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Old 01-05-2009, 03:10 PM   #1
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jacquelineforde HB User
failed or successful nerve root injection?

Hi again all
I had my nerve root injection exactly seven days ago, and have just read a very informative post on what it may be all about, but would like more info please if anyone can help.
I have DDD at L4/L5, nerve impingement and bulging disk. I had two steriod injections to SI joint last year before the nerve root one. During this injection I had very strong pain shoot through the right leg at every injection moment (where knee pain had also been). The pain was significantly reduced for about three days, but it has now come back stronger that ever. I am in agony as I write this. The surgeon mentioned it was for diagnostic and therapeutic purposes but i never really understood this. However, from the other post I read I understand that this may mean the surgeon "knows where he has to work on for surgery". This freaks me out as I always thought this injection was similar to the SI joint ones, i.e. to reduce inflammation and maybe help relieve pain. My idea was that if this nerve root injection does that I would be able to really go for intensive core stability exercises (pilates, swimming etc). I never really wanted to contemplate surgery so early on (if at all!) so the thought that the nerve root injection may be "preping" me for that is very worrying to me.
All replies gratefully received.
__________________
MRI:
1.Dehydrated disc L4/5, L5/S1
2. 7.5mm Tarlov cyst at level of S2
3. L5/C1 diffuse disc bulge extending into right extra foramina area and impinging on exiting nerve root.

 
Old 01-05-2009, 08:51 PM   #2
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megss HB User
Re: failed or successful nerve root injection?

Hi-

I had my second nerve root injection last week on New Years Eve. Neither one has given me any relief. And I also swear that after each one my pain has permanently gotten worse. I have grade 1 Spondylolisthesis at L5 on S1, disc disease with a tear and bulge at L4/L5, and a herniated disc at L5/S1. After this last injection, I have had an increase in numbness of my left foot. I meet with the surgeon again next week, and am looking at having a two level spinal fusion. I have also been in physical therapy for 1 month with so far no results. Sorry I can't offer any help, but I wanted to let you know that you are not alone!

 
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Old 01-10-2009, 02:36 PM   #3
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jacquelineforde HB User
Re: failed or successful nerve root injection?

Thanks for your story-it is always interesting to compare and know you are not alone in these awful trial and error procedures. I had terrible, new pain about 4 days after the nerve block,lasting for three days, and seems to have settled to the old level pain now, two weeks in. Can anyone suggest what my next move should be? Due to meet 6 weeks with surgeon. Are there any success stories out there with core muscle building?
__________________
MRI:
1.Dehydrated disc L4/5, L5/S1
2. 7.5mm Tarlov cyst at level of S2
3. L5/C1 diffuse disc bulge extending into right extra foramina area and impinging on exiting nerve root.

 
Old 01-10-2009, 08:57 PM   #4
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ms_west HB User
Re: failed or successful nerve root injection?

Hi and welcome.

Nerve root injections are done to help your doctor determine if a particular nerve root is responsible for your pain. My surgeon personally would rather put a patient thru this instead of the other alternative know as a discogram. The discogram is by far more painful but well worth the results in clearly showing the pain generator.

When doing the nerve root injection, they bathe the nerve root with steroids and a numbing agent so yes you are receiving medication which sometimes does help reduce the inflammation. When you receive the injection, you may experience a flash of pain but it will settle down quickly when they add the numbing meds. After the procedure if your pain has disappeared, this means that they have found the correct level.

The bad thing about a nerve root injection is that to get a true response as to which level is the pain generator, you can only do one nerve root injection at a time. If you do multiple root levels, how do you know which level is causing the pain? You don't which is why some drs perfer the discogram. With a discogram you do multiple levels and no steroids are used. Dye is injected directly into the disc.

Hope I have not confused you and this makes sense.

 
Old 01-13-2009, 01:38 PM   #5
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jacquelineforde HB User
Re: failed or successful nerve root injection?

Very informative, thanks. How can we be sure they have found the right level? For example, I hear about the pain stopping, meaning they have found right level, but mine is hard to tell. It stopped for 3 days after, then was agony for two days, then settled into the usual pain. My surgeon mentioned he may need to try L5 if this was not right level (this injection was L4). I really don't want to go through another nerve block injection if possible but want to make sure I give him exact feedback on this pain diary. Does it sound like it was right level?
Also, is he just doing all this in preparatrion for a fusion op?
My last resort to avoid that is swimming. I have just heard that this can possibly hold off surgery especially for a bulging disc. True?
__________________
MRI:
1.Dehydrated disc L4/5, L5/S1
2. 7.5mm Tarlov cyst at level of S2
3. L5/C1 diffuse disc bulge extending into right extra foramina area and impinging on exiting nerve root.

 
Old 01-13-2009, 03:37 PM   #6
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Re: failed or successful nerve root injection?

[QUOTE=jacquelineforde;3844894] Are there any success stories out there with core muscle building?[/QUOTE]

No success story. Mine was a nightmare. After my first nerve root injection, I was sent to physical theraby for core muscle building. After only three visits, I was so much worse, the physical therapist told me not to come back. My dr. never mentioned physical therapy again.

 
Old 01-16-2009, 02:13 PM   #7
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jacquelineforde HB User
Re: failed or successful nerve root injection?

Sorry to hear that. So what is your next step? I'm mean, what can we do to avoid fusion, when we have tried the nerve block route?
__________________
MRI:
1.Dehydrated disc L4/5, L5/S1
2. 7.5mm Tarlov cyst at level of S2
3. L5/C1 diffuse disc bulge extending into right extra foramina area and impinging on exiting nerve root.

 
Old 02-06-2009, 07:53 AM   #8
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ksbadback HB User
Re: failed or successful nerve root injection?

My surgeon has recommended a nerve blcok on the L-5 S-1 area. I have a herniation on L-4 L-5 and a narrowing of the foramen on the right side. I have never had this procedure and for some reason I am terrified. I am not usually this way, but have been reading too many instances of horrible pain w/procedure. My doc says if it works I don't need to see him again. However, reading these posts suggests the block is more of a test to see if it is the right level. Is the block the same as an epidural? And if so, is this different than the epidural that a pregnant woman gets during labor? Last item, does anyone know anything about FAI (femoral acetabular impingment). I am making contact with Dr. Thomas Byrd in Nashville, TN recommended by my doc here in KC. Doesn't sound good. Any feedback appreciated. I've found a bunch of info, but more is better if anyone has anything. Thanks

 
Old 02-08-2009, 12:14 PM   #9
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jacquelineforde HB User
Re: failed or successful nerve root injection?

ksbadback,
Can't help you with those questions sorry, as I share your confusion. Is a nerve root block more diagnostic than therapeutic? If so, I am still not sure what my doc will say at follow up meeting. To summarise: I had relief for about two days, then back to normal pain (or more). Does this mean he got the right level or may want to do another one? If he got the right level what is he likely to advise me as next step? Are there still plenty of steps before surgery? I have stared swimming and pilates to strengthen core but have to say I am in lots of pain after. A friend has suggested a sympathetic block. Never heard of it. Good idea? So sorry to throw so many questions...reflects my state of mind I'm afraid!
__________________
MRI:
1.Dehydrated disc L4/5, L5/S1
2. 7.5mm Tarlov cyst at level of S2
3. L5/C1 diffuse disc bulge extending into right extra foramina area and impinging on exiting nerve root.

 
Old 02-14-2009, 10:39 AM   #10
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Posts: 59
jacquelineforde HB User
Re: neurosurgeon good idea?

Would still really appreciate viewpoints on my next steps in my current post nerve root injection situation. Also, with the exercise path i have just started I feel some pain, but feel I can no longer diagnose "normal" from "warning" pain, since my good day/bad day ratio has been increasing over the years anyway. I'm due follow up consultation of nerve root injection, but am wondering if I should think about getting a neurosurgeon's input soon too. Given that I have nerve impingement, is a neurosurgeon a good idea to back up/second guess the orthopedic?
__________________
MRI:
1.Dehydrated disc L4/5, L5/S1
2. 7.5mm Tarlov cyst at level of S2
3. L5/C1 diffuse disc bulge extending into right extra foramina area and impinging on exiting nerve root.

 
Old 02-14-2009, 04:13 PM   #11
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Location: Boca Raton, FL, USA
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PittyPatty5 HB User
Re: failed or successful nerve root injection?

I just had my 3rd (and last) nerve root injections yesterday for L4 and L5. The jury is still out on this last one, but for the first 2, I got very short-lived relief. So short I thought the injections were failures, but since learned that if you feel immediate relief the injection is considered a success for diagnostic purposes, even if the pain relief is very brief. I was told that if I was lucky, I might get pain relief from the injections for a longer time, something in the range of a month or 2, but I wasn't so lucky.

The 1st injection was prescribed for diagnostic purpose by my ns to confirm that I need a fusion of L4/L5 and L5/S1. I am trying to postpone as long as possible, so 2 more nerve blocks, and 4 weeks of pt were prescribed for core strengthening of my back. So far my pain has been worse with the pt, but I am trying to tough it out.

The 1st nerve block was done at an outpatient facility with iv sedation. The procedure was mostly uncomfortable with a very brief but bearable moment or two of pain. The next 2 were done in the physician's office with only a local numbing agent. I found these injections to be pretty painful, and with each injection there was such a strong jolt of nerve pain shooting down my leg that I felt like I was in the electric chair. So I would recommend going the sedation route if possible! Of course this is more hassle as you will need to be picked up after the procedure, but I think it's worth it if your a wimp like me. I request sedation for long MRI sessions too!

Best of luck,
Patty

 
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