Decisions Decisions...
Coming home from my appointment the other day, I was contemplating what lay ahead. The pain specialist was telling me I needed to have an injection in my neck to help alleviate the swelling and inflammation caused by a herniated disk that was pressing up next to my spinal cord. This was leading to my intermittent pain, weakness and tingling that I was feeling in my arms and fingers. Since the whiplash I suffered from a rear-end accident, I was suffering with severe pain in my neck and shoulders and physical therapy was helping but had not helped the problem significantly enough since I started it in mid-September.
So here I am in a situation several of my readers have been in over the years - needing to make a major decision about an invasive procedure. So how was I going to go about this...
I could appreciate the fear and concern that goes with the news of needing such a procedure. And I like anyone else can appreciate the questions and concerns about making decisions that have a potential for complications and unforeseen outcomes.
An epidural steroid injection takes just a few short minutes but a lot can happen during that time. Because of the nature of the location, precision is a necessity. It takes place in a surgicenter using fluoroscopy. Sedation is necessary to ensure absolute stillness so not to create a "moving target" for the doctor performing the delicate injection. I am told that a post-procedure waiting time of about half-hour is needed to let the sedation wear off and I would then need to be driven home to rest for about a day and a half.
As I speak to my husband about it, I share some of the concerns I have. The doctor says he has never had any serious problems from any of the many injections he has performed and he takes every procedure seriously and with utmost caution. Even though it is just an injection, it is still an invasive procedure with risks.
My first thought is to read about the procedure so I know what will be done. I have a great book that describes the procedure in depth including pictures and sketches of needle placement and so forth. I plan to read the chapter about this and then take out my paper and pen and write out my columns for pros and cons of having the procedure.
I do have a couple questions. I need to ask my workers' comp case manager about timing--whether I have an option of waiting for a later time or if I am placed under a time stipulation for having the procedure performed.
If I decline to have it performed now will I be able to opt to have it done some time down the road should I find myself unable to use my arms or hands? I also want to ask my doctor when I see him what he thinks - if waiting would be detrimental to my healing or not.
I am afraid like anyone else might be. I do not want to find myself in a situation where I am more limited or uncomfortable than I already am. And I don't want to suffer complications such as a hematoma or further neuropathy that could occur from the injection.
So I see I have some work to do and things to think about. I will be diligent and learn as much as I can weighing the pros and cons and hopefully feel I can make the best decision I can...I think that is all anyone can hope for...
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Technorati Tags: neck pain, whiplash, steroid injections
28 Comments:
I keep having middle and upper back pain.Mainly I have a bunch of knots in my rhomboids.I strecth regularly go to chiroprator and get massages.Nothing seems to help and is very uncomfortable.Do have any suggestion on what I can do?Please contact me at patrickf75@charter.net. Thank you
I had severe neck and shoulder pain following an auto accident in 2000. Not the standard whiplash, though - my vehicle was shaken violently from side to side several times, and I described my condition as a grown up "shaken baby". NO ONE was able to help me heal, although I was sent to PT at 3 highly rated centers over the following years. I still take more muscle relaxers and pain killers than I would like to.
The problem is, all the very short muscles that support the head are injured or weak now. Isometrics is the only exercise that helps, but there are so many muscles and I don't know how to work on individual muscles. Driving on the freeway is pure hell!
Getting chores done: never reach higher than your line of sight, and don't look up. Stand on a ladder and work with your neck in a neutral position. Never work on ceilings unless you have a roller on a pole and can stand fairly far away - and keep your arms no higher than your shoulders.
We all think we can reach JUST that bit further, lean over a bit further - and we can, but we'll hurt a LOT more the next 2 days.
i'm having knee pain from a fall two days ago on concrete in a department store. i can walk on my leg and bend it, however it is uncomfortable to bend and when resting, it feels like it's bruised although i looked at it and it doesn't look swollen. should i go get an xray or just take pain relievers.
I am having the same symptoms. Rearended and horrible back pain especially my neck. It is affecting my whole family life. My husband says he understands but his tolerence is running out. I had an injection from a specialist who puts anasethia into my neck 12 joints to see if it took the pain away. It didn't so next proceduree will be a discogram. The joint injection was so painful. It is so hard because I look fine but I am not. I do not think the same either.
I want to die at times nobody understands me and how much the pain hurts. I don't have the emotional tolerance to back up my feelings of dread which makes me as well so much vulnerable. God Bless.
I keep having pain in my rhomboids as well. I have had them for over 6 years. All the Dr.s do is give me pills or shots and it only last for about 3 weeks and the pain comes back. so if you give me any info. please do. thanks. wiseone917@hotmail.com
t, I have that same rhomboid pain, for about 6 years. It could have something to do with the tendons in that area. I'm pretty sure it came from overuse. I've tried it all but still have pain. Let me know if you come up with something.
I had a car accident a year and a half ago. Low speed. Ran into the side of a car that pulled out in front of me. Sever thoracic back pain. After many different doctors I was sent to PT to have the PT send me to a shoulder specialist. Torn up shoulder. Had that fixed. Then the lumaber pain took over. Finally, after 10 or so back/nerve doctors a back surgeon said I needed to have a discogram.
I did not find out until after the procedure what they call it at the hospital- a scream-o-gram! NO KIDDING! Indiscriable pain!
Now the big decison, fusion or replacement of 2 discs.
I have already has a diskectomy in my neck. I had for a long time migraines but then I got worse with the pain and numbess down the left side. The MRI showed the disk out of place so in my case I had no choice but to have surgery. I still have a little trouble when my neck swells but 99% of all the other sysmptoms are gone. Now I have low back pain and have gone through the shots ( 7 rounds) plus therapy and finally 4 days ago had a discogram done because the MRI wouldn't show what was going on. I have been on pain meds for a year and what it showed is I have a bad tear and the disk is out of place. I know I will need surgery so I can get off the pain meds. Most of the time it is worth the surgery. You have to check around and asked people on the best doctors for the job an so on. For people that dont know there now is artificial disks that can be used instead of plates and pins that most of the insurance companys will pay for now. I dont know if any of this will help anyone, but all good luck.
lower back pain, disc a gram on the 17th How bad is the pain???????
L4 L5 AND S1 is my troble...work injury. one operation on 6.6.07
still having pain. living on pain killers feel sick alot. had 2 sets of shots.
Could someone please tell me what is a discogram is? The nurse who booked the appointment said it hurts. What do they do? thanks for your help..
I keep having the pains of pins and needles up and down my whole body area..I hurt my lower back 4 years ago at work and the pains and the tingling keep getting stronger and almost unbearable at times...Any comments on this please contact me at tammi_painter90@hotmail.com...Thank you
I feel like the muscles from my sholders to the top of my neck where they reach my skull are completely knotted up. I have a constant pain that feels like it starts from the bridge of my nose to the lower part of my neck; shooting across the top and through my head. I have not encountered any injuries from and accidents, it just hurts all of a sudden. Please contact me with some suggestions....Please!
Smith_douglas2007@yahoo.com
Thank You.
To those of you posting questions about specific pain issues or back pain:
Please visit our back pain support group message board, or Indie's Pain Management message board.
Thank you.
I HAVE HAD SURGERY (ANTERIOR INFUSION) DONE ON MY NECK . IT IS VERY HARD TO MOVE SINCE THE SURGERY BUT MINUS SOME OF THE PAIN. STILL HAVE HEADACHES DAILY. HAVAD MRI , XRAYS, AND THE CAMOUS INJECTION IN BACK TO HELP WITH THE PAIN. NO AVAIL !! NOW IM GOIN IN FOR THE DISCOGRM WHICH I HEAR IS VERY PAINFUL. DOES ANYONE KNOW WHY THIS NEEDSBE DONE AS MY DOCTOR HAS ALLREADY STATED HIS OPIION ON WHAT DISCS ARE RUPTURED AND BULGING. WHY AM I GOING THRU THIS PAIN CANT THEY JUST DO THE SURGERY ? I HAVE BEEN ON PAIN MEDS SINCE 2004 AND HAVE ZERO TOLLERANCE TO PAIN NOW, NOT TO MENTION I HAVE ANXIETY , AND JUST DONT WANT TO PARTICIPATE IN LIFE ANY LONGER DUE TO PAIN AND BEING MESSED UP ON MEDS THAT HAVE CAUSED NUMEROUS ADDITIONL HEALTH PROBLEMS.. CAN ANYONE PLEASE HELP WITH SOME INFO ??
Hi, I am in a similar situation, car accident whip lash 2 years ago with bulging disc one bulging into my spinal cord.....feels recently like herniated due to weakness in hand/arm and high narcotic pain meds not working. I go to see a neurosurgeon in a few weeks and had a discogram scheduled but rescheduled by the Dr due to my primary putting me on predisone due to high pain......I also have been so so scared regarding the discogram since the first procedure to rule out diagnostically was a joint injection and was pure hell. Anyone who does this or any of these procedures has a horrible quality of life I can attest. The hardest thing is you look fine to everyone else you are in a constant battle with how you feel inside and who you use to be. I wonder if a new MRI or mylogram or CT would do the trick. I see my phsyiatrist tomorrow, let you know. Food for thought to anyone reading if you are in chronic pain.l...be ready and prepared to casemange yourself or you will not get the care you need. Hope all goes well with you.
In 5 days I will receive a steroid shot to my neck for a bulging disk, it was a shot or being cut open. Will this steroid shot just be a bandaid? I would just like to be normal again before I was hit on the head. Any one have advise for me Iam dealing with work comp and fill uncomfortable with not having a say in my med doctors and the thought of my jobs insurance deciding on my future makes me fill out of control.
I am terrified that I am rapidly becoming a total invalid. After a left knee injury 6 months ago which resulted in swelling of the entire leg 3-4 times it's normal size, knee joint pain scale of 10, unable to do physical therapy or swim. MRI showed a large ruptured Baker's cyst with hemmoragic debrie vs possible bone fragments, the ligaments and tendoms completely stretched but not torn. My internest Put me on large doses of Lasix with KCl suppliment. I could barely walk and no matter what position I assumed the pain was relentless. 4 different orthopedic surgeons disagreed on treatment. One thought a joint replacemnet was in order after reviewing the pathology of the MRI, venogram neg for DVT. Steroid injection helped but lack of pain caused me to turn wrong with a resurgance of pain and swelling. I could not tolerate the pain of physical therapy which one ortho MD said that an inability to tolerate PT was a distinct sign that my problem was psychological. No one will now do anything including an arthroscopic surgery because the knee became infected after the steroid injection.
Now in my 6th month, my fibromyalgia has worsened to the point that I can't get out of bed without help. My weakness tingling and numbness from shoulders to fingers when I wake up. The weakness has caused me to fall on several occasions injuring my shoulder, back and both knees. I am so fatigued and sleeping 20 hours a day. The pain has caused me to become depressed and anxious and I had to start back up on Lexapro and Klonipin. My muscles are in constant spasm. I have long periods of severe cramps in my left calf. My doctor has increased my K+, added calcium and magnesium with no improvement. I finally went to a new physician who is carefully reviewing my lengthy case. Figromyalgia first diagnosed by a Board Certified Rheumatologist in 1999 and confirmed by another
rheumatologist in 2005.
Could not tolerate side effects of Lyrica. TAke 1500mg of Salicyclic acid for pain but an bleeding all the time form minor cuts. Soma as a muscle relaxent was stopped after 15 years of helping because I was between doctors and now restarted with helpfulness. The klonipin helps the acute muscle spasms of the shoulders around the scapular region but when I had acute carpul tunnel syndrome, the ER and neurologist prescribed Valium and that helped the muscle spasms better. Currently on 60mp oxycodone, with minor relief, Fentany patches did not work. HELP 10:30 am MST
hello evelinrose..wow you got some troubles. I, too have a bakers cyst that came back in back of my left knee. I had 2 holes put in front of my knee to take care of torn cartilege..dr. always said, walk, walk, walk,,right doc..but now you don't know how much pain I am in cause I also have spinal stenosis and some mornings I can't get out of bed. I am all hunched over...what I wouldn't give not too feel all this pain. I think the dr. said something about draining the cyst. I never heard of this? do you have any information on this I would appreciate it immensely. Take Care! Connie
I had a steriod injection in my left knee yesterday to relieve pain. I have had two scopes and need a knee replacement that won't be on the market for another2 yrs per my doc. About 5 hours after the injection, which was the most painful thing I have ever experienced since childbirth, I can't put any weight on my leg and have been in bed. My doctor says it takes 24 hours for the pain and soreness to go away. My knee is very swollen and warm. I have talked to other people who have had injections and they said they have never had the problem I'm experiencing. I've also had injections in my elbow and always felt sore, but nothing like this. Any advise or suggestions?
A discogram is indeed a painful procedure. The doctor inserts a needle or needles into the disc(s) that may be causing your pain. He guides it by floroscopy for accuracy, but depending on the condition of your bones he may have to try more than one time to get the needle in the disc. That is not the painful part. After he has placed all the needles a fluid or fluids are injected into the disc and an initial pressure reading is taken of the disc. After the measurement is read more fluid is inserted into the disc until you feel pain. The doctor will stop and ask you where the pain is located, where do you feel the pain. If you have a serious pain, this is the painful part. It can be very intense pain and last for two or three days after the test. They are able to take pictures of the area they are injecting also. I have heard from nuerosurgeons that it is a valuable tool for them when they are preparing for surgery...but it hurts just as bad or a little worse than the pain you are having on your worst day. Hope this helps. I have had a few. They always hurt. Haven't found a pain med that stops it either.
Being the procrastinator that I am I have probably actually saved myself a huge amount of time, money and suffering. I suffered horribly from pain in my neck shoulders and back from being hit directly in the drivers door by a speeding car through a red light who never slowed and didn't have their headlights on in the wee hours of the morning as I was going to work in the middle of the night as an RN on call. He was doing no less than 45 miles per hour, had no drivers license, no insurance and was probably not in the USA legally. I was single with three kids and a full time job and a part time job. I didn't have time or money to be sick or see doctors. I did what I could. Then I met someone who went to a homeopathic doctor. I now do not eat red meats except rare occasions then from cows not fed antibiotics, hormones or pesticides, drink milk without antibiotics or hormones given to the cows, stay away from ice cream, cheese, and any smoked meats. I eat non-fried foods, skinless chicken and fish non-breaded, fresh or frozen vegetables and fruits. Once I started eating properly I began seeing my young, just out of school chiropractor who eats the same way, is up on the latest techniques and incorporates acupressures, acupuncture to his methods. I started exercising first by stretching, then walking. I went to a licensed massage therapist the day after I saw the chiropractor, now only once a month. After 8 years of taking better care of myself by monitoring what I put into my body, weighing 144 lbs at 5'7" through eating right and mild exercising I work circles around the 20-something gals and I'm 57. I now only occasionally have pain if I've not taken good care of myself. After many warnings about the pain never going away, needing invasive surgery after the dreaded painful discogram, I'm living proof that steroids, painful procedures and surgery isn't always the best medicine. Watch what you put into this body, and how you treat it. You may not be able to avoid injury by someone else, but you can help the outcome.
Hello, little over a year ago I was diagnosed on haveing 2 buldging disk in the T12 reagon and some pinched nerves in my lumbar reagon. The doctors had me through therpy which I am still in and things have not got better, they are worse. The doctors just keep giving me more medicine. Now they put me on a diet and said if i lose weight i will relive some pressure of the nerves and i wont hurt no more. That is a meth i believe, because I lost 60 pounds and I am in worser shape now than i started. I hurt so bad, the meds are not helping. I am diabetic, high blood pressure and just recently been diagnosed with raynauds disease. so if anyone has any sugestions that can help me, Pleae let me know. The pain is stoping me from my daily living. I am only in my 30s and i feel i am in my 80s. Help Thank you
I injured my back in a fall 2 months ago. I have had 2 MRI's and told by my workers comp doctor that I have an annual tear and a bulging disc (bulging to the R-side). Yet I have pain in my left leg?? He says that is not possible or a usual when it is bulging to the left. I have complained about pain just to the immediate left of my thorasic region but was dismissed because nothing was seen on the MRI. It still hurts and sometimes burns when I bend my head forward?? What else can be done to see if there is a problem in my thorasic area next to my spine or is it just a muscle spasm that has gone on for over 2 months?
I have what has been explained by a workers comp orthopedist that I have an annual tear and a bulging disc (bulging on R-side). Yet my leg pain is in my left leg and lower back on both sides where the little dimples in your back are. I have pain in the thorasic area but they only called it a muscle spasm and dismissed it as a problem. This is after an MRI on both lumbar and the thorasic areas. Is it possible there is a problem in that thorasic area even though it did not visibly show on an MRI? The pain is from a fall over two months ago?
I too have had the same kind of pain do not really know specifically what caused it. I do have scolosis and arthritis but these are not causing this pain in my neck and shoulders, I too have had physical therapy, pain killers, pain patch, and now am undergoing the injections in my neck and back from a pain doctor. While they seem to help some at first it doesn't last very long, and this last one a few days ago has caused me to have extremely itchy skin, inner jumpiness, depression, or is it just the fact that the pain just does not go away. I have found one thing that has helped some, water aerobics. I am taking them at the Y and it helps some. Really any kind of being in the water (WARM if possible) and just moving around some helps a little. So some of you could try that if you have access to a pool with fairly warm water.
To the person that was asking what a discogram is, go to this link that I found on the Web and it will tell you everything.
http://www.spineuniverse.com/displayarticle.php/article646.html
yes i have had knee surgery as a freshman in highschool to remove 3 bone fragments lose in my knee. well im now 20 and im starting to get the same pain but something different is happening now. when i walk ill on occassions have a sharp pain and pressure on the right side of my left knee. and when i go to feel on it i can feel a bump and its not large enough to be visable but you can sure feel it and well i can push it back in and when i do so the pain and pressure will go away. i know i need to get it checked out i was just wanting to know if you had any clue on what it could be before i go get it checked to kind of do away with any suprises i might recieve in doing so. if you could email me back at mdillonharris@yahoo.com thank you!
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