i posted this on the back board but i also thought i would post it here.

i am seeing a pain specialist on feb 4. i will probably be told to try injections. if this doesn't work does the pain specialist send you back to the neuro-surgeon or do they try other alternatives? i am on the lowest dose of vicoden and it just isn't working. if the injections don't help then is surgery my only other choice? just wondering if the pain management doctor would give a stronger rx or is that the neuro-surgeon's job? also, i am seeing a physiologist(sp?) at the end of Jan. i believe she will only suggest PT. i've tried that before and it didn't work but i will do it again if that is what she suggests even though i know i will be in more pain. i don't think it sounds good to tell her no i won't do it since i have tried it before.

i just want some relief and don't know if the injections will help at the thorasic area.

thanks for listening and any advice will be appreciated.

i just don't know where to turn for help. i guess i'm just a little blah today.

kathy

I have had nerve blocks in my arms and then in the back lower neck area. They did alright for a few hours then it was right back to the same pain. I suffer from carpal tunnel on both wrists. Surgery 1 1/2 years ago on R side. Then fell 1 year ago both hands out flat. I hope you have better luck than I did. Here's wishing you well.

i spoke to you on Back board Kathy and i'm not sure if i told you i had many nerve blocks and only one of them worked and that was a total of 48 hrs, you will find 50/50 on this Subject Kathy.. and as for the Injections they are nearly all done like so ...
NERVE BLOCKS: Part I

After last month’s Pain Update about epidurals, I received several questions about what blocks we do and why we do them. I will provide you with a two part synopsis.

What are blocks?
Blocks are injections of medication onto or near nerves. The medications that are injected include local anesthetics, steroids, and opioids. In some cases of severe pain it is even necessary to destroy a nerve with injections of phenol, pure ethanol, or by using needles that freeze or heat the nerves. Injections into joints are also referred to as blocks. Although not technically correct, such “shorthand” is commonly used.

Why do we do blocks?

Blocks with local anesthetic can be used to control acute pain. (Hence, the shot at the dentist or the epidural block for a surgery or a delivery.)
Pain and injury often makes nerves more sensitive, so that they signal pain with less provocation. Think about lightly brushing against your skin when you have a sunburn. Blocks can provide periods of dramatic pain relief, which promotes the desensitization of sensory pathways.
Steroids can help reduce nerve and joint inflammation and can reduce the abnormal triggering of signals from injured nerves.
Blocks often provide diagnostic information, helping to determine the source of the pain.
Remember, blocks are not the best treatment for all pain problems. Patients often ask me, “Doc, can’t you just do a nerve block?” Often blocks are not possible, are too dangerous, or simply are not the best treatment for the problem.

Spinal Injections:
The most common spinal injection is the lumbar epidural steroid injection. This is particularly useful for pain that radiates from the lower back into a leg, and is caused by disc herniation or spinal stenosis (narrowing around the nerves) which triggers nerve root irritation. Similar injections can be very useful in the cervical spine, where the symptoms will extend into the arms. Thoracic epidural steroid injections are most commonly used to reduce the pain associated with herpes zoster (shingles). Such blocks may reduce the risk of developing persistent postherpetic neuralgia (i.e., pain which persists long after the skin eruption has healed).

The facet joints of the spine can also cause pain. Injections into the facet joints or blocks of the nerves that go to the facets can often be very helpful with these pains. This problem is more common in the lumbar spine, but also occurs in the neck.

Discograms (intradiscal injections of contrast under fluoroscopy or CT imaging) can determine if and which disc is the source of the pain. This can help a surgeon determine which levels of the spine require surgery. If the patient is found to have a painful disc, they may be a candidate for a new and promising technique, intradiscal electrothermoplasty (IDET). In a procedure similar to a discogram, a wire is temporarily inserted into the disc and used to heat the disc. This destroys the invading sensory nerves and causes the proteins of the disc wall to reshape and slowly strengthen (over 3-6 months). The procedure cannot be done if the disc has already severely degenerated.

Hope this hope you a little Kathy x

Love brandy x

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[This message has been edited by moderator2 (edited 01-23-2003).]

thank you brandy for taking the time to explain the different procedures. none of them sound very pleasant but if it helps control the pain i am all for it.
thank you agan.
kathy

Kathy..
I'm glad i helped a little..Please tell us when you are going to have them and we may then support you honny..

love brandy x

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18 yrs of pain..disc and nerve damage..
Three lower levels fused ,yr 2001..
had plenty of nerve block's and the dreaded discogram..

I am expecting more surgery?
I also had my Surgery in Britain, i moved to spain two yrs ago..But soon to be back in Britian for good, Had lots of long Hols in Spain..

HI,I HAVE HAD 75 INJECTIONS.THEY STARTED FROM LOWER LUMBAR TO TOP OF NECK AND THEY DID NOT WORK FOR ME.I HAVE HAD A INTRATHECAL PAIN PUMP BY MEDTRONIC SURGICALLY PUT IN MY HIP AND THE CATHETER AND TUBE GO AROUND TO MY BACK AND IS PUT INTO SPINAL CORD AROUND THE MID AREA.IT GETS FILLED WITH PURE MORAPHINE EVERY 3 WEEKS BY INJECTING A NEEDLE THROUGH MY HIP INTO PORT IT HURTS BUT IT DOES GIVE SOME RELIEF IT IS VERY EXPENSIVE AND THE LAST RESORT,BUT SOME OF YOU SHOULD CONSULT YOUR PAIN DOCTOR ABOUT THIS. HOPE INFO HELPS

Kathy:
I had Epidural Steroid Injections in my Thoracic spine a few months ago at T10-11. After about 10 days I did notice some relief...However, it only lasted about 2 weeks.
My pain went from a level of 7-8/10 to a 4-5/10. Not much, but every little bit helps.
Of course, some people have complete relief, while others get no relief at all. Overall, I'm glad I did it.
hope this helps,
fracback

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04-11-02 Injury Date
Initial Findings:MRI herniated disc at T10-11
Lumbar Radiculopathy
Dessicated Disc At L5
3 Months of PT - Didn't Help
3 Epidural Steroid Inj. in Thoracic and Lumbar
Saw neurologist - Had EMG/NCV - Normal. Hyper-reflexic in Upper and Lower Extremities - Neuro says I must have impingement of spinal cord in neck - orders MRI - WC won't pay
Had CT Scan of Lumbar in Oct. Showed bilateral Spondylolysis and Grade I Spondylolisthesis
Spine Surgeon wants to do fusion - Elected to go to PM doctor first
01-22-03 Had Facet Block L4-S1 - No relief yet