure on the nerves in the lower back and that can cause all kinds of pain (hip, leg, etc).

 

[C.Ann]

Wow! Some great info here! My DD has sciatica problems but sees a chiropractor and is good as new when she walks out of there..

I'm really concerned about the mood swings - is she taking pain pills too? Also, my Dad was diabetic and when his sugars were out of whack he would get SOOOOOOOOO mean - and he was the gentlest, kindest man on earth.. Could also be the beginnings of dementia, as others have suggested.. Someone needs to call and speak to the doctor because I'm sure she doesn't "enjoy" being nasty, you know?

Keep us posted!

 

[minkydog]

when the sciatic nerve is being somehow "hurt" the pain is in the hip, even though the nerve is kinda sorta in the back.

She could also have herniated discs putting pressure on the nerves in the lower back and that can cause all kinds of pain (hip, leg, etc).

This is what happened to me. I herniated the lowest two lumbar discs, the ones right above the sacrum. The bulging discs were pressing on the nerve root which would shoot pain down my leg. I also felt pain in my calf and the top of my foot! Weird! And it all was coming from my back. I thought I just needed a good massage(shows you how much i know )

Sounds like the MIL needs a second opinion,at the least. Surely something can be done to help her pain

 

[OhMari]

Wow! Some great info here! My DD has sciatica problems but sees a chiropractor and is good as new when she walks out of there..

I'm really concerned about the mood swings - is she taking pain pills too? Also, my Dad was diabetic and when his sugars were out of whack he would get SOOOOOOOOO mean - and he was the gentlest, kindest man on earth.. Could also be the beginnings of dementia, as others have suggested.. Someone needs to call and speak to the doctor because I'm sure she doesn't "enjoy" being nasty, you know?

Keep us posted!

I don't think she is taking any pain meds C.Ann. Her mood swings actually started after she retired. She really doesn't have any direction in her life at all know that she is retired. She ran a bank in her small town that was a branch of a larger bank. So ethically she could not talk about anything that she heard. But now that she is retired, it is like she threw the gloves off. I'll have to ask her if she is on any other meds. I told my husband the other day-that when I retire I hope I don't make my whole retirement about going medical issues after medical issues. They are constantly running to the Dr. for any little thing-and yes she does have legit medical issues-but I am starting to wonder if she is one of those people that have 3 Dr's going at once. She did say a different Dr. is now giving her-her shots-she didn't trust the 1st one anymore.

 

[laura001]

Seeing a chiropractor for the sciatica problems is a great idea, rather than masking the problem she would be taking care of the root of the problem. The chiropractor would be able to distinguish between a sciatica problem or a herniated disc.

As for the dementia, it could be medication based or an actual onset of dementia or alzheimer's. Either way, she should be checked out ASAP by her physician.

 

[LuvDuke]

My mil has been receiving epidoral shots at least once every month for the last 6 months. She claims she has a cyatic nerve that travels from her back, to her hip and down her leg. The shot gives her about 3 weeks of relief and it eventually wears off the 4th week-hence she goes in for another shot.

Her sister claims it is probably her hip and she should have her hip replaced. During these 3 weeks she is able to walk about 1 mile on her tread mill for exercise. The week it wears off she is unable to walk again.

What exactly is an epidoral.

Anyhow, my mil has extremely huge mood swings-which is uncharistic of her. She retired 3 years ago and so did my fil. She laughs at things that are not funny, she called her 5 yr old granddaughter a terrible name the other day-she told her cousin how noone helped her when her daughter was a baby and had a birth defect and had surgeries and noone gave them any money. (Her cousins grandson is going to be 4 and has stomache cancer) - her cousin was so stupidfied and told her, "but he has cancer".

I guess this last episode was very upsetting to her cousin that she called me and asked me what is going on with my mil. I apologized to her and told her maybe it was this epidoral shot she was receiving. This cousin told me it is also considered a steroid-cortisone. She told me her cousin would have never ever said anything like that before. It was so out of line-that she didn't say anything back to her. And she felt something was going on.

So anyone have any info what these shots can do?

The epidurals didn't a thing for my mother and she had 11 of them. She couldn't find anything to relieve her sciatica and the she went to an acupuncturist. The very first treatment, she was pain-free and this was after 3+ years. She's taking a break from the acupuncture now, and she is still relatively pain-free.....she estimates about 80% of the pain is gone.

Having seen what my mother went through, I would recommend acupuncture to anyone.

 

[Disney-Kim]

I had the epidural shots for a ruptured disc in my back. It was the last step before surgery. You can get up to 3 shots, 2 weeks apart, thats it.

the first shot was cortizone/benzicane. for swelling and to numb pain a bit.
second shot was all cortizone.

I was lucky and 2 shots helped me to not have to have surgery. It took the swelling down and allowed the healing to begin. It took me 3-4 more months to feel better, but the pain relief was quick. I had lived in agony for months.

I had a shot to numb my back, then the epidural. in outpatient surgery room by an anesthesiologist. It was not fun, but not very painful I did feel the shot pop my spinal sack.

the first shot made me dizzy but I had NO side effects that I can remember.

 

[laurie31]

My DH has a herniated disc and gets epidural injections for pain. He is limited to 3 per year so he really rations them out. He's been doing this for 9 years. We are hoping for new adances in surgery to make another option possible for him but so far this is his best bet (yes, we've seen a surgeon).

I had terrible sciatica with DD2 and was helped tremendously by a chiropractor.

A second the thought that the mood changes are totally unrelated to the hip/back problem and she needs to be evaluated for that. Sudden mood changes like you described are a huge red flag. She needs medical help.

As for whether the epidural steroids are appropriate for her condition I couldn't begin to hazzard a guess here on the 'net, but I might consider a second opinion. They seem too frequent. DH would LOVE it if he could go that often.

Laurie