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facet joint injections first time

Hi everybody =) I went yesterday to a new pain management dr to go over recent MRI results. He switched my anti inflammatory from celebrex to diclofenac along with misoprostol to protect my stomach. So far (4 doses) I have felt no effect from the new med. I have buldged T 5/6 , T 6/7 , T 7/8. Hyperintensity within central spinal cord from T5-T10, Myelomalacia. Failed discectomy, right sided laminectomy L5/S1. Spurred from T2-T10 and advanced DDD L5/S1 with spur disc complex there, L5 nerve root compressed. I am starting physical therapy in 10 days. In 4-6 weeks the pain dr wants to do multiple facet joint injections. I have had cortizone injections in the lumbar before as well as in my hip before it was replaced. Have any of you had these thoracic injections before? He told me I have to be sedated for it. I have no idea what to expect as far as the procedure goes or what I will experience after. I hope this PT and injections help, this pain is wearing on me... Any suggestions, tips, advice, all of the above would be soooooo appreciated. Thank you!!! oh and he told me the images are classic of Ankylosing Spondylitis...I have appt with Spinal Surgeon on Feb 14th, NOT looking to have more surgery, its only a consult for him to play a part in the proper treatment to avoid surgery.


  • jellyhalljjellyhall Posts: 4,373
    edited 02/07/2013 - 12:19 PM

    I can't offer you any advice about thoracic facet joint injections, but I am interested to learn about them too.

    I also have thoracic problems and have been offered epidural injections to see if that will help. At the moment, I am coping without them, but want to learn about them.

    I have had a lumbar fusion of L4/5 and an ACDF of C3/4/5.

    I wonder what the spinal surgeon will say on 14th February. The hyperintensity on the cord from T5-T10 doesn't sound good! Please let us know how you get on. :-)
  • Hi, I had two facet joint injections into my lumbar spine just over a month ago.
    Firstly - great idea to be under for it. I wish I was as it was so very painful. I do not take to pain relief well so that may have made it worse but if the joints are inflammed, the injections will hurt. I was very sore for about a week, couldnt really bend over as it felt like it was being pinched where the needles went in. However this slowly wore and now after a month I can definitely feel some relief, I can sit for over 30 minutes now and not be in agony. Bending still hurts in general but it has definitely improved my pain levels.
    They of course will wear off but thats up to your body as to when this happens. After the procedure one of my legs went a little numb because of the anesthetic but that wore off quickly too.
    Im from Australia so our method may be different but it only took 10 minutes for the two injections. They used a CT machine to pin point the joints and double/triple checked it was correct. They insert the needle (painful), then put the anestheic in (more painful) and finish with the medicine (also painful).
    I hope they work for you as the success rate isn't the best but fingers crossed and let us know how you go.
  • MrsBMMrsB Posts: 8
    edited 02/15/2013 - 6:57 PM
    Hi there and thank you for your responses. I appreciate the input and will try to get as much info out as I can as well. I went to the spinal surgeon yesterday. He ordered a cervical MRI (scheduled upcoming Tuesday) due to symptoms of pain and numbness in my forearms and hands. My right hand is the worst, I cannot properly feel temperature in the right, I discovered this when I stepped into the bathtub and scorched myself after testing the water with my right hand. This has been like that since last summer. I have told all of my doctors and no one has done anything finally getting that MRI done!! Anyway, surprisingly the doctor said we will just redo the thoracic MRI in 1 year to monitor the myelomalacia. He explained this to be like a blister the shape of a straw running down the center of my spinal cord and he really doesnt know why its there. He was not concerned much about it. I am rather surprised by that so I dont know if I should be comfortable about leaving it at that? What do you think?? I mean this really hurts!! He said that what I have going on with the involved discs (thoracic) and arthritis is not causing the pain in my mid/upper back, chest, and rib cage which is radiating around my left ribs. He said all of that is not putting any pressure against the spinal cord. I'm kind of baffled here. He said my pain is caused by whats happening on the inside of the spinal cord. He advised AGAINST the facet joint injections that the pain management doctor wants to do. He said I will not get relief and its just not necessary to go and do all of those injections for nothing, That was that, he said nothing more about it and moved on to discuss the lumbar. He is sending me to Urology because I have been having bladder problems for quite some time. That appointment is next Wednesday. He seemed to be much more concerned with the spur disc complex at L5-S1, he said that it is severely compressing that right nerve root, which I have had an MRI every year since surgery 3 yrs ago, this was there a year ago. My right foot has dropped and I feel like some of the sciatica has burned itself out, if thats even possible? So I start physical therapy Monday, go to Rhemy on Tues, and Urology on Wed. Friday I am going to warn sunny Florida for 5 days, I cannot wait. I havent had a break away in 5 years and right now is perfect timing to get away from all of these head spinning appointments. I hope I didn't forget to put anything here from the appointment. Please if you recognize anything or have had experience with any of this I would love to hear your story. Thank you all so much and I hope that you are not in pain!! Many thanks!
  • jellyhalljjellyhall Posts: 4,373
    edited 02/16/2013 - 12:33 AM
    I certainly understand the frustration of appointment after appointment, and not really getting a conclusive answer.
    I hope that your next array of appointments will bring some answers and ideas for helpful treatments.

    I also have some similar symptoms to you.
    My right hand and wrist seem to have reduced sense of temperature. I was making jam and it was splattering onto my right arm as I stirred it. I could feel it on my forearm and washed/wiped it off. What I didn't realise though, was that I had some on my outer wrist. It was only the next day that I saw and felt a burn blister about the size of a 1p piece. I had not felt it at the time at all. I also told my doctors about this, and they didn't appear to be worried by it.

    I also have pain in my upper and mid back and chest. I sometimes get pain and tenderness over the spine at that level. Very often I get tightening and spasms in the muscles around my chest at about bra strap level, especially on the left side. Sometimes it is so tight that it makes me make a sound as the air is expelled from my lungs. My surgeon has said that this is probably being caused by the herniated discs in my thoracic spine. I do have slight compression of my cord from two discs in my thoracic spine. As I said higher up, I have been offered injections to try to help this. For the moment I can cope, although I did have an awful day when the pain lasted much longer than usual and I realy struggled to breathe. I was in tears and thought we would have to go to hospital. Then slowly it eased off. I did have pain for a few hours after, but at a much more tolerable level.

    I also get tightening spasms every morning in bed and as I get up our of bed. I also get them when getting up from a chair when I have been sitting for a long time. These spasms are in both legs and around my abdomen and cause me to stop and wait for them to pass before I can walk. They don't last long and are not painful, but they are weird! No-one has told me what is causing them other than it could be anything from my brain right down the length of my spine. I have had a 2 level ACDF done 3 months ago, and I am still getting them. My surgeon had thought they may go after the surgery.

    I would say from my untrained opinion, that your bladder problems and foot drop could indicate that things do need addressing soon. I hope that these will be followed up soon.

    Take care and have a wonderful holiday in Florida,

  • Hi there Jellyhall =) Thank you so much for sharing your story, I greatly appreciate your response! Wow we really do seem to have a lot in common. Gosh, I am so sorry that you have been burned that badly because of your temp guage problem. That really is terrible and the spine surgeon told me that is not good and needs to be figured out quick. He is the first Dr who has given attention to this. I mean, as you know this really is dangerous and we really have to be so cautious. Im so sorry to heat you had such a bad pain episode that made it a struggle to breathe! Maybe you should have gone to the hospital? I was told that if my breathing becomes impaired to that degree I need to go straight to the ER because my lungs or heart could be compromised over nerve dysfunction? I do experience that quite often but it is typically short lived and not quite as severe as what you explained. It sure is scary. What you have happening with the spasms in your legs and abdomen sounds like it needs to be addressed. It seems like maybe your nerves somewhere are really being affected. I hope you get answers about that and help for it soon. My surgeon called me this morning to tell me he got me scheduled Wednesday with Neurology following the Urology appointment. He asked how I was feeling, coincidentally I was awake with pain until 5am this morning. I even went out into the back yard at 3am trying to walk some of it out. Did not help but I was going stir crazy. And then of course, after talking to him I experienced for the first time ever one of the most embarrassing and most difficult things to talk about..I could not go to the bathroom. My bowel began to move then nothing..It was stuck. I wont say anymore than that as it is extremely embarrasing but I will say that I am getting scared. Thank you so much again for responding, I hope that you are doing well today. Take care and I look forward to talking to you more.

  • I also felt like these spasms I get several times a day should be investigated and addressed. I have been referred to a neurologist for testing to rule out MS and some 'other rare conditions'. He felt that all my symptoms could be coming from the cord 'lesion' (my GP said by this he meant the cord compression.) Since my 2 level ACDF, I am still having these spasms as much as ever! I have even been taking 9 x 300mg of gabapentin/neurontin a day, and still I have been getting them. My neurosurgeon thinks they are being caused by the cord compression. Well that has been dealt with now so I wonder why I am still left with them.

    I think that if I get such bad pain and breathing problems again I will go to the hospital. If I didn't know that I had thoracic problems I would have thought I was having a heart attack.

    I hope that your appointment on Wednesday goes well and that they discover what is causing your symptoms. I think you should let your surgeon know about the latest bowel problem. I know that it is very embarrassing to talk about it but it could be very serious.

    Take care, and hope that you have a good Sunday. :-)
  • Thank you for following and responding Jellyhall, and anyone else who may respond. I am on my vacation and having diificulty enjoying being here. I haven't been away in 5 years and so far am beginning to really get dissapointed. It is the morning of day 2, I've had 3 broken hours of sleep due to the pain in my mid/upper back (last nights sleep). We arrived at our hotel at 4pm the day before yesterday and by 7:30 pm I had to get in bed. I just couldn't move anymore due to pain and stiffness plus fever of 100.6 which I attribute mainly to adjusting to the humidity level here. Yesterday morning when I woke up oh boy was I in a great deal of pain, more than usual. I had sciatica in my right leg and my body was so stiff it was very difficult to move. It took me 3 hours to get in the shower. By noon I felt much better and was able to go on with the day and enjoy myself despite the pain until about 7pm when it began to become unbearable. I could not sleep last night until about 2am and woke at 5 with my upper back just unbearable. Here it is just after 8am and I don't know what to do to get comfortable. This past week I gained more information that I have many questions about and have rising concerns and fears now. I had the cervical MRI without contrast which revealed bulged C4/5 no compression, C5/6 no compression, C/6/7 flattening the spinal cord. The report was written completely vague. How I stated it is exactly what it says. In addition to new info I had my urology appt. Exam revealed neurological deficits of bladder, inner bowel, and my private area. I was scheduled for consult with gastrointestinal specialist on March 6th for testing. Does this time stretch in appts sound normal and safe? I am scared of permanent nerve damage and the pain inbetween my shoulder blades is getting more persistent and sharp as the days are passing. I have growing concern regarding the myelomalacia from T5-10. How can such a wide stretch within the spinal cord not be of more urgent concern to my doctors? Maybe its just from ongoing pain and sleep deprivation but right now I am feeling abandoned by the professionals when I feel they should have given me more insight....I will be going home Tuesday and plan to make a few calls first thing Wednesday morning for help.
  • mickkrmmickkr Posts: 166
    edited 02/25/2013 - 2:19 AM
    I would be very concerned about the bladder/bowel problems and foot drop. These are classic flags indicating cord impingement. I know this, not because I have any medical expertise, but because the precise same symptoms were the immediate precursor to my emergency surgery 10 years ago!

    My advice, for what it is worth, is to make sure EVERYONE you speak to here on in, knows you have herniated discs and the bowel/bladder and foot drop problems.

    Not to get too graphic, the bowel problem I had was, if you can imagine a sausage making machine, that it had been set to "giant salami" with no end in sight rather than manageable normal size sausages. I think this is something to do with the anal sphincter muscles being put out of action by the cord compression. Enough said, I feel.

    Don't be shy. Demand answers.

    I'm not young enough to know everything - Oscar Wilde
  • Thank you mickkr for your input! Over my last 2 appts I have made sure no matter how difficult it was to be sure and tell all to the doctors. Nothing has changed since my last post. I fell in the shower the day after my last post. My right leg just went completely out. My right foot slid back and hit a metal post that was about 2 inches tall on top of the tub drain. Within and hour I had a black lump half the size of an egg. I had NO pain in my foot when I think it should have been unbearable. When i stepped on the foot I could tell the lump was there because my foot would not flatten on the floor as if I was stepping on something, again NO pain. I treated my foot as it was injured even though I could not feel the pain, iced it and elevated it. I left a message with my spinal surgeons office first thing yesterday morning and have heard nothing back yet. I just arrived home late Tuesday night. In regard to the spinchter, after my exam with the urologist, he said the inner spinchter had no response and the outer had minimal tone. I dont know if together the doctors are waiting to see what the gastro dr has to say or what, but the way they are allowing this to stretch over time is really scaring me. I will do as you said and make sure that all I speak to are clear on the fact of my disk conditions as well as the rest. Today I had pain in the bottom of my right foot that felt like I had a metal or glass sliver in it. I even had my husband looking with a flash light~NO SLIVER...this is not the first time this has happened either. Im getting exhausted of pain and doctors, I just want to be better and feel that my spine and limbs are safe and reliable. Thank you and feel free to offer any tips or advise, it is much appreciated!
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