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bluestone
01-06-2014, 05:23 PM
I had my 3 year check with my surgeon today and told him I'm still getting awful pain in my middle back especially around some prominent screws. He can see my reluctance to have my hardware removed so he's suggested injections, they will also give him some idea whether my pain is actually from those screws. I am even more reluctant to have my hardware removed now he has said he hasn't had to remove anyone's hardware for the last 10 years-he said its unusual to need this. I just pray I get some relief from the injections and will take it from there.

Has anybody here had injections for pain relief?

titaniumed
01-06-2014, 08:48 PM
Blue

I never had injections....was scheduled with surgeon #5 after being on the other side of the world and got this call “Can you come in on Thursday?”

Right.....

Poor communication, don’t you love that? Well that’s another thread.....and another surgeon. “cough, cough”

Like I posted on another thread this evening, We have to think 3 times before committing to out initial surgeries, and 6 times before our revisions. Trying the shots is conservative.....and seems to make sense. Then again, this is a surgeons decision.

It can be hard to find exactly where the pain is coming from.....and might take a few attempts.

I have trouble saying hang in there since you have been hanging for a long time.....I’m so sorry.

Ed

bluestone
01-08-2014, 09:31 AM
Blue

I never had injections....was scheduled with surgeon #5 after being on the other side of the world and got this call “Can you come in on Thursday?”

Right.....

Poor communication, don’t you love that? Well that’s another thread.....and another surgeon. “cough, cough”

Like I posted on another thread this evening, We have to think 3 times before committing to out initial surgeries, and 6 times before our revisions. Trying the shots is conservative.....and seems to make sense. Then again, this is a surgeons decision.

It can be hard to find exactly where the pain is coming from.....and might take a few attempts.

I have trouble saying hang in there since you have been hanging for a long time.....I’m so sorry.

Ed


Thanks for the reply Ed :)

I don't know what's going on with me, I feel as though I've slipped back a year. It hurts to bend or reach over, I feel stiff and heavy again. Maybe ive become too inactive because of this pain, maybe I'm one of the unlucky ones and my body just doesn't want all this metal inside. I've got to put some hope into those injections and take it from there.

titaniumed
01-08-2014, 09:38 PM
I've got to put some hope into those injections and take it from there.

I agree....

I sure hope they can find your source of pain. Chances are that it’s a small area that’s causing your whole body to feel bad. I know that I have been in situations where it truly was a specific area, but I felt just horrible all over, a complete nervous system shock.

Using shots for locating a pain area isn’t easy, and might take a couple of attempts, but its worth a shot. (no pun intended) These shot locations need to be planted within 1/2mm. That’s 2 matchbook covers. This way you know that you shouldn’t give up in case it doesn’t work the first time.

Ed

Irina
01-08-2014, 11:56 PM
So sorry, bluestone. I thought your surgeon was pretty sure that your pain was caused by protruding screws, and you are back to the square one. I hope that injections will help.

bluestone
01-09-2014, 03:53 AM
So sorry, bluestone. I thought your surgeon was pretty sure that your pain was caused by protruding screws, and you are back to the square one. I hope that injections will help.

My surgeon still agrees with me that its most likely the screws causing my pain-I told him I'm absolutely certain because they impinge and dig at me, I'm not sure whether the pressure is being caused by them though or all of my hardware. When he suggested the injections to get some relief I asked if it would tell us whether its the screws and he just nodded yes but I got the feeling he's suggesting them for some pain relief more than anything else. I suppose if they work and I feel so much better I have to then seriously consider removal.

rohrer01
01-09-2014, 09:10 AM
Bluestone,

I've had lots of injections and no surgery. It can take a full two weeks for them to really kick in, and sometimes it does! Also, not to contradict Ed, but when the steroid goes in, it spreads out over the area. Think about putting fluid into anything, it's not going to just cover a tiny area. That's why they will instruct you to not use heat or take a bath for a couple of days. They will instruct you to put ice on it to keep it from spreading out too far and not being concentrated enough on the affected area. I hope they work for you. If not, my surgeon says the most common revision he does is hardware removal. He doesn't just see his "own" people, but also people that have had surgeries by other doctors. I hope this is helpful.

Take Care

bluestone
01-12-2014, 01:11 PM
Bluestone,

I've had lots of injections and no surgery. It can take a full two weeks for them to really kick in, and sometimes it does! Also, not to contradict Ed, but when the steroid goes in, it spreads out over the area. Think about putting fluid into anything, it's not going to just cover a tiny area. That's why they will instruct you to not use heat or take a bath for a couple of days. They will instruct you to put ice on it to keep it from spreading out too far and not being concentrated enough on the affected area. I hope they work for you. If not, my surgeon says the most common revision he does is hardware removal. He doesn't just see his "own" people, but also people that have had surgeries by other doctors. I hope this is helpful.

Take Care

Thank you for the information, I have no idea what to expect with these injections. I do feel apprehensive though because I have heard a lot of cases where they didnt work. I'm also confused as to how they can help surgeons diagnose where the problem could be coming from because if they don't work how is it going to be of any help to them?

Although my surgeon says that he hasn't removed the hardware of any of his patients for 10 years he doesn't know whether they went to another surgeon and had it done does he?

rohrer01
01-12-2014, 02:35 PM
Thank you for the information, I have no idea what to expect with these injections. I do feel apprehensive though because I have heard a lot of cases where they didnt work. I'm also confused as to how they can help surgeons diagnose where the problem could be coming from because if they don't work how is it going to be of any help to them?

Although my surgeon says that he hasn't removed the hardware of any of his patients for 10 years he doesn't know whether they went to another surgeon and had it done does he?

You're welcome. If the shot doesn't work, then in your case I think they will know that it's the hardware. On the other hand, I had a friend who had an epidural shot in her lower back (not fused) and claimed that the shot made her pain worse permanently. I don't see how that can be after having shots myself. The meds DO wear off after about three months. If her pain really got worse from the shot, I would have thought it would have gotten better after the steroid wore off. She has other issues, though, that I'm not feeling at liberty to discuss.

Like I said, my surgeon says that the most common "revision" he does is hardware removal. It's not just his own patients that he removes hardware from. He sees lots of people with fusions from different doctors. So, yes, you are right. Unless he still seeing those patients, they may have had it done somewhere else.

I think trying the shots is a conservative way to try to manage the pain. The only shot that I had that was painful was my SI joint injection. They do numb you up pretty well before giving the actual steroid injection. I hope it works for you and you can avoid surgery. However, with that said, if your hardware protruding is bothering you, there's nothing wrong with the other choice. At least you have some options.

I hope you feel better.

titaniumed
01-12-2014, 03:22 PM
I'm also confused as to how they can help surgeons diagnose where the problem could be coming from because if they don't work how is it going to be of any help to them?

Its kind of like counting beans in a jar. If the count is questioned or is in doubt, you have to start over. Back to square one.

If the first shot doesn’t work, it doesn’t make sense to stop. If the second shot has some sort of result, you have your 1st answer and a clue. If the steroid spreads all over, if looking for a problem area, this would make it that much harder for location. If a reduction of steroid is used to prevent spreading, maybe this method is used to track down a specific area. Blue, I would go ahead and address this with the doctor who does your shots. Find out if they are looking for a specific area, or just going to target the whole area. Find out their proposed plan of attack. Corticosteroid’s are not pain relievers, they reduce inflammation which reduces pain.

I was just quoting a surgeon from a scoliosis meeting years ago and I remember things like measurement values.

I did see your screw heads photo over on Scoliosis Support....it looks like 3 of them just off to the right side.

I do know that Methylprednisolone “Oral” steroids worked great on my cervical herniation’s last April. It took a month.
How long will this pain relief last, I don’t know. I do know I have herniated discs and that problem will not go away since my discs are compromised.

Jess is our shot queen....she probably had done more shots than anyone here. Since I was offered corticosteroid injections before my surgeries, it just didn’t make any sense to me since my whole lumbar situation was looking bleak. It would have been like throwing I gallon of water on a campfire. The fire goes down but the coals are still burning. I would have delayed my sorely needed surgeries to an older age.

I also wonder if you could have a single screw just hitting a bone nerve???? You can see why removing “all” the hardware doesn’t make sense in a case like this.

When do you go in?

Ed

jackieg412
01-12-2014, 05:57 PM
HI blue,
I had an injection at t1o level for pain. At the time I was fused t-10-pelvis. It did prove that was the spot--however I was really fractured at t-9. I did not have the hardware removed--we were talking about it--but my doctor said that he doesn't do it because it usually doesn't help. And then I would be upset with him. I did not do it--but about a year later I was fused t-2-t10. That helped for awhile. I am back in PT because of pain in that area. I hope it helps. This pain stuff is a drag for sure!
Hang in there and keep looking for an answer. I do not think that my doctor believed me much when I told him that it really hurt--until he found the fracture.

tae_tap
01-12-2014, 08:44 PM
If the injections are the same as what we use in the feet then it is a combination of steroids and lidocaine. The lidocaine is used to temporarily numb things until the steroid can do its job to reduce inflammation. I don't know how they spread over a long area because in the feet they are pretty localized and that is why we are only able to do so many in each given area.

But I am only experienced in the feet. But would expect it to work in the same manner.

Tamena

rohrer01
01-13-2014, 08:56 AM
I think I was misunderstood in my post about the steroids spreading. They don't spread over a "large" area. It's just not a pinpoint area. When I looked at my fluoroscopic photos, I could see the area that the steroid spread over. It's like a couple of cm. Some doctors will dilute the steroid a bit so that there is more in the syringe and cause it to spread over a larger area. My doctor did that and the shot wasn't nearly as effective as the shot I got from the doctor that didn't dilute the injection material. I asked him not to do that anymore. Over time, these shots seem to be less effective for me as the degeneration progresses. I do have a pinched nerve on the left at the L5/S1 disc.

bluestone
01-13-2014, 05:20 PM
Thank you for your helpful comments.
I have decided to write to my surgeon (he always responds to letters) asking him for more information and some answers to some questions I have before going ahead with the injections. I really want to try everything before I decide on hardware removal.

Ed-I totally agree with you, if it is just one screw having all my hardware out seems to me a bit drastic. I am currently on the waiting list for the injections and I'm not sure how long that will be.

susancook
01-14-2014, 01:03 AM
Bluestone (is that really your first name?), I am in favor of almost any treatment short of spine surgery if it can solve your pain. My heart goes out to you.

Although I am not the Queen of injections, I have had numerous corticosteroid/lidocaine injections both before and after surgery. All of them had some positive effect, some better than others. Since surgery, I have had SI joint injections and cervical injections. One point to remember, the lidocaine provides some temporary numbing just with the procedure....but then again, it certainly did not result in a pain free procedure. The corticosteroid takes a while to kick in, longer than I thought that it would. So, don't get disappointed if you don't get relief quickly. I was pleased, call it surprised that the SI joint injection provided relief after surgery for my Left buttocks pain.

I wish you the best of luck and I hope that you find something that helps, even temporarily.
Susan

bluestone
01-14-2014, 08:29 AM
Bluestone (is that really your first name?), I am in favor of almost any treatment short of spine surgery if it can solve your pain. My heart goes out to you.

Although I am not the Queen of injections, I have had numerous corticosteroid/lidocaine injections both before and after surgery. All of them had some positive effect, some better than others. Since surgery, I have had SI joint injections and cervical injections. One point to remember, the lidocaine provides some temporary numbing just with the procedure....but then again, it certainly did not result in a pain free procedure. The corticosteroid takes a while to kick in, longer than I thought that it would. So, don't get disappointed if you don't get relief quickly. I was pleased, call it surprised that the SI joint injection provided relief after surgery for my Left buttocks pain.

I wish you the best of luck and I hope that you find something that helps, even temporarily.
Susan


Thank you.
I have spoken to a patient of my surgeon who had injections-for diagnostic reasons and she said she was sedated. Would it be better to be sedated because your muscles would be more relaxed for the shots?
I don't have a problem with needles.

By the way my name is Sarah :)

susancook
01-14-2014, 03:45 PM
Thank you.
I have spoken to a patient of my surgeon who had injections-for diagnostic reasons and she said she was sedated. Would it be better to be sedated because your muscles would be more relaxed for the shots?
I don't have a problem with needles.

By the way my name is Sarah :)

Sarah: I have had injections both ways, sedated and not. The procedure is somewhat uncomfortable although they do use very small needles, so the part where the needle enters the skin is not uncomfortable. They do the procedure under fluoroscopy so they can make sure that they are on the right spot. Sometimes they are not, so they need to hunt a little. I always ask to watch if my neck can turn in that direction to see a little screen that they have for patients to watch. I always want to know exactly what they are doing and how they are doing it, so I always ask Dr. Chen to tell me what is happening. The procedure itself does not take very long, depending on he number of sites being entered. It does take a while to get you positioned, get the fluoroscopy machine focused on the area, clean off your back with Betadine or something, put the drapes on, then they usually study your back to make sure that they are in the right area, etc. They play music of choice at OHSU which helps. You could bring earphones and your own music.

During the procedure or any procedure I do relaxation breathing and put myself in another zone. I had natural childbirth, so in general except for denervations, I do not have sedation. So, it is your choice. I wouldn't slight anybody who wants sedation and on a day that I have a migraine which happened once ;+{, they gave me lots of analgesics which helped my headache a lot.

Let us know how you do and if it helps. Like I said above, I was initially disappointed in the relief from my SI injection as I wanted more immediate relief. Then after 2 weeks, I noted that my back on the L was much better! Hoping that you also get some relief!
Susan

bluestone
01-15-2014, 05:13 PM
Sarah: I have had injections both ways, sedated and not. The procedure is somewhat uncomfortable although they do use very small needles, so the part where the needle enters the skin is not uncomfortable. They do the procedure under fluoroscopy so they can make sure that they are on the right spot. Sometimes they are not, so they need to hunt a little. I always ask to watch if my neck can turn in that direction to see a little screen that they have for patients to watch. I always want to know exactly what they are doing and how they are doing it, so I always ask Dr. Chen to tell me what is happening. The procedure itself does not take very long, depending on he number of sites being entered. It does take a while to get you positioned, get the fluoroscopy machine focused on the area, clean off your back with Betadine or something, put the drapes on, then they usually study your back to make sure that they are in the right area, etc. They play music of choice at OHSU which helps. You could bring earphones and your own music.

During the procedure or any procedure I do relaxation breathing and put myself in another zone. I had natural childbirth, so in general except for denervations, I do not have sedation. So, it is your choice. I wouldn't slight anybody who wants sedation and on a day that I have a migraine which happened once ;+{, they gave me lots of analgesics which helped my headache a lot.

Let us know how you do and if it helps. Like I said above, I was initially disappointed in the relief from my SI injection as I wanted more immediate relief. Then after 2 weeks, I noted that my back on the L was much better! Hoping that you also get some relief!
Susan

I also had natural childbirth with my second daughter-the pain after my surgery was worse than that when I was in hospital! I also had an apasectimy without sedation-I wasn't even offered it and it was like being 'butchered' in my mouth, just awful but I coped very well. Re the injections I will take it as it comes, I'm not sure NHS will offer the things that you get offered when having it done on health insurance though.

I will let you know how it goes........when I get a date through.

susancook
01-18-2014, 01:03 AM
If you are unsure about needing medications with the procedure, tell the nurse about it. The medication is given via IV, so they could insert the IV, but not give sedating or analgesic medication unless you feel that you need it. That will probably be the best way to go since you will be covered either way.

They will use lidocaine before they give the corticosteroid which does numb the area somewhat locally. I hope that everything goes well for you as well as well as your pain decreases. Best of luck and please let me know how the procedure goes as well as how much it helps your pain.
Susan

jrnyc
01-18-2014, 08:01 PM
i do not think any doctor offered me any kind of sedation
for all the injections i've had...and i've had LOTS....
no surgery...but lots and lots of shots...

jess

dailystrength
01-18-2014, 10:04 PM
Hi Jess, glad to hear you're still doing well with your injections. It's that cold and painful time of year when I start googling about surgery, and of course I landed here. :) I will maybe try an injection- I've never had one. --Christina:)

jrnyc
01-19-2014, 10:13 PM
hi Christina
i had to give up injections about 2 years ago...when i got overdosed
with steroids by one doctor in CT and it caused my cortisol level
to crash...feels like mono....exhaustion...i was lucky, and 6 months
later the level came back...
this will be my first shot in all that time...out of desperation...
because i cannot take any NSAIDS anymore...
i had another allergic reaction to another NSAID....third one i
reacted to...i didn't realize how much pain relief i was getting from the last one i was on...Diclofenac...the one i had allergic reaction to...
but wow...the pain came crashing in after i could no longer take
an NSAID....the bursitis in left hip is burning pain....
so i will be getting a shot in hip this Friday, Jan 24th...hope it helps

jess...and Sparky

jackieg412
01-21-2014, 10:39 AM
I have an injection question---the surgeon recommended an epidural at the C-7 T-1 level. The problem I had was insurance denial from the doctor's group. So I am working on a different location and their reaction is a lot of pain management doctors will not inject at that level.

Has anyone else had an injection at tha level? C7-t1.

Good luck Jess, I hope it all goes well!
Jackie

rohrer01
01-22-2014, 12:39 PM
Hi Jess, glad to hear you're still doing well with your injections. It's that cold and painful time of year when I start googling about surgery, and of course I landed here. :) I will maybe try an injection- I've never had one. --Christina:)

Christina,
It's REALLY nice to see you here again and I really like your signature!

At first the injections worked really well for me. Now they don't help as much but are still worth getting. They keep me walking. When I first got them I was able to go pretty much off of all narcotics for awhile. They were 'as needed' and a much lower dose than I take now. Now, if I didn't have my pain meds, the shots probably wouldn't give me what I consider satisfactory relief. But, coupled with the pain meds they do keep my lower back pain at bay quite well. I am FULLY aware when the pain meds and when the shots wear off, though. Yes, the cold weather is rough but I hurt all year 'round.

I'd say it's worth a try for you. Your curves are within the "range of error" of mine. For me, it's a better option than surgery if it continues to help. They talked about replacing my L5/S1 disc a couple of times now. I'm not going to do that for fear that it may destabilize the rest of my spine. I was told about a couple of options, 1) a prosthetic disc which would still give me range of motion and 2) a fusion.

For those of you who are afraid of the injection and talking about sedation:

The pain of the injections themselves is not nearly bad enough to require strong sedation. Some of those IV's they give you hurt worse than the injection itself. It's mostly anxiety for people who fear the injections. I would ask for an anxiolytic or a mild sedative if you are nervous, just to calm you down. General anesthesia would be out of the question for a procedure that literally only takes 10 minutes or less.

rohrer01
01-22-2014, 12:44 PM
I have an injection question---the surgeon recommended an epidural at the C-7 T-1 level. The problem I had was insurance denial from the doctor's group. So I am working on a different location and their reaction is a lot of pain management doctors will not inject at that level.

Has anyone else had an injection at tha level? C7-t1.

Good luck Jess, I hope it all goes well!
Jackie

Jackie,
I haven't had an injection there. When I was a teenager they thought I had a cyst or a tumor at that level where the nerve root comes out. They described it as C7/C8. I know most people don't have a C8, including me. That's just how they phrased it in my paperwork. It wasn't an insurance question, either, since I was getting free assistance at the time.

bluestone
01-22-2014, 05:13 PM
I've had my appt come through already for my injections, typical when my pain isn't as severe as it was a couple of weeks ago, its just pressure which I can't see injections getting rid of.

The letter says I have to be admitted on the ward at 7.00 am which means we would have to start our journey at 5.30 am-I feel ill when I have to be up so early, and I can't eat after 2.30 am which must mean they presume I want sedation? There's no information whatsoever and at the moment I'm thinking of postponing. I didn't expect to have to be admitted onto a ward, I hate hospitals and don't really want to do this now.

jrnyc
01-22-2014, 08:21 PM
wow....i wonder if all that is because you had the surgery...???
i never went thru all that just to get an injection...

thanks for the good wishes, Jackie.

even when i got first epidural at hospital in Manhattan...
i did NOT have to go in early the way one does for out patient
surgery....i just went in at noon....they put an IV in but
i got no sedation....the IV was in case of emergency...that never
happened...
most other shots i got in doctor offices....even the next two
epidural shots i tried...

if you do not feel ready for the injection, can you postpone it
and reschedule for a month from now...??
also...is there any doctor who would offer you the injection in the office...???

jess....and Sparky

susancook
01-23-2014, 12:07 AM
Unsure if this answers your questions, but whenever I have an injection, denervation, etc from OHSU, they always want me not to eat and drink for 8 hours and come early. The no eating and drinking seems to be their paranoia about having one of those very rare problems that requires resuscitation or intervention. Coming in early is to fill out their forms ("on a scale of 1 to 10....") and the nurses getting you ready for the procedures like partially undressed, forms signed, resident/fellow talks with you....
Seems to be over the top on precautions!

Any why is it that you (me) are always in mild discomfort when we go for a procedure where the night before, pain is at an "8-9"?

Susan