cervical spine injection?

[xrayspex]

Has anyone gotten steroid injected into neck for cervical stenosis pain and dysfunction? I am considering doing it with a competent pain doctor. My PCP said they first do lidocaine and see how that goes before continue the injection further with steroid. I respond really well to lidocaine at dentist, it seems to block neck pain for a couple days afterwards --I am very sensitive to chems and when they do nerve block I think it works systemically in my neck head area

one thing I am worried about tho are side effects....I had lidocaine at dentist last week and my neck felt better briefly but since it wore off am feeling worse than before....its probably the trauma of procedure I had done but a part of me worries it could be also side effects feeling from all the lidocaine now that its not numbing me.....hard to know whats doing what sometimes

any experiences with any of this appreciated, especially if you are chemically sensitive too

 

[heapsreal]

Ive had similar for lower back pain . Steroids can help with inflammation but lidocaine only lasts a few hrs.

I think my back was too far gone to be relievedby steroid injections but lidocaine gave temporary relief and helped diagnose the actual problem more accurately .

I have since had a facet joint ablation where the nerve causing the pain is burnt by heating up a needle thats injected into the facet joint nerve. Sounds alot scarier than it is, plus its day surgery, probably an hr at most and no recovery time from procedure but instant relief.

The nerves do grow back eventually but pain relief last from 6 months to a few years. My last ablation has lasted 3 yrs and due for one again soon. I find for me it reduces pain alot but doesnt take it away , so i still require pain killers but its alot more effective and i find worth it.

Like everything you have to try it and see if you're a responder .

 

[xrayspex]

hey thanks for sharing heaps
yea sometimes burning pain is killer
other times its not pain like that but feels like strangulation in the neck, compression just makes me want to jump out of skin
I wonder what it would be like in lower back, did you have sometimes strange uncomfortable neuro symptoms that wasnt pain per se but just as unsettling as burn or stabbing?

 

[heapsreal]

hey thanks for sharing heaps
yea sometimes burning pain is killer
other times its not pain like that but feels like strangulation in the neck, compression just makes me want to jump out of skin
I wonder what it would be like in lower back, did you have sometimes strange uncomfortable neuro symptoms that wasnt pain per se but just as unsettling as burn or stabbing?

It varies alot, lower rightlumbar is where i have problems and it can be a stabbing pain directly in that area. Most of the time my whole back tightens i guess to try and protect it and or muscles in my hip and groin get tight and painful and right butt cheek. All those muscles have some sort of effect with the lower back. Because its arthritic , im stiff has a board when I wake up in the morning , usually bent over slightly until the tramadol kicks in.

I think with neck pain it involves less issues with supporting muscles like lower back pain and more nerve pain with burning and stabbing pain as well as tension headaches from it.

I know neck and back pain are common in the general public but i wonder if more common in cfsme due to extra inflammation etc which can wear down joints quicker??

 

[Jonathan Edwards]

Dear @xrayspex Do you really mean epidural and do you really mean cervical stenosis? Neck pain problems are very complex. I have never been very convinced that injections into necks are more than placebos and the neck is not a good place to be sticking things into without good reason.

Exactly where did you think the injection would be put?

 

[heapsreal]

Dear @xrayspex Do you really mean epidural and do you really mean cervical stenosis? Neck pain problems are very complex. I have never been very convinced that injections into necks are more than placebos and the neck is not a good place to be sticking things into without good reason.

Exactly where did you think the injection would be put?

@xrayspex
Just to clarify what i had was a facet joint injection and later a facet joint ablation . This is different to injections into spinal discs and a much greater safety profile and outcomes. These can help with diagnosing what your pain is, ie facet joint injection/ablation that works can help to diagnose facet joint arthritis which is a common cause of neck and back pain.

This is probably a more gradual step having this procedure before considering any procedures involving the disc and nerves closer to the spine.

To get an idea of the anatomical structures it might help to view a few utube videos on ablations and compare it to other procedures. The ablation i had may not be effective for stenosis as its involving different structures of the spine. But worth ruling out facet joint involvement as its such a common cause of neck and back pain.

If it helps its worth looking into as it can provide better pain relief and less reliance on pain killers that have their own risks in chronic pain.

 

[xrayspex]

ok--I will have to get back to you....because perhaps I do not mean an epidural..........I am waiting for a call back from the doctors clinic....they are a university affiliated place, not that that means anything, but they would only do EBT medicine and probably be fairly conservative
I will amend the title to just say injection until I get more info----- but yes it would be for cervical stenosis to help shrink the area in there that is too crowded causing pain, whatever type of injection uses lidocaine and then steroid for that --I want to find out exactly where they are injecting etc they have a good track record as far as risk benefit

 

[xrayspex]

Dear @xrayspex Do you really mean epidural and do you really mean cervical stenosis? Neck pain problems are very complex. I have never been very convinced that injections into necks are more than placebos and the neck is not a good place to be sticking things into without good reason.

Exactly where did you think the injection would be put?

Hello-so I saw the physician again--who is a fairly newly educated pain specialist specializing in injections as part of her job who is affiliated with a University---anyway she said a nerve block and epidural are same thing in this situation and that it would be targeting the area of t1 thru c7 and that one bends their head forward for the injection-, into a nerve I believe-I didnt quite catch exact spot they inject it but somewhere in neck and probably relates to one's mri in part perhaps?

thing is she scared me with all the possible adverse consequences that I didn't commit to memory all the details but she said I could research epidurals to learn more about it. But she said some people complain of more ongoing pain from them so she didn't want me take a big risk without being fully informed--but she did say if I decide in future do want to take the risk that we can do it.

Since my pain in that area isn't currently relentless and is episodic and I wasn't in bad worst neck flare that day I decided against. I am also concerned about the poorly understood part of some pain that I get that seems to be maybe neurogenic or AI and is not confined any more to the neck and i know folks with M.E. can get bad pain in the neck and head and body---so it seems so hard to ferret out what is causing what which makes it hard to decide on safe treatment.............if I wasn't as sensitive as I am I would be more willing to go for it but I do not tolerate meds and invasive procedures well due to structural and organic reasons..............

frustrating!

she said another type of injection is trigger point for spasms but spasms haven't been a huge part of my spinal pain syndrome over the years --I don't have fibro type thing where I jump if someone touches me--massages can feel good but I don't get them because I get delayed pain reaction from fascial or other manipulation--even cranial sacral hurts me real bad for upto a month after--quit getting that like 13 years ago.

 

[Jonathan Edwards]

Hello-so I saw the physician again--who is a fairly newly educated pain specialist specializing in injections as part of her job who is affiliated with a University---anyway she said a nerve block and epidural are same thing in this situation and that it would be targeting the area of t1 thru c7 and that one bends their head forward for the injection-, into a nerve I believe-I didnt quite catch exact spot they inject it but somewhere in neck and probably relates to one's mri in part perhaps?

Dear xrayspex,
I hate to question colleagues but an epidural is not the same as a nerve block. I used to do epidurals way back in the 1970s but gave up when I became a consultant because I realised, when the buck stopped with me, that I had no justification for them or evidence for benefit. Since that time the pain management sector has expanded and people use various sorts of injections but I am not convinced there is good evidence they are any better than a jab of steroid into a muscle.

An epidural goes in to the epidural space and spreads widely up and down spinal roots. If a blocking drug like an anaesthetic is used it will numb quite a large area. A nerve block attempt to block an individual nerve. I am not sure how you can cover C7,C8 and T1 (T1 through C7). If you block those nerves most of the hand should be numb. (If the pain is due to a problem with one of these roots you would be feeling it in the hand, not the neck.)

I doubt there is any evidence that injecting trigger points does any good. I fear there is quite a lot of pseudoscience in these injection techniques.

 

[xrayspex]

thanks for sharing your experience JE------food for thought---I am pretty conservative now when it comes to invasive stuff so no rush to try this unless more desperate--I have minimal hand/arm involvement from my stenosis which surprises neurosurgeons because MRI looks like I would---I think maybe because I lie around a lot for years (due to pain and fatigue) I haven't challenged my anatomy some people do with spinal issues that have to keep going out of necessity or lack of self care--but I am able to take walks w/out flare usually to try to maintain some which has been good

I have talked to some folks with spinal issues on another forum that do like these injections but some of them were in much worse shape from accidents and willing to take the risk--I don't know what stats are on outcomes tho
The physician who explained it to me did caution me--she wasn't nonchalant about it by any means and didn't seem sure at all that it would be good outcome-but said it was my choice

I was intrigued by the idea because I had had extra lidocaine for dental procedures recently that was a nerve block and by numbing up my head area like that I had felt for a day decreased pain in neck and head area---could be occipital neuralgia or trigeminal neuralgia (have some tmj and ear involvement w/pain etc) so I thought if there was a way to prolong the effect I'd had from lidocaine injections it could be good
but I am not sure about steroids, if would be same as lidocaine

 

[perchance dreamer]

I've had steroid shots in my cervical spine, and I'll never do it again. I had really terrible insomnia for a couple of weeks afterward.

I've had this procedure done a couple of times. I had forgotten about the insomnia side effect, so consented to it again some years later. Again, I had sleep problems from it for a couple of weeks.

I don't know how common that is, but if you google steroid shots, side effects, and insomnia, a lot of entries come up.

 

[xrayspex]

I've had steroid shots in my cervical spine, and I'll never do it again. I had really terrible insomnia for a couple of weeks afterward.

I've had this procedure done a couple of times. I had forgotten about the insomnia side effect, so consented to it again some years later. Again, I had sleep problems from it for a couple of weeks.

I don't know how common that is, but if you google steroid shots, side effects, and insomnia, a lot of entries come up.

thank you for sharing that with me perchance---that was one of my big concerns as I am very sensitive to steroids ---a PT I went to was trying to tell me maybe for a couple days I would be edgy but then get over it and I was thinking, yea you really have no idea about people with chem sensitivities.....