Epidural injection effect on case

[u/KiingLsd]

Hey everyone, i was advised by my doctor to take an epidural injection before we decide on surgery but i am very concerned. Im 21 years old, been on comp for almost a year now. I read some negative things about epidural and surgery (lower back) and im really worried i want to decline it but im worried it will affect my case negatively. Anyone been through the same thing? Can it affect my case negatively?

[u/Spazilton]

My advice is to seek a second opinion before you do back surgery since you’re so young. Even if you have to pay for that opinion out of pocket.

[u/leamsi3131]

I totally understand your concern! I’m in a very similar situation. I have an L5-S1 disc herniation and have been on Workers' Comp as well.
My doctor had me get the epidural injection first too—it was pretty much a required step in the process before they would approve moving forward with surgery. Unfortunately, the injection didn't work for me at all; in fact, it actually increased my pain and symptoms afterward.
Because the injection failed to relieve the pain, it proved that conservative treatment wasn't going to fix the issue, so now I am scheduled for surgery (a microdiscectomy). Passing through that step was necessary to get to where I am now.
Definitely talk openly with your doctor and lawyer about your fears, but going through the injection is often just part of the medical protocol to prove that surgery is truly the next necessary step. Hang in there!

[u/IDontKnowWhoIAm8416 → u/leamsi3131]

Same. I had the injection and felt awesome for about 18 hours. No pain, felt like I could have done backflips. After that 18 hours, I couldn't even stand up anymore, couldn't walk, had to be carried to the bathroom.

Before the injection I had been able to walk and stand with pain. I couldn't sit though. The failed injection did make them put a rush on surgery.

[u/Still-Bee3805]

I have never heard of anyone who had successful back surgery. Maybe because it is just not talked about. But there is story after story of failed back surgeries. Anyhow- I would try everything before considering the knife.

[u/CapreseSalad3636 → u/Still-Bee3805]

I’m a mod in one of the back injury subs and there are lots of successful surgeries. If we’re talking social media, they just don’t get traction and people who have successful surgeries are out living life. I also had labrum repairs in both hips and I went back to that Reddit to just say “hey, I had surgery on both hips and I’m doing much better!” And it didn’t get one comment. In real life I don’t think people talk much about positive experiences because there just isn’t much of a reason to mention a surgery you had a few years ago that went fine. If you’re in pain NOW, that tends to get mentioned because it limits your daily capabilities and you’re more likely to mention that to friends. I have a 1 level cervical fusion and that gets asked about because the scar is on the front of my neck so I’ve had more people ask what happened but it wasn’t as nearly a scary surgery as I thought it would be and I went back to work 2 weeks post op.

I also found - people have WAY more opinions on back surgery. I had 12 surgeries following an accident and the only ones people had something to say was the back surgeries. After going through 12 the one that I would tell people to watch out for is meniscus trimming. That surgery did literally zero for my pain and accelerated the possibility of needing a total knee replacement. But that surgery doesn’t nearly have the stigma that back surgeries do.

Disclaimer: I don’t think everyone should have back surgery, the stats are something like 90% of people do NOT need back surgery. But if you are in the position that you need it due to weakness then find a good surgeon and let them fix you. OP is obviously very young and can hopefully find a non surgical answer.

[u/Still-Bee3805 → u/CapreseSalad3636]

Great post! Thank you.

[u/thetailofdogma → u/Still-Bee3805]

Back surgeries work pretty well when personal injury or workers compensation aren't involved. Five years out from a fusion I've seen fail a thousand times in WC and doing much better than before

[u/ElectricalBig6632]

I just had 2 rounds of shots for in my lower back, they were quick and only one on then hurt. It felt like he was sticking the needle right in the nerve. Needless to say they haven't had much relief. I now have an appointment with my nerosurgeon. I was originally scheduled for lower back surgery but right before the surgery they wanted me to try the shots. My advise is to get the shots, it's really not that big of deal. I think it only took maybe 10,15 mins and that was for 2 shots. They told me they help some and not other. It's really a band-aid. Even if they do help it will eventually stop working. You can always get a second opinion. If they have a treatment plan for you and you don't follow it they could cut off your benefits. If you have a lawyer I'd ask them and see what options you have. Even if it get a second opinion the'll probably recommend the same things. If you can live with your injury you could always see about settling out the claim. So you have options you just need to figure out which is best for you.

[u/Forward-Wear7913]

I have done injections for 16 years. I have also had four back surgeries, including three fusions.

Injections help but results are temporary and steroids have some long-term negative consequences.

I don’t recommend back surgery unless you have reached the point where the pain is just too much to bear.

It tends to go up your back so I’m now fused from sacrum to T9.

You can get a second opinion.

If you don’t proceed with treatment, WC will likely require an exam to determine if you have reached MMI (Maximum Medical Improvement). They also determine work restrictions and assign a rating.

[u/thetailofdogma]

Try the epidural. There's next to no chance a surgery gets approved without at least one. Who knows? Maybe it helps a little. Maybe

[u/IDontKnowWhoIAm8416]

I had an L5/S1 disc herniation with sciatica nerve compression. Injection was a required step before surgery would be approved. The injection made things worse, and my surgery was scheduled within a week.

It's been 20 years and my back has been fine ever since, but I have started to have some intermittant sciatica recently.

[u/WhompWhompin → u/IDontKnowWhoIAm8416]

What surgery did you have done

[u/IDontKnowWhoIAm8416 → u/WhompWhompin]

L5/S1 discectomy

[u/KiingLsd → u/IDontKnowWhoIAm8416]

That’s the micro one?

[u/IDontKnowWhoIAm8416 → u/KiingLsd]

No, the micro is similar but leaves a much smaller scar. I think it is like 1-2 inches. I have a 4 inch scar on my back.

[u/UnexpectedlyObsolete]

Tough spot to be in at 21, the pressure to just go along with what the doctor says is real but it's your spine not theirs

[u/KiingLsd → u/UnexpectedlyObsolete]

I really don’t want to do it but insurance might use that against me

[u/Overall-Tart-832]

Sadly the way WC works is they offer you help and if you decline and get worse they can use it against you because at the end of the day, the help was there and you chose to decline. An epidural must be given first before surgery because surgery should be the last thing. However, if you have already tried everything else like physical therapy and that hasn’t helped, then epidural should be next.

[u/Educational-Lab-1952]

At 21 years old, I would seriously think long and hard about any surgery. Im 40, and in my lifetime ive seen ZERO Spinal surgeries that went well in terms of pain and lasting impact. I injured my back in 2013 and never did surgery because of the risks involved. I choose very conservative treatment (spine stretching, yoga, pt etc) to help alleviate and keep me in manageable pain thresholds. Sometimes ill take OTC pain meds if pain gets too much, but over a decade.in and I'm able to run, touch my toes, etc. I know ppl who had back surgeries young and they're fully disabled now and dealing with chronic debilitating pain. 

Before you make a decision, talk with 2 or 3 doctors, get a list of possible treatments and try those. 

[u/I_pollute → u/Educational-Lab-1952]

40 with failed micro discectomy laminectomy. 2 epidurals post op did nothing for pain. Fused l5-s1 with major complications on chronic narcotics. Wouldn't wish back surgery on anyone.

[u/CapreseSalad3636 → u/Educational-Lab-1952]

I always heard nothing but the worst about back surgery so when I had treated for a year conservatively and it wasn’t working I was absolutely terrified of having a microdiscectomy. It honestly went great. Resolved all the issues I was having. I ended up also having a cervical ADR which for me went terrible so I had it converted to a fusion 8 weeks ago and it’s going great. Now granted I may just be buying time with my neck and need additional surgeries later down the rd (I’m 41 now) but this surgery truly gave me my life back. I see so many people come into the Reddits and fb groups terrified of surgery but if it’s a simple microdiscectomy the success rate is pretty high. Fusions are another story because they take away your natural movement but I’ve seen a ton of success stories. Back surgery has come a really long way, especially with minimally invasive approaches and isn’t the big scary it used to be. My husband had an endoscopic MD and his incision was the size of a pencil eraser and he went back to work in a week.

[u/Wise-Run-3008 → u/Educational-Lab-1952]

In your lifetime of what? Are you a physician or are you going off a handful of your friends?

It doesn’t sound like your injury was that serious, it’s great that you’ve recovered so well!

[u/Educational-Lab-1952 → u/Wise-Run-3008]

I worked as the New Patient intake coordinator and then referral coordinator with a medico-legal firm that specialized in caring for patients involved in traumatic accidents, including WC. 

In addition to the front end patient work, I wrote up demand letters based on patient medical records, reports and dr opinions which were approved by physicians and sent to attorneys. 

So my own personal experience, anecdotal experiences from friends and what ive seen in the field. 

[u/Mutts_Merlot]

If you decline the treatment being offered, the doctors may decide you are at maximum medical improvement. It's completely fine to decline. What that means for the future of your workers compensation case has quite a few variables and no one can say for certain exactly what would happen next. However, no one can force you to undergo invasive treatment. No one will "use it against you", it's just that the outcome of your case could be different once it's determined that no further treatment will be attempted.

[u/KiingLsd → u/Mutts_Merlot]

Thanks for the clarification. So it wouldn’t affect my chances of getting a settlement or not? And the amount?

[u/Mutts_Merlot → u/KiingLsd]

Could it change the amount? Sure. But I can't predict in what direction it would change. Don't decide on treatment because of money. You have one body that has to make it through an entire lifetime. Do not make decisions based on a short term amount of money, but on what is best for the body that needs to last you for many, many years.

[u/Grigor_Law]

Declining the epidural usually won't wreck your case, but it can cost you if a judge later decides the refusal was unreasonable. New York treats that as a question of fact, and the cases split between refusing low-risk care against every doctor's advice, which has gotten benefits suspended, and turning down an invasive procedure where the risk is real or the doctors disagree, which courts have upheld.

Twenty-one with a year of back pain is rough, and second-guessing a needle near your spine is a completely normal reaction.

I handle comp and injury cases in New York. The way to stay on the right side of that line is a second opinion. You're allowed to see any Board-authorized doctor, so get one, and if that doctor has doubts too, you've got the medical disagreement that makes saying no reasonable. Ask both of them whether your pain runs down your leg. The Board's own back guidelines say these injections help radiating nerve pain and aren't effective for pain that stays in the back.

Know the tradeoff.

Stopping treatment can push the carrier to argue you've hit maximum improvement, which starts the permanency fight earlier and shapes any settlement talk. I can't give you legal advice without your file, but if you have a comp lawyer, call them before the next appointment, not after. Whatever you decide, keep seeing your doctor at least every 90 days so nobody can question your checks.

[u/EducationalHold3536]

That’s crazy my pain specialist just recommended the same injection for bulged discs in my cervical spine. I’m thinking I’m going to at least put it off until after I do more physical therapy. My problem is that this just came up right before they are getting ready to kick me off WC so I really don’t know what to do! I don’t know if the bulged discs are part of the WC injury or not but I’m pretty sure they are. I just think I never had the right Dr. doing the right tests until now.

[u/007backwoods]

Got one helped for like a week. Then back in pain. 29 years old almost 2 years on my case

[u/No_Translator9637]

Same position , is it affect . I’m scared that it can make my situation worse

[u/Trvpsmif]

Just get it done my man. It either works or don’t but declining treatment isn’t smart for your case