2nd Selective Nerve Root Block

[bigbossman26]

I have had one selective nerve root injection block in L-4 L-5 and S-1. How many of these "shots" will I need to have and if more than one how far apart should they be spread? Also if this is assisting in making my situation more tolerable, will I need to have this procedure done for the rest of my life? Isn't this just masking the real problem? Wouldn't surgery "fix" on a more permanent basis? If these shots are given every so often is there anything to look for or watch out for? What I mean is repeated doses of this "medication" can't be healthy can it? Wouldn't a person's body stop producing the natural "pain medication" all together? UPDATE: I am slated for a second injection in a week. The span has been from Feb 2008, and now the second one. I found relief from the 1st injection for about 10 days and right back to where I started. Still getting pain in right leg, spasms, and burning, stabbing pain to my toes. The last 3 toes from the o/s of my foot are numb 90% of the time, so getting some feeling back would be great. I was told by my neurosurgeon that if this second shot fails he would consider surgery. I am frankly fed up with this whole situation I have been suffering like this for 2 years!! I just want to get this over with and get back to my life even if it is somewhat limited but gerally pain free. I have taken most medications talked about on this site and am tired of being a guinea pig for drug companies. Lyrica, was a wild ride when the dosage was upped and I could barely function, took the pain level way down but my whole body was numb including my brain!! Have recently been put on Cymbalta, which coupled with the other medications is not much better but I will give it some time before passing judgement on this one. The surgeon spoke of another type of surgery whereby the nerve in question would be severed and cauterized and therefore stopping all feelings of pain in my leg. I am not sure what level of functioning I would have after such a procedure but living with pain on a daily basis has just about destroyed me physically, mentally, and spiritually. If this is a test from up above I give up!!

[metronycguy]

bbm what is your injury it sounds similar to mine cauda equna injury l4 through s1,

[bigbossman26]

Herniated L4 L5 S1 discs is all I was told or eventually had been diagnosed as. Caused from years of abuse I suspect. I was at work and dropped to my knees to perform a simple task that I had done a thousand times before in June/06. I finished my shift in pain but thought nothing of it as I was going on days off. Well, the next morning I felt EXTREME pain in lower back, buttock and right leg. Seen doctor who prescribed a few meds and told me to go home and rest. Well, to make a long story short, I did not have any further testing done until Worker's Comp. finally agreed to send me for MRI in Dec/06. MRI showed what I was explained as a mild disc bulge @ L-4 & L-5 and S-1. The very next day I had a CT scan done which only verified the MRI. Nothing further was done to me or with me until the spring of 2007 when I was placed in Physiotherapy which consisted of EMG? where they place electrodes on your body and vary the length and intensity as well as traction. The traction would offer little relief until one day the machine went a bit too far for my pain tolerance level and I shut it down. It gave me one or two last "tugs" that almost made me cry. I continued with this course of physio and light exercise until a 2nd MRI was done in the summer of 2007 with not much change in my situation and what the MRI showed. I then waited for an appt. with a specialist. Specialist indicated that he wanted to wait until things got worse before he would do anything. Worse?!?!? I compared his recommendation with a bald tire on a car, said the cords are showing but it's still holding air so don't bother changing it until it blows or in my case rupture the disc. I was not happy with that plan of attack so I requested to see another doctor. The next time I seen another specialist was in Jan/08. This doctor was a little more understanding and took the time to explain what options I had and left it up to me what I wanted to do. I opted for the least intrusive measure offered and decided to try the selective nerve root block injection. Well the first one gave pain relief that lasted about 10 days, and a couple of months later I am going for a second one, if this fails then it is surgery I will be seeking. Although the odds he gave me are not any better than 50/50 I have to give it a shot, as I cannot continue to function this way. I cannot feel the outer part of my thigh, calf or outer 3 toes on my right foot, when there is any return of feeling in my foot it feels as if it "is waking up" from falling asleep pins and needles type feeling. I will have many spasms thoughout the day regardless if I have taken my meds or not. I have greatly reduced strength in my right leg both inner and outer as well as raising my thigh or leg curls, as an example I can leg curl over 50 lbs with left leg and about 5 lbs with my right leg. I can't bear weight on my right leg alone as the pain is too strong and my leg is so weak, and it takes forever to acheive an erection. Not sure if you wanted all of this but I felt I had to let you know I am not para or quad but suffer a lot of the symptoms described in many of the posts here, I applaud all of the members for the work they do and time they spend on this site as I have learned so much from all people who are a part of this site. If I can decribe further my situation and symptoms I will be glad to. Thanks again, keep up the good work!!!

[Lee555]

That last part about the sexual problems points to a pinched sciatic nerve. Obviously in several places. You might talk to your doctor about shooting some numbing stuff into the piriformis muscle in the right butt cheek. When you had the injury happen, dropping to your knees like you did, did the right buttock start to hurt or spasm after that? Having had a bulging L5 S1 myself, and the buttock, leg pain, numbness and sexual problems some years ago from a shock to the piriformis muscle, I know what you are feeling. I had foot drop and toes went numb as well. It was first the piriformis muscle as the cause, but when the neighboring muscles got weak, the sacroiliac joints started giving me trouble as well. And it was this that caused the low back pain. A competant Pain doctor can do shots into the SI joints to numb and take the inflammation down, long enough for you to get your strength back.

[bigbossman26]

:( Well, just arrived home after 6 and a 1/2 hours of gruelling travel back from getting my second injection. Wow!!!! did he ever hit the nerve this time. Felt the biggest electrical shock I have ever felt in my life right down to my toes. Holy cow!! The first one felt nothing like this one. Almost has to break out a spatula to peel me from the ceiling!!! Felt ok for the next couple of hours then the freezing came out!! Started eating pain meds like they were Tic-Tac's. Made it home and ate a couple more before finally being able to pass out. Woke up this morning hurting the same. Basically a rough ride the whole way there and back and not looking forward to getting anymore of these things. I guess a little pain if I get some relief wouldn't be all that bad. I was talking to another patient before they called me in, and she had just received her 7th injection!! I felt so bad for her. The doctor said this one hurt so bad because he injected me right in the middle of the nerve this time!! I will try to find out exactly what magical potion was put in me but hope that it works somewhat. From what I understand the surgeon said if this doesn't work then he will be slicing and dicing me. What is planned; I am not sure but will be posting the name of the procedure when/if he decides to cut so I can get some feedback from the members. And to Lee555 I did have SI Joint injections done in 1991 when I injured myself then. The only thing I can tell you about that was I went in had the injections and then everyone left, doctor's, nurses, everyone, was told to get up and that I could go and get dressed, started walking to the change room and things started to go black, hands and feet were tinlgling and I passed out falling head first on the concrete/marble? (flooring in Hospital's) When I came to, there were a pile of people standing around me asking if I was OK. Well, not OK actually, I had a back problem when I came in and after I still had pain in my back as well as a killer headache. Well, the hospital would not release me after that and they kept me in overnight for observation and released me the next morning with a golfball sized lump on the back of my coconut!! Since then I experience migraine headaches. Probably get 3 a month since this happened. Thought about suing the Hosp./Doctor etc, but was only 20 years old and didn't know enough of what my rights were. Coincidence????? Not sure if it was from laying on my belly for so long, or allergic reaction to the medication? Don't look forward to having another one of those done..........................:(

[Kathi49]

bigbossman,

I feel for you. But I wanted to say I have had a few selective nerve root injections and they do NOT stick you right in the nerve. ;) If the doc had really ACCIDENTLY hit your nerve or nicked it or whatever you would be in screaming RSD type of pain. No, what they do is to get as close to it as possible; that's probably why it hurt so bad. I had one done once where my arm flopped like a fish so my PM backed way off and started over. I know they aren't fun! I have cried many times before...but my new PM is quick, efficient and it is over with in no time. As a matter of fact, I see him pretty soon and want to BEG for some facet injections in my lumbar. :) And my husband just had an SNRI too. He was forever saying he couldn't understand why I would say they were pretty painful (speaking of my neck here). But when he had this last injection it was an SNRI and he sat me down and actually apologized for thinking I was a wimp. On a happier note. My husband was complaining that this last injection didn't work. He was expecting it too in no time flat. I told him...give it two maybe even three weeks. By the beginning of the third week he was getting relief and still is. And this was done about a month or so ago. So, hopefully, it will give you relief too. Hang in there and just remember to give it some time...two weeks is the norm although sometimes relief can come quicker. Oops, forgot to add though. The PM told my husband IF this injection did not work, time for referral for surgery. And I think that is coming sometime down the road. For now he is still doing okay.

[bigbossman26]

Yeah that's the same story I was given, if this dosen't work then surgery. I never thought I would be pain free as soon as it was done, just relating how I felt was all. Wondering why this one was more painful than the first one. I asked the doctor why and his reply was "this time I put it right in the middle of the nerve and last time I put it at the end of the nerve." Maybe the first one would have worked if it was like this one I don't know, but when the doc asked if he had the right spot the last time I sure felt the pain, thought it must be the place as I felt it all the way to my toes but not near as intense as this shot was. Here's to hoping that this type of procedure will work for me. I could handle having one or two of those a year if it were helping me and I would be able to function without hurting too bad.

[mountainman]

Hey Boss It Sounds Like Its Time To See A Neuro Doc, Not An Ortho, A Neuro Surgen Works With The Nerves In A More Delicate Manner,that Is The Way They Were Trained. I Also Had This Same Problem,building Water Tanks And Refinery Tanks Beats The Crap Out Of You. Well After About 12 Yrs Of Living With This Agony I Went And Had A Double Lamenectomy L4-l5-with Severe Stenosis They Took Out The Bulges And The Stenosis Free,d Up The Nerves That Were Smashed,-----and Did Not Do A Fusion------ .that Area Of My Back Now Is Good, I Got 6 More To Get Fixed And I Will Feel Some What Human Again. If This Problem You Have Is Messing Up Your Day To Day Life Get It Fixed,save Up Some Cash To Get You Through For About 4 Months,the Shots Are Only A Mask & If They Are Not Working Its Time To Get-r- Done , I Really Feel Bad For You, I Know How Bad It Hurts, I Had To Keep Working Because Of Paying Child Support,i Couldn,t Let My Kids Down. Good Luck Bossman

[bigbossman26]

I am due to see the Surgeon at the beginning of July for review of the injection. You see this wonderful health system we have here in Canada and especially with tossing WCB in the mix the surgeon was not the one to actually do the injection, he sets it up/contracts it out with another surgeon in the center that can see me as soon as possible. This time it happened to be the same doc that did my first inj. Even he indicated that this was just a temporary fix and I could be coming back to see him on a regular basis if something wasn't done (i.e surgery) and even post surgery he said I may be coming back to see him anyway. I have heard so many success stories lately with different back surgeries that I think they have come a long way. I have heard of the horror stories as well and I have to accept the fact that not every one is a success. I just can't possibly accept the fact that this is as good as I will ever feel. I would like to believe that some day I will be able to do some of the things I previously enjoyed with relatively minor aches and pains instead of the pain I have been in for so very long. I know this may not be the right forum, but has anyone tried "natural" pain relief measures? Things I am thinking of are things like herbs, vitamins? things not so pharmacutical with any success. Glucosamine comes to mind, shark cartilage, stuff like that? At this stage of the game willing to try almost anything. Unfortuately the green herb only amplifies the pain for me......(I know sounds totally backwards) but that is the result. Go figure......................:confused: :confused:

[Kathi49]

bigbossman,

I have tried Glucosamine many times but my stomach can't handle it. Actually, I am very hypersensitive to meds and I am not really a firm believer in taking alot of supplements UNLESS it is necessary. Without going into my whole spinal history I will just say that I was recently given samples of Limbrel for OSTEOARTHRITIS. It is really a botanical medical food that works like an NSAID. You can go to their website and read up on it. Anyway, I was given the 500mg sample, oh, and it is by prescription only. I could not believe it! I took in the late afternoon and by well into the next day I felt soooooo much better. I did have a slight headache and a bit of an upset stomach but I think that was more due to withdrawing from the Duragesic patch. I know they make it in 250mg and I am waiting for my next appointment to possibly get a script for it. I just think MAYBE the 500mg was too potent at first. Anyway, it is really not supposed to work that fast LOL but I SWEAR I felt less stiffness and aches and pains. You can even browse the internet and look for reviews about it. It has obviously helped some people. Not sure if it would help with neuropathic pain but I would assume if it helps to treat inflammation it MIGHT help with this other. I had one doc tell me his patients are cancelling their injections because it is helping them so much. Anyway, just a thought. :) And I should add my whole body is just full of OA so just eliminating or taking down that kind of pain and stiffness helps.

[mountainman]

Hey Boss The Only Thing I Found Thru All The Years Of Pain That Helped Me Relax Enough At Night After Work That I Could Sleep Was A 12 Pack Of Bud And Some Tylenol!! Seriously I Drank Alot Of Bud,but It Helped Ease The Pain. I Don't Want To Sound Like A Jackass But That Was The Only Way I Could Fall Asleep,otherwise I Could Not Get Comfortable In Bed,my Back Would Just Kill Me. I Tried All Different Kinds Of Over The Counter Meds But Non Of Them Worked As Well As Good Old Buddy Wiser ! Well Boss I Wish I Could Be Of More Help But I Told You Everything I Can ,i Know It's Tuff Trying To Work And Keep Up When Your In Pain, Maybe A Few Bud's Will Help You Relaxe The Muscle Spasm's That You Are Getting That Make's The Symptoms Worse. After Years Of Back Pain And Spasm's Your Spine Start's To Staighten Instead Of Being Curved And That Will Cause You More Problem's In The Long Run As Far As Trying To Bend. Well Good Luck With Your Doc I Wish You The Best. Jeff

[bigbossman26]

I know what you mean. I have drank a little while taking the meds. You know to give it that little kick, I know I know all the responses I will get from saying this but if it works so a person can at least sleep a bit then I say go for it!! Pills and booze don't mix :zombie: but I am tired of being looked at as a junkie every time I get a different prescription, at the Pharmacy because the doc is saying try this , and try that, and when those don;t work he tries me on something else again. I think it is horrible that the staff there all know me by name and ask "what do you need this time?" and kinda roll their eyes. Doc should have samples and that way I wouldn't look so much like an addict. I should be getting AirMiles for the amount of money I have given them I could be flying across the world hee hee hee. I guess I am sort of an addict, as when I went to have the second injection I had to be medication free for 24 hours before the injection so I could direct him to the right spot with the needle. Well, I was not feeling too great without the slight relief that the pills gave me. I guess I hadn't realized what relief they did bring as without them I felt like a steamroller passed over me a couple times. I can't imagine how much fun it will be to wean myself off of this stuff if and when I ever get better. I have been experiencing a lot of cramping in my right leg and it is real shaky when putting any weight on it. My feet are both freezing cold both to my senses and to the touch. Have tripped over my own feet as well a couple of times since the injection, coincidence or just clumsy not sure there. Maybe I should try a bungee jump, maybe that will straighten out all this mess...............................:)

[mountainman]

Hey Boss Give Me A Couple Days Heads Up On The Bungy Jump I Would Like To Be There .if It Works For You Then I Will Try It. Like They Say No Pain No Gain. Man O Man They Would Probley Need A Crow Bar To Get My Ass Off From Around My Head After The Jump. Aw Just Funin. Yea I Had To Stay Off My Meds For Surgery A Couple Of Times,it Wasn't Long Before They Knocked Me Out But For A Few Hour's While I Was Awake It Sucked.hey Have A Good Weekend If You Can ,we Are Gonna Have A Heat Wave Saturday 90's That Will Sweat The Meds Out.well Later Then .jeff

[wkriski]

I've been having back pain for the last 6 years off and on (mostly on). Within the last year it's gotten worse, after I had ART done on my piriformis. The MRI I had over a year ago said there were mild disc bulges at L4/L5 and my S1 disc didn't fuse in childhood. So I've been doing chiro and physio and most recently intramuscular stimulation on the piriformis. The ART triggered brutal muscle spasms in the buttocks during the night. I've had some numbness in my left foot off and on and it started again over the last few days. With the severe spasms came a really difficult walking and I was really skewed to the right to compensate for the tightness and pain.

Due to the numbness they're finally going to send me for a nerve root blockage on S1 and if that doesn't work then L5. I'm in Canada. At what point would they do surgery, since no one seems to think the discs are bulging enough. And I'm not very aggressive with the doctors even though I've been suffering way too long with this. It's most likely due to all the office desk work I've done as an engineer and IT consultant, I've never had any traumatic events.

Any help/advice would be appreciated!

[bigbossman26]

Well, after suffering with this condition or similar issues for over 20 years now. I am not sure when the doc's will do the surgery, I too have been too soft or "accommodating" with the medical professionals in saying that it's OK I am fine and then drag my hurtin ass to work again because I can't stand to sit idle and "wait for the fix" I guess I am just a bit impatient so after a short while I return to work and just live with the pain and limitations. I also have been told to "suck it up" and "it could be worse" "you really don't want to go through surgery" Well after this long I have about had it and have tried everything under the sun short of standing on one foot with a pig's foot waving around my head chanting to the devil to take my pain away. I think that the doc's are usually pretty good and knowing the waiting lists are out of this world here in Canada are trying anything and everything possible to assist in healing without cutting but sometimes it seems the Pharmaceutical Companies are the one pulling the puppet strings. Most recently if you have read the thread in it's entirety, I have been off work now for two years and I am not giving in until I am healed and am not suffering in agony every day. I know now that because of the waiting game and the long waiting lists to get in to see specialists, etc. that some of the damage is unrepairable and have been told this from the surgeon himself. Said if I had gotten in sooner, he could have easily gone in and done his thing and most likely with some physio been back to work and back to "life" a long time ago. Of course this is barring any unforseen circumstances however I'm quite confident that the sooner the medical intervention the sooner the road to recovery can begin. All I can suggest is to keep strong, keep believing that one day you will get better, and if it hurts to let someone know (doctor) don't be shy about admitting when even the slightest pull this way or that way has you writing in pain. Also if your pain changes in any way, or you develop new symptoms let him/her know immediately, i.e. incontinence, inablility to achieve "wood", etc. These issues although embarrassing, could be indicative of issues that need to be addressed immediately and should not be left "alone" hoping that they go away on their own. As well one last thing I have discovered is to keep as active as you possibly can. I don't mean start running marathons, but do keep active. Sitting/laying around is OK for a while but do not let your body become deconditioned waiting to get better. Even though I hurt I still go for walks, and putter around in the yard as much as tolerated. I may not be able to lift this or carry that but sometimes even being outside helps keep your mind off of the pain. Not sure if any of this helps you or anyone else reading the thread but just my thoughts.;) ;)
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[gabby70]

I have a bulging disc and sciatica. I am in constant pain. No medications, my dr does not believe in giving pain meds. I am having a nerve root block tommorrow. I have had cortizone shots that have not worked. I am too the point that I can not function anymore due to the pain. I have numbness and tingling in my right leg. Which makes it hard for me too walk. Do these nerve root injections really help or are they just another way to prolong the pain? I have been like this for the last 5 months and I can not take anymore. If you have any advice I would appreciate it.

[bigbossman26]

gabby70, The injections helped me but only temporarily. That is to say, that within a few days I was exectly back where I started off. For some, as in above postings, and other threads, they are successful in treating someone with the symptoms you describe. I can't say I would be willing to get another one though. I have to travel 250 miles one way by car/van as My wonderful ins. co. WCB will not pay for someone to travel with me. The hosp. will not release me alone, someone has to be there with me or they keep me overnight for observation. So it is a long an painful drive. I know exactly what you describe, I have been feeling this way since 2006!! I would however suggest seeing another doc. You have to have something to aleiviate the pain. I can't imagine going 5 mo without anything besides Acet. or Ibupro. Are you still working while feeling this way? was this a work related injury or?? Just some background would be helpful is all. Give the injections a try if you want, I can't recommend either way but they are no help to me.

[Kathi49]

gabby,

It sounds like what you are having done is a selective nerve root injection. They work and worked for me in the cervical spine. It was the two ESI's I had that did NOT work in the lumbar. I wish you well with the injection. Just know that there may be an increase in pain for a few days. I usually put a cold pack on after they are done and rest for that day. I should add that my husband has had both; ESI's and SNRI's for his lumbar and he has gone for a year before without having to another. I think the last one he had was an SNRI and it has almost been a year come to think of it. But, today, I have to call his spinal PM to see what can be done...the pain is coming back. :( Good luck with your injection and I hope you get some relief.

[gabby70]

:nono:Yes it is a work injury. I was lifting a very good sized patient when it happened. I have been off work for the last 3 months due to the numbness in my leg and the fact that it went totally numb while I was at work. I had the injection today. It took the edge off the leg pain but I am having spasms that are unbelievable. The back pain itself is still the same but a little relief is better then none. The injection dr said he does not understand why they have not just scheduled me for surgery. he does not recommend another injection for me and said he was putting that in the report to my dr. He did not let me leave right away due to the weakness in my leg. Work mans comp is sending me to a fourth dr next week. I guess 3 drs opionons are not enough. The injection dr also said that my disc was putting a lot of pressure on my sciatic nerve. I am so glad that I found this site and people who understand and do not think that I am crazy! I was actually beginning to think that I was. Thank You all very much!