Give the medial branch block a few days to take effect. It sounds like your PM is doing all the right things in order to diagnose where your pain is coming from. I also went to a chiro in the beginning and am convinced that he actually did more harm than good. Do not be discouraged. I went through much of the same for years going from one doc to the next. It was a PM doc that finally diagnosed my spinal issues and was able to help me. The injections will often only give temporary relief but if you do get even temp relief that is a good indication that is where your pain is coming from. Hopefully your PM will be able to suggest a procedure that may give you longer term relief based on his findings from doing the injections. There are lots of different tests that a PM will do besides xray and MRI. My doc told me that only the most severe issues show up on MRIs. So be patient with the PM. Work with him and he may just be the answer for you. Good luck and please keep us posted.

where I was hoping that he was headed. It really sounds alot like your facet joints and a rhizotomy does usually give me about 9 months of relief. Just remember that ice 20 minutes on and 20 minutes off is sometimes very helpful for pain at the injection site. Try and stay focused on the end result of all this which will hopefully be relief from your pain. I know it is easier said then done.

I would think that you could get something a little better than Tylenol from your doc? Do you have a PM that does injections only? No meds? I do not think that I could handle that. I feel like you should be able to get meds that will at least take the edge off.

might want to ask the PM for something that does not contain any ibuprofen. I do not like taking meds either but have come to realize that sometimes it is just what I must do to survive. Good luck and please do keep us posted.

As I was reading your posts, I too was thinking "why nothing stronger"?

Maybe as you did not ask for it they think you don't need it - just a thought.

Can you call and tell them it is this bad?

PS: welcome to the boards - this is a GREAT group of people. You never have to feel alone with your pain again - just that alone keeps me hanging on when I think I can't

hi and welcome to the forum! we are here to offer you support and answer what questions we can. so glad you stopped by. i hope you have pain relief soon. give the injection a few days to feel better. good luck and keep us informed. Jenny

I am thinking the medial branch block was not the answer, back has been hurting pretty bad all day. How long is the block supposed to last anybody know? Any ideas on what else could be the problem? I don't go back to the PM untill the 16th ugh.

tbat you could call and get an earlier appt? The block is usually temporary and will last from a few weeks to a few months. My experience with these injections and blocks has been that sometimes it gets worse before it gets better. I think that there may be some inflammation just from having the injection done. Has your PM mentiomed doing a discogram? This is a good test to see if it may be a disc that is causing your pain. It will show things that do not show on MRI.

but if the cortisone helped maybe they will try a rhizotomy next.

Welcome to Spine Health. Your situation sounds so much like mine. You should see if you can get your PM or primary doc to get an MRI or CTscan scheduled for you.

I too did chiro treatment, PT and the injections since my xray didn't show anything. I later had an MRI which an orthopedic surgeon indicated it didn't show anything significant to be causing the pain I was describing. I later had a discogram which confirmed that my L5-S1 disc was bad.

In my opinion, I agree with others that you should call the PM and see if you can get something stronger to help with the pain when you need it and to push for an MRI or CTscan.

good luck and keep us posted.

If the block did not work it seems the only things left to try would be an MRI and maybe a discogram. A discogram will show if a particular disc is causing pain even if it does not show up on the MRI. You really need to get some type of pain meds to get you through at least the worst flare ups until you can get a diagnosis. I never wanted to take the pain meds either but you will find that they can be a lifesaver when they are needed. Have you tried keeping a pain journal? It really can be helpful if you are keeping record of your pain levels and possibly narrow down what activity if any seems to make your pain spike.

Really can be frustrating but believe me most of us have been through this same process in order to get a diagnosis. The problem is that what may cause pain for one person may not cause any pain at all for another. It really is a process of elimination unless something major shows up on your MRI.

i have not thought about a pain journal, i probably should start one. I just feel like a pin cushion, and hope the PM isn't like the chiropractors that i have seen just keep coming for the money.

The PM really does have a purpose in all of these injections. They are diagnostic. If any of them work even short term it will indicate what area your pain is coming from. Not like the chiro that wants you back 3 x a week. Hang in there. It will take persistence to get a diagnosis.

I agree a pain journal would be a good idea. I think this will help to prove you are serious about the pain you are experiencing as well. Us Spineys have had issues with docs labeling some of us as drug seekers. There are so many non-chronic pain sufferers that abuse these that ruin it for us that really do need this to cope with everyday life.

There are many different types of injections and as JJ stated it's for diagnostic reasons. You and I could have the same exact symptoms in the same exact areas of the spine but respond differently to the same injection. What might work for me, may not work for you.

I wish you the best of luck and please keep us updated.

Ming, that's why am afraid to ask for any pain meds i don't want them to think i am just seeking pills. But then again its probably not to good to take 2000mg of Tylenol at a crack and that does not seem to help either. I do understand what you are saying about the injections, i just want relief soon. I am impatient and more so when i am in pain.

Too much tylenol is not good for your liver so you have to be careful with that. I know they will take you more serious if you do have a pain journal and you do have a long history of suffering with this pain. Most of us spiney's can only suffer so long before we have to graduate up to the strong meds such as vicodin. I don't know how personable your PM doc is but maybe you could express your concern of being labeled as a seeker and that you are worried that you may damage your liver or kidneys by taking to much over-the-counter meds and if he/she could prescribe you something stronger so you don't have to take as many tylenol. Best of luck to you. When's your next appt with your PM?

Next week monday.

Welcome to Spine-Health. I'm glad you found us.

I was just reading this thread and what you're going through sounds similar to my story since last June. I'm having lower back pain, hip pain, and pain down the back of my legs. (Are you still only having lower back pain? Has it spread to anywhere else?)

I've tried ESIs, facet joint injections, and the latest injection, a medial branch nerve block. Most often the nerve block is done as a diagnosic tool to see if you get relief from the numbing agent during the 6 to 8 hours after the injection. If you get relief, then most likely a Rhizotomy (or nerve burn) will be helpful. If you don't get relief, then most likely a Rhizotomy won't help you either.

I don't see how they'll be able to move forward until they do an MRI and possibly even more tests to see exactly what's going on with your spine. It could be facet joints, stenosis, bulging disc, DDD, or all of the above.

Developing lower back pain so often takes quite a few tests to rule things out and I know it's very frustrating. The final decision my doctors made after all the injections I've had is to have a TLIF surgery. I'm not at all saying that this is in your future, but wanted to let you know that sometimes it comes down to that.

Take care Jeremy and keep us posted.
Cath

The pain is only in my low back, every once in a while i get a stabbing pain from hip to knee but i just figure that as a cramp because it usually only last for a short time. I vacuumed the floors and did a washed a couple dishes, now my back is hurting very bad again.

not a doc but it really does sound like it could be your facet joints. The pain in my facet joints affect me that way. It is movement that makes the pain worse. I agree that you do not need all of that Tylenol. You should be able to get something more effective and less harmful from a PM. Don't worry so much about being labeled as a drug seeker. Take your meds as prescribed and follow your doctors orders. Don't give them any reason to believe that you are just a drug seeker and once you establish a mutual trust relationship with your doc and prove that you are being responsible with the meds you should not have any problem at all.

I called the PM office this afternoon, just can't keep going the way i am. The nurse called me back late and said she would talk to the doctor in the morning and let him know i didn't get any relief from the block. I also let her know about the how much Tylenol i have been taking with no relief and that i would like something that would work. So she is going to see what he wants to do next and see if he will give me something for the pain.

JJ, I don't feel so bad untill i stop moving. Is that what you get or does the movement itself hurt you?

usually when I stop but say that I walk further than I should. My back will lock up on me and stop me dead in my tracks. Also in the mornings I wake up very stiff. It takes me about 20 minutes to straighten up and start moving. I have to walk myself up my bed psot with my hands. When I stand longer than I should I can get some relief from leaning forward on a counter with my forearms on the counter. I take the pressure off my back by placing my weight on my forearms. If that makes any sense. Good choice calling the doc. That Tylenol can destroy your liver quick.

Actually I had good results from the medial branch blocks. Not sure why you did not. But you said that you did get temporary relief from the epidurals so that may still be a good indication of facet joint issues. It really sounds like it is. I also have to lean on the cart when shopping and if I do too much my back still locks up. You may want to ask your doc about this possibilty next week.

is that your son in the pic? He is a cutie!

incentive to get some relief from the pain. I bet that he is a real handfull!

He keeps me going thats for sure.

I am not happy today, PM's nurse called me back today and said the PM just said to waite till my appointment on monday and he would go over treatment options with me. Which is b.s. last couple times i was in and out in less than 5 mins. Basically showed up so they could schedule me an appointment for an injection. Sorry i just had to vent a little no offense to anyone, i am just so sick of this crap i think i would rather just suffer.

Wow, JJ, what you're describing is what happens to me with my LBP also. I have additional pain in the back of my legs from stenosis, but the facet joint pain is killer if you stand or walk too long. Bending down helps, but it's kind of a double-whammy because if you bend down for a while (like shaving my legs in the shower, sorry if it's TMI) then start to stand up again, it's extremely painful and takes a while.

Mornings are bad for me, too. It takes a long time to get up and going.

Question: after standing too long and your back starts to hurt, do you get pain in your tailbone when you sit down? I've been getting that and not quite sure what it is.

Jeremy, I don't blame you at all for being ticked at your PM. There are a lot of members here who have had to shop for the right PM for them, not just one who's willing to give them pain meds, but to find the right fit for them. The obvious point of pain management is managing pain, and if they're not doing that then they're not doing their job. I realize that it takes a lot of tests sometimes to narrow down how to treat the problem, but if they can't also help you inbetween these tests, really, what good are they doing you?

I don't think it would be out of line for you to start another thread in, say, Pain Management posting where you live and asking if any other members can suggest a PM that they consider very good. You can't name any names or institutions publicly, but you can ask for any members who can help to PM you with some referrals.

Just my two cents on that. But it's interesting that what you and JJ are feeling is the same thing I'm feeling.

Cath

Cath, I also get a pain the the tailbode area after i am hurting from standing or walking to long and sit down. When i am working and can no longer stand anymore i squat down for a little while and have less pain in that position. But i fear that if i get called back to work soon i will not be able to do my job. I do electrical work and when i get home i hurt so bad i just want to lay down and do nothing and that bothers my wife because i don't want to talk or anything else.

Jeremy, I guess I'm not surprised that you also get that pain when sitting down. It must be a facet thing.

Doesn't it seem like things should be moving a little faster for you? From what I've read, you're having to hurry up and wait with no relief in sight. I'm so sorry you're having to go through this. Why isn't someone prescribing an MRI for you? Or any other test? I just don't get it.

What you're saying about when you get home is another reason to try and get some medication help until your situation can finally have a treatment that will help. Anyway, you know how we feel about that and I hope you finally get it through your doc's thick head that you need some help here.

Your little guy is very cute. What a motivator he must be for you. I have a puppy and he's the one that gets me out for a walk every day whether I like it or not. LOL

I also get the tailbone pain. Especially when sitting or standing too long. It feels like my tailbone will just snap in two. I am really convinced that you have facet joint issues like I do. Too many similarities.

Well if he does not give me something to help with the pain on monday, i think i am going to beat him with a sock full of wood screws. Just kidding i won't but i sure feel that way right now. I told my wife i am thinking about seeing a different doc. but she don't seem to comprehend that! I am baffled that he has not done anything but stick me with needles, and nothing to actually take a look at things.

to me too. As long as you have been dealing with this it does seem like an MRI would be ordered at a minimum. Although the insurance companies will require that you try certain things first before getting an MRI unless you have symptoms of it being something severe. Sometimes it really is hard for friends and family to really understand what we are going through. It is one of those things that you just have to experience yourself in order to understand.

You made me laugh about the wet sock full of screws thing lol that was funny. Make your PM doc sit and listen to your concerns and take your serious, if he/she won't then I agree, it's time to move on and find another one.

I also have that tailbone pain. Does it hurt if you try to bend backwards at all? How about if you lay flat on your stomach on the floor with no pillows then try to get up, does your back lock up on you? I have these issues and was told was my facet joints. I've had the diagnostic injection (I think it was the medial branch block) in my facet joints and that didn't help me either so I was not a candidate for the rhizotomy or whatever it is. They called it radio-frequency ablation which is the same thing I think. It burns the nerves to stop the pain receptors from going to your brain.

I really hope you get some answers soon. I would really push to have a MRI or CTScan. Your son is adorable. They sure grow up fast. My baby boy is now 7 almost 8 and it doesn't seem possible. My kids are what keep me going though. I think I would have a much harder time pushing through this pain if I didn't have them.

Hang in there and keep us posted.

Ming, I do not seem to have pain when i bend backwards. actually i used to get some relief when i would lay with my back on my wife's core ball seemed to take some of the pressure off of my back. But that has not been helping lately. As far as laying on my stomach and getting up i have not had my back lock up. But there have been a few times just bending down to pick something up when it has locked up.

Also i get a lot of clicking, popping, snapping noises from my low back area like if i tilt my pelvic or move my hips from side to side. I cannot pin point where it is actually coming from, or if it has anything to do with my back issues.

One thing i forgot to mentions is that when i go to bed is if i get rid of the pillows it takes a little pressure off of the back. Anyone elese get this?