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Thread: Injections?

  1. #1
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    Injections?

    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?
    Fused T2-L4 with costoplasty on 3/11/10

  2. #2
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    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
    49 yr old male, now 62, the new 63...
    Pre surgery curves T70,L70
    ALIF/PSA T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  3. #3
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    Quote Originally Posted by titaniumed View Post
    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.
    Fused T2-L4 with costoplasty on 3/11/10

  4. #4
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    Quote Originally Posted by bluestone View Post
    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
    49 yr old male, now 62, the new 63...
    Pre surgery curves T70,L70
    ALIF/PSA T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  5. #5
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    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.
    I am stronger than scoliosis, and won't let it rule my life!
    45 years old - diagnosed at age 7
    A/P surgery on March 5/7, 2013 - UCSF

  6. #6
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    Quote Originally Posted by Irina View Post
    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.
    Fused T2-L4 with costoplasty on 3/11/10

  7. #7
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    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
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  8. #8
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    Quote Originally Posted by rohrer01 View Post
    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?
    Fused T2-L4 with costoplasty on 3/11/10

  9. #9
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    Quote Originally Posted by bluestone View Post
    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.
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  10. #10
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    Quote Originally Posted by bluestone View Post
    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
    49 yr old male, now 62, the new 63...
    Pre surgery curves T70,L70
    ALIF/PSA T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  11. #11
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    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.

  12. #12
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    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
    Diagnosed at age 12 with a double major curve

    Braced till age 15

    SSBOB T12-L2 Anterior age 34. (October 22,2012) Dr. Robert Gaines Jr. ( Columbia, MO)

    Revision Surgery T2-Sacrum with Pelvic Fixation Prosterior age 35 (November 13,2013) Dr. Michael Kelly (St. Louis, MO)

    Revision Surgery L4/L5 due to BMP Complication age 36 (November 20,2014) Dr. Michael Kelly (St. Louis, Mo)

    Revision Surgery due to broken rod scheduled for October 19, 2016 with Dr. Michael Kelly (St. Louis, MO)

  13. #13
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    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.
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  14. #14
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    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.
    Last edited by bluestone; 01-13-2014 at 06:23 PM.
    Fused T2-L4 with costoplasty on 3/11/10

  15. #15
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    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
    Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
    2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
    2018: Removal L4,5 screw
    2021: Removal T1 screw & rod

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