,Epidural& morphine for pain on low back ,they have to many side effect ?
Answers:
When referring to epidural, I assume you are referring to a lumbar epidural steroid injection. (As opposed to the medcial epidural described by our nurse.although a very accurate and good description). This is also called an LESI, and it's purpose is to reduce swelling from a bulging/herniated vertebral disc or around the covering of the nerve root. Reducing swelling of these structures can have the potential effect allowing more room for the nerve root to move, and thus reducing pain.
This is in contract to morphine which is strictly an analgesic.or pain killer. It does nothing to alter the physiological structure of the nerve and/or disc.
Both carry risks and side effects. Morphine, of course is highly addictive and can have many side effects including decrease in blood pressure, dependency, and uphoria. The LESI (most commmonly used drug is cortisone) is very local and very little enters the blood stream which leads to less side effects. Yet, there is a risk of central serrous retinopathy (an eye condition) which is very rare. Most risks/side effects are related to the procedure itself including risk of cerebral spinal fluid leak, and of course, the risk of injuring a nerve. However, when done under videofloroscopy (is sort of the "live" x-ray) these risks are very low. Infection is also a risk but is also very low (I've never seen it).
In my opinion, morphine does nothing to change the problem that is causing the pain; and, therefore, is only a "band-aid" to the real problem. The LESI, is often very successful in breaking up the pain and inflammation cycle that commonly occurs in neurogenic back pain (the nerve gets irritated, it swells and causes pain, the swelling causes the space to become tighter, the nerve gets pinch again.it swells again.etc). It frequently takes two or three injections, and I see it work best when combined with physical therapy. (The patient can tolerate doing the excercises more).
I had epidural's for a herniated disk between the 4th and 5th lumbar region of the lower back, they doused the spine and disk with steriods to bring down the swelling, and aside from being numb in the lower torso for an hour afterwards, they work well with no side effects whatsoever.
Using morphine= a big chance of getting addicted to it. Unless your pain is excruciating all the time, ask about NSAIDs (non-steroidal anti-inflammatory).
Take it from this nurse. Any medication has side effects. Epidural is a method of administating a pain medication such as morphine or dilaudid. Epiduaral is a small cathater placed in ones spinal area to deliver pain medicine directly into the spinal column. Minor side effects are rash and itching, but it can also cause difficulty in breathing. It is usually patient controlled.. a small amount can be infused every one hour and a patient can press a button to administer an extra, previously set amount of the medication for break through pain. It is mostly used for short term pain control and then switched to a medication for pain which will be taken by mouth. Patients with terminal painful deseases, such as cancer, are given these medications to ease their terminal pain. These and other medications can also be given intravenously as in a morphine drip, given to patients near death or also by (PCA )Patient Controlled Analgesic, similar to the epidural. Being a nurse and also a patient who has had 3 back surgeries...I understand back pain and will always live with some pain. I recommend you find a doctor who specializes in Pain Control. These doctors helped me tremendously. Now I'm off any heavy pain medication. A few months ago I have had a spinal stimular implant placed in my back. It's great. Now when in pain I turn it on placing a small control wand over the implant placed directly under my skin in my bottom, turn it on and electricity travels to my spine and down my legs and interupt my pain. After having it on for a short while I turn it off and most or all of the pain is gone. On bad days when I over do it I turn it on before bed and fall asleep pain free. So get a Doctor who only specializes in pain control and get the help I know one with back pain needs. Feel better soon!
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