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Old 05-25-2007, 02:22 PM   #1
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Pain Management Appointment Was Today

HI all. I dont often start too many posts, but thought would update everyone on my journey of seeing a Pain Management Doctor today. It went really well, I think. I thought we were just going to talk, but we did that first, then he fully examined me. After we decided on this:

I have two separate issues, continued lower back pain/lowgrade sciatica on both sides, and nerve issues in the legs/feet.

Since my lower back pain is center stage all the time, we decided to do nothing at all about the nerve pain for the time being. He told me to let him know if we need to address it along the way.

He has 4 ideas/strategies in the lower lumbar and SI area that could be generating my pain. So he suggest to begin a process of elimination and test things to see what, if any relief is achieved in doing so.

First will be to try SI joint steroid injections (though he thinks might not be the problem, but still could be). He will do them in two sets, 2 weeks apart to see if I get any pain relief from them. If so, then we stop going further with other trials and focus here. If not, then,

Two, he will then look toward the facet joints as a possible, and shoot them with a numbing agent to put those areas to sleep. He will then send me off to do activity that would normally make my back ache more than usual and at the 4 hour mark.. call him and let him know how things went. Did I get relief any, alittle, all and on cloud nine! If relief, we stop here and treat by,

Three, doing ablation (nerve burining) at those facet joints. But if no relief, then

Four, consider removing the hardware to see if that relieves the pain. If that were to fail.. then I guess I am then FUBARred at that point and then thrown out to pasture till the buzzards come and clean me off the field! hehehe.

Nah.. the last resort would be to consider NS. He said it used to be focused use for leg pain, but the new ones do a really good job at reducing lower back pain by 50%.

So I like this guy's approach to trying to identify what's goin on. It's a start. I will call them next week and get the ball rolling. I was hoping for no more injections.. tha'ts what I get for hoping eh? hehehe.

Hope everyone has a great weekend!
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"believe in the beauty of your dreams"- E. Roosevelt

L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
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A Success, but still improving!

Last edited by Justoneofus; 05-25-2007 at 02:25 PM.

 
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Old 05-25-2007, 02:36 PM   #2
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Re: Pain Management Appointment Was Today

From what you have written it sounds like you have found a pretty good pain management doctor. His plan sounds pretty good. I wish you the best in finding out what is causing your pain.

Sage

 
Old 05-25-2007, 02:48 PM   #3
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Re: Pain Management Appointment Was Today

This sounds about right. My PM doc and physiatrist did these. I'm at the SNS stage.

 
Old 05-25-2007, 03:06 PM   #4
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Re: Pain Management Appointment Was Today

Hey Justi... sounds like a good plan & Doc!!! The 2nd Neuro I just saw wants me to go to his physiatrist to go over my situation & see if he can help... my question is if I'm not in serious pain, just numb & tingly w/pressure & mild pain in both feet, what would he be able to do for me?

Take care... Dave!

 
Old 05-25-2007, 04:06 PM   #5
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Re: Pain Management Appointment Was Today

Hi Justone of us. I like the way your dr. is thinking and over all, think he has a good plan. I just have one question...why is he shooting up the SI joints with steroid before knowing they're the pain generators? Why not use the numbing agent and see if you get relief as he is doing with the facet joints?
There is no need for all the steroids, especially if the SI turns out not to be generating pain. Why not ask him that question because it could turn out to be a lot of steroids injected over a short time span and that isn't good. Too much steroid can cause lots of problems, one being bone thinning! You will be way over the limit for steroid use.

Other than that, it sounds like a good plan and it all sounds like a dr. who cares and wants to help. All in all, it's a thumbs up.

Carol
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Old 05-28-2007, 10:23 PM   #6
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Re: Pain Management Appointment Was Today

THanks for everyone's thoughts.

Carol.. you bring up a good question, and one that I can not answer and will discuss with the doctor.

Doc says Im certainly not an emergency case and to take my time of when I would like to begin this journey, so I may hold off a bit for now with my schedule and of course start sooner if my pain level were to rise.

But when I get an answer to your question about the SI injection I will send a post out on that. The only thing I can think of is the numb the area there, maybe it spreads out too much and the whole leg could go to sleep.. dunno? Good question!
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"believe in the beauty of your dreams"- E. Roosevelt

L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
Solidly Fused Nov-2006
A Success, but still improving!

 
Old 05-29-2007, 05:02 AM   #7
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Re: Pain Management Appointment Was Today

Hi Tammy--Yep sound's like your Dr. is following the Golden rule , My Dr. did the same thing . I don't like injection's either ! Yuk ! Have you considered the stimulator for pain ? It didn't do much for my lower back but did make my leg' and feet pain less , but everyone is different. My surgeon want's to remove my hardware also. He think's I could have pain from the metal. I can't wear jewlry because my skin is sensative , I break out in a rash and I just wonder what's going on in my back ? You been dealing with the back issue's for some time now . I wish you the best in finding a cure for pain.

Shawley

 
Old 05-30-2007, 07:59 AM   #8
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Re: Pain Management Appointment Was Today

The MRI results on me stated that I have bulging disks in neck, c5 & c6, my chiropractor is sending me to see a pain management dr. If he decides to give me steriod shots in neck how long do they last, is it just a band-aid not a cure, will they eventually not work after years of shots? Should I see a neurologists instead/
Thanks....

 
Old 06-01-2007, 12:54 AM   #9
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Re: Pain Management Appointment Was Today

Hey Shawley! Thanks for your thoughts. THe stimulator would be the last thing on the list to try for my issues at the moment. Sounds like you had some success though with the trial eh? Good to hear!

Jake.. some people get enough relief from the injections that they feel that is enough for them and they continue to get injections from time to time. It is a bandaid.. as it does not cure the problem, but masks it. Also, for many, the injections offer little to no relief at all. It's worth trying to see if they help you. No one wants to have surgery unless non-surgical options have produced little to no help.

TTFN
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"believe in the beauty of your dreams"- E. Roosevelt

L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
Solidly Fused Nov-2006
A Success, but still improving!

 
Old 06-01-2007, 02:33 AM   #10
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Re: Pain Management Appointment Was Today

Justoneofus
I am glad that you have a plan of action. My Dr did the same with the injections. I also had the facet joint injections which I think were more for diagnoses than anything. I got very little relief. Even the nerve burning did not bring much relief but did buy me some time before surgery.

Hope that you are feeling better and that the injections work. Keep us posted.

Please also know that I greatly appreaciate all your support you have given me since day one. You were one of the first to ever respond to my first post and I will never forget the support you gave me. Know that I will be there for you and you are in my prayers and thoughts.

 
Old 06-01-2007, 04:37 AM   #11
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Re: Pain Management Appointment Was Today

Tammy ,
I was curious , don't you have nerve pain , and no surgeries will help you ? Why wouldn't you want the stim ? I'm just wondering if you know something I don't because I have no idea why you wouldn't give this a try ? Please don't take this the wrong way , I want to know what you have heard bad about this before I go getting this device put in me.

Thank's and hope your injection's work .

Shawley

 
Old 06-01-2007, 08:15 AM   #12
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Re: Pain Management Appointment Was Today

Hey Tammy,
So sorry for chimming in so late int he post, it sounds like your PM is on the right highway. I believe in taking it slower, sometimes your body needs time to respond to things. I sure hope you don't have to struggle down that long road before you find relief, maybe the first thing will be the miracle thing that helps, I'm praying for ya.

God Bless

Carol
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Old 06-01-2007, 08:41 AM   #13
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Re: Pain Management Appointment Was Today

Justone, funny! But i saw my PM Doctor yesterday too and he told me that the stim will help only my neuropathy legs pain, but not back pain or weakness of my legs and foot.
He also thinks i have to go first for the same shots your are looking into and see what happens. I am thinking he is right since my main concern is my back pain - so just to eliminate legs pain will not be enough to feel better.

I am glad you finally know what can they do for you - this gives you piece of mind and helps on your recovery. Good luck to you!

 
Old 06-01-2007, 03:03 PM   #14
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Re: Pain Management Appointment Was Today

Hi All and Thanks again!

Clove.. ditto back to you. you may not have been on here when I first started here, but you have been so helpful and supportive to me also.. thank you!!

Shawley.. dont ever think asking a question is off limits with me ever. The stimulator is said to be of the last resort for me, per my doctor. Yes, I do have some nerve pain in my legs, but it is secondary to my continued sciatica/lower back pain at the moment and pretty much always. The doctor also said that in the past the NS was primarily used for leg pain, but the new ones do very well for reduction of back pain. I dont know if this helps you much, but he said that for most it reduces back pain by 50% with the new Stims. New susrgery "may" help.. it's unknown at this time. I do still have a bulging disc at l5/s1 that's been there forever. It may be part of the problem too. Not sure. And of course, we've discussed hardware removal, which is surgery as well. But the other discs "look" really good at this time.

Moldova.. well I can't say I have peace of mind with things, but what was said to me is almost exactly what I expected to hear him say to me. And I owe that knowledge to the members of this board. If I was not apart of this fab group here in learning from all of you, I would have walked into all this back stuff "unknowing" and that to me, is the scariest of all. And I do thank you for all of your words and support also!

Carol, thanks gal! Only time will tell and to be honest.. Im getting used to this back thing being the new and unimproved me! hahaha. As long as I dont get worse.. I can deal with this! But it would be nice to explore the possibilities of making it better though! hmmmmmmmmm. Stuff to ponder on for awhile before I decide, or until the next flare anyway! hehehe. Thanks again friend.

Thanks everyone.. you are all truly a light to me!
__________________
"believe in the beauty of your dreams"- E. Roosevelt

L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
Solidly Fused Nov-2006
A Success, but still improving!

Last edited by Justoneofus; 06-01-2007 at 03:06 PM.

 
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