Injection differences - many questions...
I'm looking for some information on the various types of injections for pain relief. I've already researched extensively on all there is out there on spinal injections.
Quick rundown of my situation. I'm 43yo female, who has been very active most of my adult life...and I would really like to remain that way for the remainder of my life. I have grade 2 spondy at L5-S1...along with severe DDD. I basically have no disc at that level...it's pretty much bone on bone. I used to have terrible sciatica in my right leg, but that is completely gone now (yes, it REALLY is!)...thanks to daily use of my inversion table at home. But the low back pain remains, and it all but consumes my daily life. I feel it when I wake up in the morning, and I feel it after sitting for long stretches of time. My back just feels like it tightens and stiffens up almost the instant that I stop moving around. Exercise, for the most part, makes my back feel good...with one exception...running. I used to enjoy running, and lost tons of weight from running. But lately, whenever I run (even if it's on a soft surface), it feels like someone is taking a baseball bat to my lower back. I feel bone-jarring, crushing pain that recently has been extending into my left hip area...mainly the iliac crest region, which is the boney part of pelvic bone near the waistline. I am convinced that this hip pain is related somehow to my lower back issues.
I have already been to a NS, been through 6 weeks of PT...nothing has changed...other than my sciatica being eliminated through my own course of action. I have made the decision that I would like to try some kind of injection...but I don't know which one would be right for me. Based on what I've read/researched...a standard ESI sounds like it's more of a benefit for those with sciatica, instead of low back pain. The success rate for ESI given for low back pain seems to be quite low.
I guess my question is...if I get a referral to an ortho, and after his evalution, he sends me to a PM...who chooses which type of injection I will receive? Would it be the ortho doc or the PM? And do they always start a patient off with a standard ESI, just to see if it works? Or is it possible that I might be given a medial or lateral branch block, or trigger point, facet joint or some other type of spinal injection right off the bat? I had an opportunity to get a standard ESI about a year ago, but I never went through with it because I felt that it wasn't the right solution for my particular problem. Can doctors determine exactly what kind of injection is needed for a specific problem? Or do they generally just try a bunch of different ones as a process of elimination? I really don't want to pay for something that isn't going to work. That would be [B]really [/B]discouraging.
Sorry for the long post, but this has been weighing on my mind for some time now, and I really need some answers. I'm sick of this chronic low back pain and I'm ready to take the next step. Thank you all!