Injection for spine pain - Input please

My background: I have a severe pain in my cervical and thoracic areas. Actual contentions are C2 and T1-3; also have fusion from C4-7 with titanium plates and screws. I also have severe headaches I believe from cervical reversed curvature, as well as from the c2-3 degeneration-herniation. In a nutshell I was deemed to have degenerative disease and fibromyalgia.

I believe most of this was caused by my massive intake of tap water ALL of my life as well as smoking up until a few years ago. Understanding through ATS (my saving grace for many insightful posters and threads) I thought I would see if I could find the sweet spot of how to rewrite my future.

After monthly doc visits with continual increase to multi prescriptions that only lead to causing my pain to amplify and the need to keep increasing my narc intake which became a vicious cycle. I took the liberty to go cold turkey and stop all the addictive end of life intake because of the horible things they seemed to be doing to me. I am recently in throws of extreme withdrawals close to the end than the peak I hope now that I have been in this stage almost 2 weeks. I am not sure if the withdrawals cause to increase the pain as wel. I know "dope sickness" and have never used recreational drugs as an adult. I am 41 and the quality of life has been basically gone through the floor. The fog may be clearing but my pain is enough to send me to the edge! (No worries - have a preschooler and a 1 yr old grandchild so those stars inspire me to take a different path. ie organics, little meat - grass fed beef by AMHA and fish if not farm raised and little sugar, gluten or dairy unless yogurt)

I have been told I need to get spinal epidurals and it may turn into like a weekly or bi-weekly thing depending on who I see and the treatment they believe I should have. Mix bag because I have medicaid and most of the confusion is are the facilities only seem to want me to ask for what I need rather then truly having compassion and now exactly what to do HELP. I actually have some wanting me to get back onto "maintenance pain meds." That is out. But not sure If seeking out surgery via ortho surgeon or just opt for the blocks and cave for weekly injections. Neurosurgeon has told me until I feel long bouts of numbnesss that surgery will not help. The menningitis scare had me very rattled and my mother had injections, tins units, cadaver fusions- 2 in her lumbar and had some complications as well and paralysis. Led her to try an commit suicide on 3 different occasions many years apart. She rides in a scooter today - she would be on hi octane opieates has I have but she is in a small town on the border of FL/Ga so Lithium, loratab, percs and fiornal are her way of life....stuck with the physician choices and no quality of life for decades. THAT IS A MAJOR SCARE.

I am swam through many posts and just can find the answers and hope to hear from some scholars here.

thanks!!

Whenever you have a fusion, the areas adjacent to the fusion are prone to premature degeneration and/or failure. It creates a viscous chain reaction.

It has been my experience that injections may work the first time but the duration of pain relief and the quantitative decrease in pain decreases dramatically with each subsequent injection, so by the time you get your 4th or 5th injection, you might get virtually zero relief. There are risks associated with the injection itself, one being increased degeneration of the joint being injected. Accumulative scar tissue from the injections can also be problematic .

If anyone is suggesting that you might need weekly injections, they are smoking crack and do not have your best interests at heart. Explore conservative chiropractic care, decompression, cervical traction, and mckenzie excercises. And no, having fusions doesn't prevent you from chiropractic care, just not rotary adjustments.

I'm c3-c6 titanium plates 6 screws and my entire lumbar spine (l1-s1) has been fused over three separate procedures without additional hardware. It still hurts and is stiff from time to time but my bladder, bowel and other involuntary systems functions normalized so I have to say the operation was a complete success.

First lumbar procedure was done by a neurosurgeon, it was worthless, he had no alternatives for me. So I ended up being referred to a pain management program where they tried the injections - only once and with NO relief. I can't recommend a neurosurgeon for anybody with spinal issues. "Their kung-fu no worky!"

I changed doctors and went to a spinal ortho specialist who fixed me up pretty good - but I've got stenosis, spondyliosis and relatively bad scoliosis. The doc says my genetics are bad and that eventually I'll probably end up with rods to correct the scoliosis. I've been disabled since 2001 and I'm fighting the rod surgery.

So a few months ago my wife comes down with back problems and lo and behold the pain management folks tryu the epidural - to no effect - then they want to do three more... So I referred the wife to my ortho spine guy. HIS OPINION is that IF the injections are going to help at all, you'll know after the first one - if they're effective, get more. If they're NOT effective, it may be time for surgery - but in my wife's case he recommended a strong anti-inflammatory and physical therapy. Two weeks into it, the combination seems to be working pretty well, so we're definitely NOT getting her any more injections. Of course, therapy can only do so much, but I was able to avoid surgery for almost 3 years with aggressive therapy, acupuncture, rolfing, etc.

SO, since you tried the injections and they didn't work for you, fuggedaboudit and get a crackerjack spine guy that really knows theraputics as well as just cutting. My docs are in Dallas and I usually use the ones with the multimillion dollar football & basketball player patients. Just my two cents. I feel for you.

ganjoa

ADD: Both the wife and myself were 300-plus pounders for a couple of decades, which is the likely cause of her maladies - I've got a family history of spine disease, thus the added severity of my conditions. However, my drive-train is falling apart now so it's looking like I'll need a couple of knee reconstructions as well. But I plan on getting better - you need to plan on it as well!

Originally posted by rimjaja
Whenever you have a fusion, the areas adjacent to the fusion are prone to premature degeneration and/or failure. It creates a viscous chain reaction.

Yes indeed that was a severe caveat because from C2 to L1 the degeneration had cascaded and the neuro basically said when need to access the priorities of what fire to put out first whiich was numbness and loss of use issues. The area fused my center vert had calaspe splnter into shards and was impinging my spine - I knew through my mother exp. to go the route of the neuro for that very fact of spine impinging bone frags. Terrified, went through with it and was short lived glee and the above and below then took the brunt of what was left untreated.

Originally posted by rimjaja
It has been my experience that injections may work the first time but the duration of pain relief and the quantitative decrease in pain decreases dramatically with each subsequent injection, so by the time you get your 4th or 5th injection, you might get virtually zero relief. There are risks associated with the injection itself, one being increased degeneration of the joint being injected. Accumulative scar tissue from the injections can also be problematic

.

This I knew from my mother's experience but no one has discussed this domino effect. Glad you included!

Originally posted by rimjaja
If anyone is suggesting that you might need weekly injections, they are smoking crack and do not have your best interests at heart. Explore conservative chiropractic care, decompression, cervical traction, and mckenzie excercises. And no, having fusions doesn't prevent you from chiropractic care, just not rotary adjustments.

The injections schedule I tought was radical and quite possibly unnecessary. Haven't heard of mckenzie exercise but will explore asap.

Chiro care...IN the beginning of this I woke in the middle of the feeling as if someone had sliced the side of my neck and was pulling all muscles, etc. out and was to the point of almost hysterics after a few hours. I opted for a chiro (vetted and decide to go in that evening.) He adjusted me after exrays torting my neck in such violent ways I KNEW THE MOMENT he twisted that something bad happened - when I thought it couldn't get worse, it did. Had to walk out with my head/upper torso at a 45 degree anglecrying like a baby. To the ER went and they gave more xrays and dillauded injection. WOW, I thought it was a miracle; only short lived. Following the coaching of the chiro I went one more time - ER saw me again the following evening. Referred me to a specialist with the news he thought I had a collasped/cracked/possibly shattered vertabrae and said I need a neruosurgeon and to loose the chiros contact details.

By the time I got to the Neurosurgeon I became pregnant (Grey Goose was my savior for a few weeks - hubby did not complain, since script anti inflamatories or tylenol 3s would not work....lol a brief time of intoxicated fueled happiness and lots of bed rest) My ob put me on ms contin and soma....yes while preggers.

Realizing I needed a new plan - I sought out a female who specialized in maternity chiro care and used the activator methods while I was pregnant. Those adjustments seemed to work long enough for lunch, market and home to the bed and ice.) I digress. Birth, pain point injections, lidocaine patches, a c-section due to my inability to push....but moving forward I had to have surgery/fusion, progression to massive narcs for 3years. I was deperate and still had no insurance (my 60k job long gone) I opted to see the femal chiro. I ended up going for 97 days straight and sometimes doubled and even trippled the daily visit. She used the activator methods and gentle adjusting but I couldnt go one day without needing to be adjusted. I did meet a chiro (male) who was joining at the end and he did actually offer gently abrubt partial left and right cervical adjustments that gave me chills how well they worked. This was not part of "his recommended app" but said it was desperate alternative. in my case. Moreover, my cobra ended as the money disipated and so did ANY alternative care! ::SIGH::TEARS::Repeat

Thanks so much for your time and response. Greatly appreciated!

reply to post by ganjoa


Thanks for your thoughts, and I am sorry for you that back pain is part of your family life as well.

After one year of surgery and post delivery/nursing/ attachment style care .....I could not wait to get into the neurosurgeon. On my 3 month follow up.....he released me as a successful patient. Continuing attachment care reaked more havoc and was back to needing opiates again - I was given a regimine through PCP and the only dr. allowing my medicaid/wellcare ins. This continued up until 2 weeks ago. 4 years on opiates was 4 years too long!

Accupunture, yoga and pilates are on the lst if I can buy time to make money after an injection to seek this alternative care. Altered naturally his the need for me going forward.

My weight is not optimum. Seems c-section along with the inability to function normally I knew then I had to seek out how to reverse any and every habbit I know which I did smoke socially (genetics mixed with smokes today isn't the best for your cartilidge and was told by the neuro that stress and smoking would continue the demise of my spine. Still trying to learn meditation to flush the stress; while I try to detox as well as radically ommitng many foods hazards and eating mostly organic. On my journey to "reset" my body and hopefully increase my body's natural healing abbilites; and finding any worth techniques to contine on the drug free path.

No chiropractor should have torqued your neck based on the surgeries you have described. There are gentle adjustments that can be done to the remaining, unfused vertebrae. I'm not the biggest fan of activator method. I will use one when someone can not handle anything else, but it is not my preference. No one should have see you for 97 days straight though. If your adjustments were not holding pmuch longer than a few hours, then someone should have investigated why. In my experience, the most likely reason someone isn't holding their adjustment is under treated or I diagnosed hypothyroidism. Have you had your GP run a FULL thyroid panel?

The fact that you have that much ligament laxity and degeneration though is problematic. You may want to find a practitioner who does iv nutrition and get a series of vitamin c infusions, maybe some Meyers cocktails, etc so that you lay the groundwork for collagen repair.

Decompression is definitely worth investigating. You can look up Cox Flexion Distraction to find a list of practitioners in your area. There are also doctors that have 100k distraction tables, but if it were me I'd look for a cox practitioner. I've seen people with full blown disk herniation or failure, people that were surgical candidates, and completely antalgic people turn around with a short course of cox

No chiropractor should have torqued your neck based on the surgeries you have described. There are gentle adjustments that can be done to the remaining, unfused vertebrae. I'm not the biggest fan of activator method. I will use one when someone can not handle anything else, but it is not my preference. No one should have see you for 97 days straight though. If your adjustments were not holding pmuch longer than a few hours, then someone should have investigated why. In my experience, the most likely reason someone isn't holding their adjustment is under treated or I diagnosed hypothyroidism. Have you had your GP run a FULL thyroid panel?

The fact that you have that much ligament laxity and degeneration though is problematic. You may want to find a practitioner who does iv nutrition and get a series of vitamin c infusions, maybe some Meyers cocktails, etc so that you lay the groundwork for collagen repair.

Decompression is definitely worth investigating. You can look up Cox Flexion Distraction to find a list of practitioners in your area. There are also doctors that have 100k distraction tables, but if it were me I'd look for a cox practitioner. I've seen people with full blown disk herniation or failure, people that were surgical candidates, and completely antalgic people turn around with a short course of cox

reply to post by rimjaja


I do have hypothyroidism!! It was ruined about 10 years ago I think. Another middle of the night awakening..with severe hives. That began a terrible journey of massive steroids, allergy injections and probably way too much of my water intake from the local municipality.

Great advice. Not sure how to get coverage for the procedures. I haven't worked in a while; am on medicaid/wellcare. And that I would love to untap from as soon as I can.

I don't know any doctor who would give them biweekly. And no need to be concerned about the meningitis.

I used to get them regularly till my back degraded so much they can't get the needle in anymore. If you get them on a regular basis, they help.

Since they do contain a steroid, pay attention to is effects, and get medication as necessary to handle the roid rage. I found xanax to help.

Have you tried other narcotics like butrans? Or nucynta?

reply to post by rimjaja


I have had the opposite experience, that you need to get them on a regular basis to be effective.

My uncle, who is only 3 yrs older than me, has been being treated for severe back pain due to mil service injury and sport injury. Neck/cervical vertebrae fused and etc in the mid and lower back. NOTHING helped until he tried the laser burning and freezing the nerves. Check into it and see what you think. They can use laser or radiofreq. Its a management tool.. one treatment doesnt work forever. You go back on a schedule and your pain is actually manageable.

apmsurgery.com...
www.advancedorthopain.com...

reply to post by rimjaja


Hi rimjaja-

Are you a chiro or naturopath? Curious as to the advice you were giving, which I again appreciate it. I did have my thyroid panels ran which were 4.9 and the pcp keeps upping my t4 and not the t3s. I am to speak to her tomorrow though about this because I think a partner practioner called in the script. I am 5'4 and weigh 185. I dont eat out because I do not want to eat hormone, antibiotic ladened meat as well as avoid vegetable oil and the likes. We eat fresh produce daily and if I have hot tea I sweetened it with organic honey and usually drink warmish water.....I should be 50lbs lighter but its hard when you feel like you need to sleep 14 hours a day. AND NO I DO NOT eat processed foods, sugar alternatives, or farm raised fish.

What does the thryroid have to do with adjustments?

Would you know why chiros won't take medicaid/care sponsored plans or is it the other way around?

I have come from a prominent spine center in ATL and I was basically told by the md for me to go to the Cleveland Clinic for a 30 - 45 day comprehensive physical therapy treatment program that they have. The physician of course did his internship there as well as work in the center before coming to ATL a few months back. This threw me for a total loop. My pcp thinks that it is the most insane recommendation she has ever heard knowing I have been unable to work for over 4 years and I am on medicaid sponsored insurance called Wellcare. She wants me to go forward with another pain specialists.

I did stop by the MRI clinic to gain my written report - it seems to sound omnious but then endss with words like minimal or mild......and my pain is far from those adjetatives. It seems though there are disc issues all the way down my back and this could be why the spine center thought that epis may not help.....I am not sure.

Do you know where I could go to find a translation as to exactly what the written reports state? Another caveat is they reference back to a 2010 mri and I had an mri in 2011 at another clinic then returned last month to the imaging center from '10.

Incidentally, the mackenzie exercises I have been doing but my chronic pain comes in about where the cervical meets the thoracic. I could go into more depth - it seems I need to practicing digressing a bit.

OH and if any of you would like to help a lost soul in the western world of medicing please flag so that maybe I could find a resident radiologist, neuro, ortho, naturopath, and at this point I may need psych.

THX a ton for you input.

Don't want to worry you, or put you off, your experience maybe completely different to mine, I was at the extreme end of it not working.

I had the injection for a herniated disc and fractures in my lower back (I have a compression fracture in my upper back also), and it did not go well. The injection itself was painless, but the fluid going in wasn't, you feel a lot of pressure. I was OK for about ten minutes after the procedure was over, when suddenly the pain hit so bad I could not walk or stand for a couple of hours. Once the pain subsided I was OK, but it did nothing at all to reduce pain from the herniated disc.

I will never do that again. I had better success with acupuncture, even though not much lol.

As far as having surgery, the usual advice is only have it done in extreme cases, because it's risky, 50-50 chance of success. It can also make it worse. If the nerves have been under stress for a long time they will never recover, and you will still have pain. I am in that situation, and now have permanent nerve damage.

I can't tell you how I deal with it now, as it's against T&C.

reply to post by ANOK


Thanks Anok for your response.

My situation just seems bleak indeed. If our "gov't supported healthcare" known as medicaid/medicare. I did pay my 30-39% tax rates for most of my viable ability to generate revenue to make someone else wealthy. My insurance was so costly I couldn't continue to pay cobra after I decided to leave my stressful career.

Originally posted by mcsandy
reply to post by rimjaja

 

Hi rimjaja-

Are you a chiro or naturopath? Curious as to the advice you were giving, which I again appreciate it. I did have my thyroid panels ran which were 4.9 and the pcp keeps upping my t4 and not the t3s. I am to speak to her tomorrow though about this because I think a partner practioner called in the script. I am 5'4 and weigh 185. I dont eat out because I do not want to eat hormone, antibiotic ladened meat as well as avoid vegetable oil and the likes. We eat fresh produce daily and if I have hot tea I sweetened it with organic honey and usually drink warmish water.....I should be 50lbs lighter but its hard when you feel like you need to sleep 14 hours a day. AND NO I DO NOT eat processed foods, sugar alternatives, or farm raised fish.

What does the thryroid have to do with adjustments?

Would you know why chiros won't take medicaid/care sponsored plans or is it the other way around?

I have come from a prominent spine center in ATL and I was basically told by the md for me to go to the Cleveland Clinic for a 30 - 45 day comprehensive physical therapy treatment program that they have. The physician of course did his internship there as well as work in the center before coming to ATL a few months back. This threw me for a total loop. My pcp thinks that it is the most insane recommendation she has ever heard knowing I have been unable to work for over 4 years and I am on medicaid sponsored insurance called Wellcare. She wants me to go forward with another pain specialists.

I did stop by the MRI clinic to gain my written report - it seems to sound omnious but then endss with words like minimal or mild......and my pain is far from those adjetatives. It seems though there are disc issues all the way down my back and this could be why the spine center thought that epis may not help.....I am not sure.

Do you know where I could go to find a translation as to exactly what the written reports state? Another caveat is they reference back to a 2010 mri and I had an mri in 2011 at another clinic then returned last month to the imaging center from '10.

Incidentally, the mackenzie exercises I have been doing but my chronic pain comes in about where the cervical meets the thoracic. I could go into more depth - it seems I need to practicing digressing a bit.

OH and if any of you would like to help a lost soul in the western world of medicing please flag so that maybe I could find a resident radiologist, neuro, ortho, naturopath, and at this point I may need psych.

THX a ton for you input.

Lots of questions!

Yes, I am a chiropractor. As for chiropractic and thyroid function, the thyroid is innervated by spinal nerves, so an impairment in nerve function may affect normal functioning of the thyroid. Additionally, if people are hypothyroid, one of the myriad of symptoms is ligament laxity. It is something we look for.

Medicare in every state covers chiropractic care. Medicaid programs will vary by state. None of the states that I have practiced in cover Medicaid but I know some states do.

Most chiropractors I know work with people on payment.. Some have flat fes for care, others have programs for financial hardship, or sliding scale. It is worth getting some recommendations from your friends on which chiropractors they like and give them a call. It sounds like you would benefit from one who specializes in nutrition. Chiropractic nutrition specialists (DACBI or DACBN) have to do a certain amount of case studies as part of their diplomate, if you find someone working on their specialty - you could volunteer to be a case study, so it is a win-win for both parties.

hope this answers some of your questions . Good luck in finding some answers!

reply to post by rimjaja


Sorry for so many questions, but I do appreciate your thoughts and advice.

I am going to attempt to get disability which would allow for me to be on medicare. It seems all of the chiros in my area do not accept medicaid. Which is unfortunate.

The previous chiro that I worked with for over 3 months she wanted me to do Ideal Nutrition but I couldn't purchase what she thought I needed. I do remember that she wanted me to get a supplement to place into smothies ....J Robb or something like that. She was a good friend but when I decided that her kung fu no worky I distanced myself sadly. Its hard to separate from professional & friendship relations to only friends when she knows my circumstances. I think she feels a bit insulted. Long story short her practice barely lasted over a year and now she trying to figure out what to do because she can't do the physical adjustments with her hands due to her own ailments in one of her wrist. I actually have 2 friends studying at Life U currently for the nutrition program. One is just inside of her first semester and the other is in her 2nd year.

You spoke of working with someone as part of a case study. How far along should they be within their education. If I recall it is at the end during clinicals? I used to bartend at a restaurant where many Life students worked. I loved it because their was always free adjustments! Too bad my career path was onward to become a proprietor of one of the restaurants where we worked - boy do I regret that. I should have enrolled in Life U.

Hind sight 20/20!

Thanks again.

Cheers!

For case studies, they will already be doctors that have been in practice for 2 or more years. The DABCI or DACbN programs are diplomates or post grad specialty programs. If you contact the parenting organizations for either program, they may be able to put you overhear with a local specialist

reply to post by ganjoa


Hi Ganjoa-

I hope this post finds you and your wife in better health then just existing!!!

I am curious to learn iff you used a chiro which gave you some moderate longer term relief. Also I was curios to learn if you were (removed from your body) or did they take the dic(s) and pulverized a vert or two? My C6 was pulverized and bonded with a genetic compound to further enhance the fusion. Which the bad news is that unbiased reports / case studies were done as to the effective ness of the procedure.Meditron (sp?) was the manufacturer of the genetic bonding substane and the FDA changed their mind that it was safe to use within the cervical area.

I went my do my neuro to inquire about this and all he asked was did my procedure work at thetime of the of my post op visit.My anwser was indeed it did. I then explained that I was worried about the genetic substance causing over grown bother growth. He answer was fron what I see the fusion is perfect and speaking with an attorney would only waste my time an in the end I would get very little comensation!!

Thanks for your imput!!

Originally posted by ANOK
Don't want to worry you, or put you off, your experience maybe completely different to mine, I was at the extreme end of it not working.

I had the injection for a herniated disc and fractures in my lower back (I have a compression fracture in my upper back also), and it did not go well. The injection itself was painless, but the fluid going in wasn't, you feel a lot of pressure. I was OK for about ten minutes after the procedure was over, when suddenly the pain hit so bad I could not walk or stand for a couple of hours. Once the pain subsided I was OK, but it did nothing at all to reduce pain from the herniated disc.

I will never do that again. I had better success with acupuncture, even though not much lol.

As far as having surgery, the usual advice is only have it done in extreme cases, because it's risky, 50-50 chance of success. It can also make it worse. If the nerves have been under stress for a long time they will never recover, and you will still have pain. I am in that situation, and now have permanent nerve damage.

I can't tell you how I deal with it now, as it's against T&C.

I just wanted to mirror this experience. For some people, they work wonders. For others.. not so much.

I have tried receiving several types of injections, all of them made my back substantially worse. Though, my own nerve damage was caused by something else. Fwiw, I have several compression fractures, recently found broken ribs, and several herniated discs that are causing me pain. They are not healing, at all, due to osteoporosis.

edit: Also wanted to add that I had injections done on my knees as well (I have plenty more health problems than just my back ) that none of the standard ones helped. However, they used an injectable numbing agent that really did help my knees feel better instantly, and for a month or so. It was non-steroidal, but beyond that, I cant quite remember.

And remember, steroidal medication can eventually lead to more bone problems, so its good to keep it at a minimum if you already have some bone or degenerative issues.

As for whatever it might be thats against T&C, it would seem that might just be one of the most wonderful medicines in existence. Not that I would know, of course.

reply to post by nixie_nox


Thanks nixie

My current meds are prescription grade anti-infamatories a muscle relaxer, prescript headache meds as well as stamping my back with prescript pain patches that is the type of meds they give you before they stick that massive needle in for numbness to proceed with major dental work.

I haven't used they type of meds; at least I don;t recall the names if they were generic or on label.

Maybe I have been turned away so many times because it seems that 2 levels above the fustion and 4 levels below are herniated, affecting the anterior area of the thecal sac - and 2 others that seem to be closer to collasping.

Sadly enough my mother went through this (degenaretive disease and bulging-herniated dics.) The pain became so overwhemly that she tried to suicide, Luckily she was saved; but only to continue a diocile member of society. Now I understand her actions because these pains will send you over the edge.

No worries about my state of mind. I had always been told by my baptist aunt and gradmother always said that that doesn't kill you only makes you stronger. I just wonder what "all" this strength I proverbially gained will come in handy.