Hi I just got home from My pain management doc-so far I have had 3 ESI's -and one facet block (two were blocked at same time) also Physical therapy-How does a Medial branch block differ from a facet block? Is it painful? I am already hurting so bad I was crying in his office.Anyway he says this is last resort-if I get no relief from this block he is sending me to a spine center for a surgical consult :eek:

I have large herniation @ L4-5, facet joint hypertrophy in several places, spondylyosis? (sp) DDD, extreme sciatic pain . any help would be appreciated. :angel: Deidre

P.S. he also upped my meds to Norco 10mg (never heard of it) I am to take one every 6 hrs. Will I be knocked out ? anyone else take this? Currently I have been takin Vicodin. Thankx

See http://www.hmcnet.harvard.edu/brighampain/faqs/facet.html. Nerves branch out from your spinal cord, so there are several spots where steroids might be injected. Inside the facet joint is one possibility. Outside is another. The nerve block I had helped very little. If your disk herniation is large and paracentral, and your pain is almost all in the leg and foot, you might be a very good candidate for microdiscectomy.

Thank you for your reply-yes he did mention the microdiscetomy and laminendetomy (sp)-several things that ended with "dectomy" LOL :jester: but I just want to exhaust all possibilities before I go 'there'-he at first wanted to send me to the spine clinic after this last failed block (on Nov 13th) but said we could try this first-I have a bad feeling about it though-the last facet block I had put me in soooooo much pain I could not believe it. They had to give me Demerol before I went home. I had 3 ESI's and they didn't help me at all-but they didn't really hurt either-ya know?

I don't know what to do-I am getting so depressed-I am a Personal Trainer and have had to cancel about 50% of my appts lately-it is very frustrating. Thankx for letting me vent and thankx for the link-it was very helpful. :angel: Deidre

It is very wise of you to try all reasonable alternatives before considering surgery. But if they don't return you to a level of function that is acceptable to you, please do consider surgery. It was very hard for me to consider surgery. I felt I had failed. I tried very hard to recover without it. Deciding to have surgery was one of the hardest decisions of my life. I felt people were pressuring me to have it because I was a burden. It is difficult being in chronic pain. Depression is part of it all. Some folks I know went on anti-depressants briefly and it really helped them. Be at peace if you need a microdiscectomy/laminotomy. With the right surgeon, the success rate is very high (over 95% get significant relief from leg and foot pain) and the recovery period is short (I was off medication in 6 weeks). After surgery you can concentrate on healing! (Physical therapy, keeping weight down, good body mechanics, walking, etc.) Before surgery most people are reduced to just trying to get through the day. Surgery just gives you a second chance to heal yourself. If your pain comes from the large herniation compressing a nerve root, you are likely to have immediate pain relief. (I was so thrilled, I refused morphine and percocet because the incision after surgery hurt way less than my leg and foot did before surgery).

You are a blessing! You have helped me more than you know :angel: Yes i am on antidepressants too-Wellbutrin & Ambiem for sleep (mostly does not help me sleep though) On the bright side The Norco 10mgs are helping *way* more than The Vicodin did. I am not pain free by any means but I'll take whatever relief I can get! :bouncing:

I have a question? I can often change positions or get an ice pack and get some temporary relief in my back/leg-but my foot is a different story-I don't know how to explain it but it aches so bad-and now the left side is starting to get tingly (which is what happened on the right side first) sometimes this pain is worse than my back/legs. :confused:

God bless you and HAPPY THANKSGIVING! :wave: Deidre

Hi Deidre,

Yes, foot pain is the worst! People with large herniations at L4-5 or L5-S1 can experience pain all over the foot. Pain the big toe (L4-5), pain in the little toe (L5-S1), numbness in the webbing (L4-5), numbness along the side and little toe (L5-S1), pain on the bottom of the foot (after I reherniated L4-5, I felt like I was walking on blisters... even after surgery I had numbness and tingling sensations for weeks... even now my foot gives me an "early warning" when I've neglected my back). There are good dermatome maps at http://anesthesia.mc.duke.edu/regional/abc/images/med-illustartion/ant-dermatome.jpg and
http://anesthesia.mc.duke.edu/regional/abc/images/med-illustartion/post-dermatome.jpg if you want to see how inflamation of a nerve root at L4-5 or L5-S1 can cause pain down your leg into your foot.

Pat you are so sweet and helpful-thankx for the dermatome charts-they did help, it still just amazes me that my (everyone's) body can be affected like this, that my back can make so many diffent things hurt just by nerve pressure-and that my foot (of all things) could be causing me so many problems---today it only burns/itches across the top-it's enough to make me insane, but it beats that shooting pain :eek: Thankx again -hope your day is going good. :angel: Deidre