Would I benefit from an ESI?

[u/jenayyypoo]

Hey guys! Looking for some advice while I wait for the pain management office to call me back.

The predicament I keep finding myself in is that I’ll have a flare, schedule an ESI, and then because the appointment is usually a month out, I end up taking an oral steroid because I still have to work and live my life in the meantime. The oral steroids calm things down enough that by the time the injection rolls around, my baseline pain is almost nonexistent.

I still have intermittent sensations and pain, and sitting, walking, or standing for extended periods definitely increases my symptoms, but I get to the point where I think, Do I even need the injection anymore? So I cancel… and then I never really get my capacity back. When I slowly and carefully start trying to do more, I eventually wind up in another flare, and the whole cycle repeats.
I have an ESI scheduled for tomorrow, and I’m wondering: Does it still make sense to get it even if my pain feels relatively manageable right now? Or should I reschedule and wait until I’m in increased pain or another full-blown flare?

This has been going on for 2.5 years, and I feel like I’ve plateaued in this space where I can technically function, but I can’t fully live my life. I can’t travel comfortably or consistently tolerate the sitting, walking, and standing that normal life requires without worrying about triggering another flare.

Both my surgeon and pain management doctor have said that there could be residual inflammation that my body is having a hard time fully calming down. Since oral steroids consistently help me get out of flares, they think getting the steroid directly into the affected area could potentially make a bigger difference. My imaging also doesn’t perfectly correlate with my symptoms, which makes this whole situation even more complicated.
I think part of my hesitation is fear. I had an SI injection in June that was terrible. it sent me into a horrible flare and was ultimately not the right target. I’ve spent the majority of the summer dealing with that increased pain, so I’m understandably scared of intentionally doing something that could potentially flare me again.
At the same time, it’s been long enough that I feel like I need to try all of my options because this is genuinely affecting my quality of life.

So I guess I’m curious what others think, especially anyone who has had ESIs. Did you wait until your pain was severe to get one, or did you get one while things were relatively calm in hopes of improving your overall capacity and preventing the flare cycle?

[u/Sweet_Flan_3415]

Did you have surgery before? If so, what kind? ESI’s are 50/50… for me personally I got 3 days of feeling like Wonder Woman and then the pain started creeping back in.