epidural steroid injections for back pain?

I am 5 months post-op and my Low back pain / Sacroilliitis has been flaring up pretty badly lately. I used to take diclofenac for it and it helped a lot with the inflammation and it would go away within about a week or 2 usually but thats a super strong NSAID and it's a no-no now. I've been taking Tylenol which does help a little bit for a few hours but the pain returns as soon as it wears off.

I work for an orthopedic group and I am thinking about seeing the spine/pain doctor again to see if there is anything else that might help, including steroid injections...but I am super confused by what I've read about NSAIDS/ steroids, etc. and I know that the pain/ortho docs may not be up to speed with what is safe for bariatric patients...
I know steroids can cause ulcers and thinning of the stomach lining when taken orally or even topically...but what about injected into the spine?

does anyone else have chronic back pain that they treat some other way?
I was hoping it would get better with weight loss but 85lbs lighter and it's just as bad as it was before some days.

NSAIDS can be really bad for our insides, so can be steroids. Both are systematic type meds- so it does not matter if you ingest it or get into your system any other way.

I have SI joints issues and spine - back pain.

I get epidurals at least 2 times a year. They do help - but not as much as I wish they would.

When I get a shot - it allows me to work out more - to improve my overall muscles health.

I know my pouch and inside don't like it - but there is not much I can do about that. I am on a very strong Rx PPI.

I also get acupuncture, do stretching exercise and see my chiro at least once a week or 10 days to adjust me. Yoga done properly can really help but lately I don't have much time to do that.

Building core muscles strength is a key to keep things together. Beside the epidurals I also get SI joints injections.

I hope you find a good relief.

I get injections similar to Hala. They are steroid shots into my back, and I've had a couple in a knee as well. They always help me, but they do wear off and I believe there is a limit on how many are safe to have in a period of time.

There just isn't an easy answer. My doc would rather the steroid injections than the NSAIDS, but as Hala said they are both systemic so both affect you're whole body. Sometimes we just have to weigh the consequences and try to go with the option that will cause the least amount of harm.

Good luck whatever you decide. I hate that we all hurt after RnY and that what helps best relieve this type of pain is the one thing we can't have.

PS: My back and knee pain is usually treated with narcotic pain meds. I'd much rather go back to my ibuprofen and it doesn't seem like there are many happy mediums. Make sure you push your docs until you get some kind of something that works for you.

I had an epidural for back pain (4 herniated discs) 12 years ago and it has been wonderful. I do still get some back pain now related to Lyme disease, but no sciatica. If I've done something like move furniture and start feeling pain, I alternate ice and heat for 24 hrs then go straight heat for another day. Tylenol or on rare occasion oxycodone. Prior to Rny motrin was my go to.

Gentle stretching and core strength will help. The weight loss has shifted the way the muscles now support your back and spine. It also affects posture leading to pain especially if there are bulging or herniated discs. Physical therapy may help as well.

I hope you get some relief soon!!

thanks everyone. I am going to start doing more core strengthening exercises I think and hope they might help a bit. I looked up some things online on which ones will help low back pain and maybe if they don't help after a month or 2 I will see the spine doc again.
I did physical therapy about 2 years ago and it didn't really help much (but the massage felt good! haha)...It's really hard to treat inflammation when you can't use anti-inflammatories and sometimes it's hard to perform a lot of the exercises without getting the pain under control first.
I'll take my Tylenol and hope for the best!

One thing too to keep in mind is chronic back pain sufferers might get an temporary increase while losing weight so quickly. When you think about it, so much about your physiology is changing very quickly and it can take a while for your muscles to catch up. Your gait, your posture, sleeping/sitting positions--these are all changing and you might be using muscles that have just been kind of hanging out and not doing much and now they're complaining. Another round of physical therapy might help now so you can be shown the proper way to perform certain exercises so you don't injure yourself.

For me, I had chronic back pain for years and years and since losing 165 lbs, it's just about non-existent. I do still see my chiropractor once a month because there's no way I've avoided lasting damage from being morbidly obese my entire adult life, but everything hurts so much less now. Hopefully you'll have a similar result!

Jen

That is a good point. I am open to trying PT again if needed...I can do some of the simple core strengthening stuff on my own without injury and if it doesn't seem to help I will see the doc...if they recommend physical therapy then so be it!

I've been under Pain Management care for about a year. Take oxycodone for pain.

I recently had "radiofrequency" ablations on my neck and back, with limited success. Pain is still there, but much less since these procedures. It's a series of two injections, then the ablation. I had the ablation without sedation, but many people do get local sedation.

I still use the pain meds, but that's because of knee and foot pain. I need a total knee replacement and bunion surgery. If not for those problems, I would probably be off the narcotic pain meds and just use OTC meds.

Look up the procedure and talk to your doctor about.