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Ideas for Athletes & Coaches Preparing for Real Competition
30
Jan
Jan
At various times in their careers, long term athletes might be prescribed a cortisone injection in a body part that has a niggling injury. Cortisone is a powerful anti-inflammatory medication. Also called Corticosteroid, it’s not a pain relieving medication, it only treats the inflammation.
When pain is decreased from cortisone it is because the inflammation has diminished. By injecting the cortisone into a particular area of inflammation, high concentrations of the medication can be given while keeping potential side-effects to a minimum.
They’re particularly useful in long-term injuries that are stubborn, even with extensive rest, physiotherapy and rehab exercises. I had an injection in my elbow after suffering tennis elbow for over a year. After the injection and a focused period of rehab, it steadily improved.
I first went for treatment for back pain in 1993. It hasn’t been around all the time, but just for periods here and there. It flared up enough in 2007 to keep me out of competition. At the time I got a MRI and the report said:
Moderate sized left paracentral disc protrusion at L4/L5 compressing the left L5 nerve root and probably the left L4 nerve root being irritated as well.
Symptoms weren’t there all the time, but were easy to bring on - I just had to sit in a chair for 10 minutes! Not a great lifestyle limitation! I type either standing up or lying down with the laptop on my tummy.
Today, after a period of unsuccessful physiotherapy, I had an epidural injection of Celestone (a brand of cortisone) between L4/L5 vertebrae to try move the injury forward faster. The procedure was relatively comfortable. That report said:
Under CT guidance, a 22 gauge needle was directed into the epidural space at L4/L5 towards to left side from a right approach. Two ampules of Celestone was administered, flushed in with a mixture of saline and contrast. Impression: Successful.
The early signs are good - practically no pain or discomfort. And most pleasingly, the serial tightness I had in my left hamstring and hip flexor muscles seems to have gone - both sides are now about equal in tightness. I believe the tightness was there because the disc was pushing on the nerve root just a little.
Of course, it’s not just about getting an injection and ’she’ll be right’. They’ll be a lot of core stability work, stretching, icing, walking and all that good stuff.
Anyway, today is just day 1 - for my benefit, and anyone who faces similar, I’ll come back to this post and insert updates below.
Day 1 - All fine, no pain in back, just iced it a few times.
Day 2 - A little trouble sleeping last night - they reckon insomnia is a possible side effect!
Day 3 - Back good - feels younger! Starting to do more core exercises. A little stiffer after sailing today, but still definitely better.
1 week - Still really happy with it. I’ve gradually worked it a bit harder and actually have some back soreness from some exercise yesterday, but it feels like regular muscle soreness rather than anything in the disc.
2 weeks - It’s still pretty good - I was worried for a few days but years of thinking about one spot on your body can do that! I can feel some stiffness develop after exercise, but it dissipates with icing and stretching.
3 weeks - Much the same.
1 month - Had some good days and not so good in terms of back discomfort, but I’ve been consistent with core and back exercises and have been able to increase the level of some of the back exercises. I feel less discomfort on a daily basis and consistently wake up less sore than before the injection. I should have had it sooner!
2 months - Improved some more. I don’t feel like it needs to be iced it as much - maybe just twice a day now. I’ve reduce anti-inflammatory drugs and have increased back and abdominal exercises without worry. So it feels like it’s on the up and up. I’m still just walking and a little bit of body-weight lifting for exercise, but hope to do a little jogging and even try cycling gently soon. By the way in the last few months I also read a book called Healing Back Pain and those with chronic back pain may also find it a very interesting read.
3 months - Still relatively good and have done a tiny bit of running plus a little more overall strength training for the back and rest of the body. I do like to keep icing it.
12 months - Went backwards a little a few months ago - got some pain in the back and my left hip when doing some exericse. I iced it, took anti-inflammatories and rested it and it settled down pretty well. It’s been ok since, but I’m still not running or cycling, just walking. I went to see a back surgeon recently and got a MRI. The MRI indicated the discs’ buldge had decreased but there was still a small tear. The Doc concluded he couldn’t make things significantly better by going under the knife. So, my daily exercises continue!
By Michael Blackburn, BAppSci (Hons), PhD (Sports Science). Michael has won two World Titles, competed in three Olympics in Sailing (winning a Bronze medal) and coached at a fourth (2008). Visit Website
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Hate to be a downer, but unless you work on correcting the underlying causes that led to your bulging disc, the pain WILL return, despite the short- to mid-term effect of the corticosteroid. I know, I’ve been there: first with spondylolisthesis and then over ten years later and bad case of sciatica. Both have been completely (I hope!) cured without any drugs or operations.
Best of luck.
Ian
i have had (4) cortisone injections in my r. shoulder (ac joint). it wasn’t until #4 that pain disappeared. i haven’t had problems with it in almost 2 years! my back is messed up now. i have (3) bulging discs and am contemplating cortisone injections in that area too. (2) of my friends needed (2) injections each in that area and have been pain-free for about a year now. i thank you for your post. it has helped me decide to opt for the cortisone injection. hope you continue to remain pain-free! (i just prayed that Jesus keeps you this way)
I have been suffering from right hip pain and sciatica for 2 months, went to the doc, had a CT scan and my report came back word for word of michaels and now i am to go and have a cortisone injection so will let you know how i get on..
Good luck Neville, I look forward to news of your pain disappearing.
hi
last month i had corticion inj.my L4/L5 disc,iwas suffering pain 24 hrs,after inj.i m still having pain on my right leg when i seat .i dont know
what next,i stop training martial art,walking makew pain goes away,keep walking boys lifes good
hi, i had a l5 s1 disc operation dec 09. Im 6FT 4 carpenter and its been hell ever since. Two weeks out from hospital had an infection in the wound separated the scar causing mass pain in lower back and left leg. 5 months on still in pain and due to go in for injections in the lower back to break up the scar tissue aroound the nerve. i heard so many blogs websites for this sort of back complaint and operation. I feel its down to each person and the surgen they have. steve
Last Friday I had my first spinal block and cortisone injections on L4/5 space and I have already felt some improvements in the pain. However, my neurosurgeon told me to rest up for 3 weeks and he’ll see me in 4 weeks. I’m just wondering if I should be on a bed or walking or exercising during this time.
Hi Jill,
Good question - personally, I was told to take it real easy for 3-4 days post-injection to make sure it had a chance to work. But from there, I began walking regularly. I think the little muscles around the spine need exercise, but I’d certainly avoid any heavy lifting, jarring or excessive twisting.
Thanks - I have just been bed resting for a couple of hours, then walking around the house and garden. It’s tempting to lift a broom or clip a bush, but, no, I am not tempting fate! You see, I have had three previous back operations (laminectomies, discectomy) and I don’t need to go there any more, thank you. They were separate work-related incidents, but now it is probably scar tissue on the sciatic nerve at L5. If this doesn’t work, and it seems to be, I don’t know where else to go to rid myself of this pain. I’m a teacher and need to be able to bend and walk and stand and ……!
Hi, I have read this blog with interest. Thank you for your honest comments. I have surgery in 1985 (L4/5) and have lived and managed pain on and off for the last 25 years by exercise and oral anti inflamatory. Things have got bad in the last month and the recomendation made that I should try cortisone injection into the facet joint. This is scheduled for next wednesday. I will come back and let you know how it goes.
I am only 23!!!! I am a carpenter and have probably always lifted things that are far to heavy! I am very fit and healthy! I was a boxer for a while and I did a bit of rock climbing. I started having pain in my lower back when I came back from a backpacking holiday. I lived in Cyprus for 10months then when to Australia for 10months then backpackd through Asia back to England. I started getting lower back pain that progressively got worse! I am not working because the pain is to much! I started going to see a Physio through NHS and I got a student. She told me it would not be a disk as i am to young, and gave me streaches to do. They made the pain worse. So i paid for a MRI and it says
“axial views show no significant disc herniation or neural compression at L5/S1 though there is a minimal right sided posterior disc bulge, which lies adjacent to the S1 nerve root.
At L4/5 there is a diffuse and mainly the left sided disk protrusion. This is sufficient enough to be causing some moderate lateral recess narrowing here in relation to the left L5 nerve root. The central lumbar canal remains of adequate proportions, and although disc material extends to the right there does not appear to be major right L5 nerve root compression.
I am now seeing a chiropractor and they recommend a Cortisone injection. I am flying back to Australia on the 5th June and will have to work hard to earn some good money to gain a Visa. So this would be a quick fix and I would be able to get on with things.
Do you recommend I have it or shall i try and rest before i leave and see how things go??????????
Hi Lee, yes, you are very young but your back has done more than most people at 50! Good for you. One of those activities, however, must have extended your back’s capabilities and you have to get it fixed. Yes, in my opinion, the cortisone injection is worth trying before any operation. My injections happened three weeks ago and have improved things, but I still have some problems. I see my neurosurgeon again next Wednesday who will revise my situation.
Being a carpenter is a good trade here but I’m wondering, as you are so young, if you might consider re-training at a job less demanding on your back.
Lee,
Do the shot friend. Age 43 myself, life long athlete and Firefighter, 10 year history of sciatica and bulging discs. Much relief, just need to adjust (sadly) the workouts to no more deadlifts, light squats only, and a ton of caution lifting things from ground level. Just had a shot yesterday, gotta take it easy I guess for next week or so before hitting the gym again.
Hey all, just an update.
Been almost a month now since last shot and I feel great. Playing softball and hockey again, going to gym as well. Got to watch the lifts, no bending to pick up heavy stuff, gotta be real careful. But pain free and active. Sure beats the last year of pain and depression. Try to stretch out every day and rest when needed. Hope this helps.
i hurt my back bending akwardly to pick up about 50 pounds at work.i’ve had 3 epideral shots in the bottom of my spine and cortizone shots 1 time but the dr. stuck me 6 to 8 times and now my back is worse.what should i do next?
How long ago were the shots? And were the 6-8 sticks all at the same appointment? Or over a period of time? Were you ever given an MRI and if so what did they say?
Jeremy,
Get a new doctor. One who does not blindly inject.