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Old 09-25-2009, 08:38 PM   #1
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Are injections the next step?

I can not stand my pain anymore. I have no life and am constantly suffering from either SI joint pain or piriformis. It's been going on since I was 18 and I'm now 23.

I've been through physical therapy multiple times. I've been to urgent care multiple times. And now I'm seeing a new Dr. I have had multiple MRIs, ultrasounds, CT scans, and an x-ray all showing nothing significant. There are no words to describe how frustrated I am. Moving in any way is so difficult, walking is impossible at times and if I manage to walk each step is excrutiating. My pain is constantly in my butt all the way down my leg (usually right leg but switches).

I have done a ton of reading on injections and want them more than anything. I have been through so many pain meds and have become tolerant to many of them -- when they barely helped in the first place. Do injections seem like the next logical step for me? I can not live like this anymore. I feel like the only purpose of my leg is this thing attached to me to cause me extreme pain. Would anyone know why a doctor would not want to do injections?? The reason I'm asking is because mine never even mentioned injections. Any words of wisdom from people with experience with this would be so great!! Thank you

 
Old 09-25-2009, 10:18 PM   #2
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Re: Is injections the next step?

Quote:
Originally Posted by iamtooyoung View Post

I have done a ton of reading on injections and want them more than anything. I have been through so many pain meds and have become tolerant to many of them -- when they barely helped in the first place. Do injections seem like the next logical step for me? Would anyone know why a doctor would not want to do injections?? The reason I'm asking is because mine never even mentioned injections.

Hello,

I am currently on meds and my dr recommended a facet injection for me. My meds do work for me though. I did not do them due to insurance (my pm is out of network) and the cost was way out of my price range. Do you see a pm? I do find that weird for him to not suggest it. I posted a thread on here about them, here is the link http://www.healthboards.com/boards/showthread.php?t=694706


It works for some and not for others. I hope you find some kind of relief soon. You are to young to not be able to enjoy life. I am young as well, not as young as you, but its hard for me as well. I have two small children and it does take a toll on you, both mentally and physically. I really hope things work out for you.
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Last edited by hb-mod; 09-26-2009 at 12:27 PM. Reason: Fixed Quote.

 
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Old 09-26-2009, 09:45 PM   #3
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Re: Are injections the next step?

I'm surprised no one has recommended injections before this - are you seeing a Pain Management physician? I recently had an SI Joint injection and it worked relatively well so now I'm scheduling an SI Joint nerve ablation. I've also done other spinal injections and in some cases had a lot of luck with having it help diminish pain.
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Old 09-26-2009, 09:53 PM   #4
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Re: Are injections the next step?

Your doctor may not have mentioned it because he (or she??) doesn't do them. And not everyone is a good candidate for injections - not saying you're not, just mentioning it.

 
Old 09-26-2009, 11:08 PM   #5
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Re: Are injections the next step?

What is your current regimen of pain killers?

It should idealy include regular use if acetaminophen rehularly four times a day, an anti inflamatory drug (such as naproxen or meloxicam), a tricyclic antidepressant at bedtime and an opoid, starting with a mild one (like SR Tramadol) and progressing onto stronger ones

Nerve block or facet injections are certainly worth trying - if they work, radiofrequency neurotomy could provide a long term "cure"

 
Old 09-27-2009, 08:39 AM   #6
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Re: Is injections the next step?

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Originally Posted by pmtest View Post
Hello,

I am currently on meds and my dr recommended a facet injection for me. My meds do work for me though. I did not do them due to insurance (my pm is out of network) and the cost was way out of my price range. Do you see a pm? I do find that weird for him to not suggest it. I posted a thread on here about them, here is the link http://www.healthboards.com/boards/showthread.php?t=694706


It works for some and not for others. I hope you find some kind of relief soon. You are to young to not be able to enjoy life. I am young as well, not as young as you, but its hard for me as well. I have two small children and it does take a toll on you, both mentally and physically. I really hope things work out for you.

Thanks so much for your reply. What is a 'pm' exactly? I only have seen my PCP and a neurosurgeon (who was no help at all). I think the main reason it hs hasn't been suggested is my Dr. seems more concerned with kidney problems that were accidentally discovered on these many MRIs I have had done for my back. My kidneys aren't causing me horrendous pain that make it impossible to move so I'm not really concerned about that.

Thanks so much, I hope you find relief as well -- I'm going to check out your link now, thanks!

Last edited by iamtooyoung; 09-28-2009 at 04:44 PM.

 
Old 09-27-2009, 09:07 AM   #7
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Re: Are injections the next step?

PM is a Pain Management doctor. Once you've been having pain for more than a few weeks you should hopefully be seeing a specialist - either a neurosurgeon (not a neurologist) or an orthopedic spine surgeon.
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Old 09-27-2009, 09:19 PM   #8
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Re: Are injections the next step?

My doctor wants to give me injections in my ankle for my ankle pain. Has anyone tried this before?? I really do not want these injections, I hate needles. Ive been on medication for quite some time and it works well for me. Anyone have any input?

 
Old 09-28-2009, 04:10 AM   #9
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Re: Are injections the next step?

Hi and welcome.

If nothing specific is showing up on the MRI's they may not be seeing anything specific to inject OR this doctor doesn't do injections. The only times an epidural or spinal injection has done anything at all benificial is when I had a disk that was partially herniated in my lumbar spine. It didn't get rid of the pain, but it did knock it down enough I could do some PT to help.

Have you been evaluated for myofascial trigger points? Keep in mind that some doctors do not even acknowledge they exist, much less that they can become a chronic disease if not treated promptly. That you have significant pain without much showing on the MRI may indicate this could be a problem, or there could be something hiding that the MRI isn't seeing, either is possible. First I would ask your Dr. about it, specifically ask about Myofascial Trigger Points. If your Dr. does not know what this is, or is not the type who takes serious questions well you might want to proceed to my next suggestion.

I would suggest seeing a Liscenced Massage Therapist, at least to be evaluated. To find one, look for a school that teaches massage therapy - what you would be looking for is someone who does treatment called Myofascial Therapy. The school should be able to recommend a few different therapists for you. Tell them you need to be evaluated for myofascial trigger points, if they don't know what you are talking about they aren't the right type of place. There are dozens of types of massage and some are strictly spa type work, and some medical. The type of massage I am talking about is a medical treatment and not at all like a spa experience. The down side to using a massage therapist is that most insurance does not pay for it. Depending on where you live it will likely be somewhere between $60-90 for a 1 hour session.

An alternative would be to find a physical therapist that is trained in myofascial therapy that is on your insurance. I don't know if a PT will evaluate you for this at your request, you would likely have to have an order from your Dr.

If you have any questions about this please ask. You are young and if it IS myofascial, you should have a good chance of recovery or at least getting good control over it with treatment. There are also injections that a PM can do for myofascial triggerpoints. I didn't have good results, but I'm not at all certain now that the PM that did them was actually hitting the trigger points. I do know of several people on this board who have had very good results from triggerpoint injections so keep it in mind as an option too.

Tigg.

 
Old 09-28-2009, 04:21 AM   #10
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Re: Are injections the next step?

Quote:
Originally Posted by demid30 View Post
My doctor wants to give me injections in my ankle for my ankle pain. Has anyone tried this before?? I really do not want these injections, I hate needles. Ive been on medication for quite some time and it works well for me. Anyone have any input?

I tried it when I bruised the bone in my ankle. I had been in a cast for 12 weeks at that point, had been ordered into a wheelchair, and was willing to do just about anything to improve things. The injection iteself was not pleasant, but it DID get me out of the cast in about 3-4 weeks. If there is inflamation in the joint this could significantly reduce the pain, I have long term shoulder problems and have had injections there which have helped a great deal. If you decide to do it be prepared for increased pain for 2-3 days afterwards, and be sure to ice it - 20 minutes on, 20 off. That does not happen to everyone - some people get the injection and feel great immediately, but it's best to be prepared. It's worth a try - injections do help for a lot of people.

Tigg.

 
Old 09-28-2009, 08:59 AM   #11
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Re: Are injections the next step?

The injection for your ankle is likely cortisone. I have had this done in my knee and it works quite well. You'll be able to lay back and not watch it happen - just let them know how scared you are of needles.
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Old 09-28-2009, 04:40 PM   #12
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Re: Are injections the next step?

Quote:
Originally Posted by SpineAZ View Post
PM is a Pain Management doctor. Once you've been having pain for more than a few weeks you should hopefully be seeing a specialist - either a neurosurgeon (not a neurologist) or an orthopedic spine surgeon.
Thanks, I have never even heard of a Pain Management doctor -- after struggling with this severe pain for years why have I never be suggested? Every doctor I have ever seen just seems obsessed with throwing me into physical therapy even though I've gone there so many times with no results.

And I did mean neurosurgeon, wow... I'm so used to typing 'neurologist' as a Psychology student I definitely know the difference though

 
Old 09-29-2009, 12:26 AM   #13
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Re: Are injections the next step?

Dear iamtooyoung,yep life is a big fat ...on most days when you feel like you are not emotionally in control due to the pain your body is telling you it has.
How do you cope? Answer most days its a case of not wanting too.
Injections of steroids and anaesthetic are very temporary and not a long term answer. However something rather than nothing, is how and why, we seek help.
Most treatments will be a bandaid option and maybe one day in the not to distant future a more permanent solution for chronic pain will be found but for now its a long and tiring journey. Choose your choices wisely and well good luck Judi Southerand.

 
Old 09-30-2009, 08:55 AM   #14
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Re: Are injections the next step?

Thank you all for your advice an input. I realize the injections would be temporary -- but I will take ANY relief right now no matter how little it is.

If an injection ends up working for you and it works for 6 months, can you just get injections every 6 months for the rest of your life?

I'm sick of drugs wearing off and nothing helping me. I was in very good shape and now since I can't move I am gaining weight which will make this pain even worse. All I want to do is be able to walk.

 
Old 09-30-2009, 11:26 AM   #15
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Re: Are injections the next step?

You can continue to get injections as long as they work - usually up to 3 times per year. For my neck they worked for me for about 2 yrs and then when they stopped working I had surgery. I'm currently doing injections for my back and they are helping.
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C5-C7 foraminotomy 08

 
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