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Thread: Neuro pain from bladder irritation (cath, uti, irrigation, etc.)

  1. #1

    Neuro pain from bladder irritation (cath, uti, irrigation, etc.)

    Hey all! Please excuse the short, choppy info. Trying to avoid making this a long read.

    My pain management Doctor does not have much experience with SCI. So, my assumptions about types and sources of pain may be inaccurate. I have a pain pump and am currently on a fairly high dose of Bupivacain. It has helped quite a bit with musculoskeletal pain. It doesn't seem to touch neuropathic pain. The neuro pain skyrockets with any bladder stimulant. I dread cath changes because it results in 2-3 days of hell. There are no stones or anything physically wrong.

    I've read about neuropathic pain sometimes being an overreaction to a stimulant. I don't have problems during the program. It just seems to happen with bladder irritation. My dr wants to try adding Prialt to Bupivacain. However, I'm looking for other options since I've heard nothing positive about Prialt and have already been through the narcotics ride.

    Questions:

    Does anyone else have neuro pain that (appears) to have a specific trigger? If so, has anything helped?

    Would a nerve block aimed at the bladder be a reasonable next step? The thought here is that if my pain decreases dramatically by blocking bladder, perhaps a more permanent surgical solution could be an option.

    I do realize that this is likely to just be the long neuro pain ride so many take. Just trying to find options.

    Thank you in advance for any thoughts/feedback"



    Jason

    C5/6 Complete - water skiing accident 1994.

  2. #2
    Using lidocaine jelly may quiet the noxious stimulation that occurs during catheter changes.

    All the best,
    GJ

  3. #3
    Quote Originally Posted by gjnl View Post
    Using lidocaine jelly may quiet the noxious stimulation that occurs during catheter changes.

    All the best,
    GJ
    You are correct. It does help for a little while. I think it's the nerve pain getting progressively worse. It has been for years. The fact that it does help short term kind of helped prompt the question. Trying to see if others have had any success blocking the source of an apparent stimulant.

    I don't really understand how the pain makes it through in the first place. So, not sure that a nerve block even makes sense. Just trying to find options other than more drugs.


    Regardless, always appreciate the thoughts GJ
    Jason

    C5/6 Complete - water skiing accident 1994.

  4. #4
    Also, keep in mind that it is VERY difficult to do a selective nerve block for only the sensory nerves of the bladder. The nerves responsible for reflex erection and for anal sphincter tone can also be easily blocked at the same time, resulting in serious ED as well as a flaccid (LMN) bowel, which is much more difficult to regulate than a reflex bowel.

    (KLD)

  5. #5
    Quote Originally Posted by SCI-Nurse View Post
    Also, keep in mind that it is VERY difficult to do a selective nerve block for only the sensory nerves of the bladder. The nerves responsible for reflex erection and for anal sphincter tone can also be easily blocked at the same time, resulting in serious ED as well as a flaccid (LMN) bowel, which is much more difficult to regulate than a reflex bowel.

    (KLD)
    Just all kinds of fun stuff to consider with pain management. Thank you
    Jason

    C5/6 Complete - water skiing accident 1994.

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