What happens next if nerve blocks dont work?

What happens next if nerve blocks dont work?

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Emj1988
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What happens next if nerve blocks dont work?

I had a 2nd set of facet nerve blocks today to determine if im a candidate for a facet rhizotomy. I was hoping this would work today and I was looking forward to 100% pain relief; but I had no luck. I have also had cortizone injections at l5-s1 disk and facets. I was told I have to go talk to my ortho and discuss other options?

I hope surgery is not the next option because I will go until I cant walk before I consider that..... so many bad stories of failed back surgery.

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L3-4: Mild bilateral facet arthroses.

L4-5: Mild desiccation and disc bulge. Mild bilateral facet arthroses.

L5-S1: Mild disc space narrowing and desiccation with a left central disc extrusion which extends dorsally up to 4mm. There is mild retrolisthesis of L5 on S1 of 2mm. There is mild ventral indentation on the dural sac and left S1 nerve root. There is no foraminal narrowing. Mild bilateral facet arthroses.

happyHBmom
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Did you try physical therapy?

Did you try physical therapy?

dave
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EMJ

Depending on the type of block you received, it can take several days before you get any relief. I had a block last year and it took a couple of days before it helped. Give it a few days before you totally give up on it. I'm sure you and your Doctor can layout an effective plan to provide you some relief if it doesn't help. Unfortunately, relief for the back is a slow and arduous task.

Dave

John
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Good luck.

Emj,
You are right in thinking that your condition more that anything else will determine the next process and we all wished to avoid surgery at all cost. Nerve blocks can determine the nature or origin of our pain and are necessary progression; it would be remiss for any treatment not to include this as an option if appropriate. You are right to be wary that even with the best possible evaluation of the origin of our pain it can be easily rectified, success and failure of fusion are only pertinent to each individual and collectively fusion have a fair success rate. That is of no comfort to those for whom it has failed and each patient has equally chance of success at the initial stage, unless your surgeon tells you otherwise.

It is difficult not to use the varied evidence here as a measure of your future and keep an open mind. If the nerve block does not work you discuss your next options knowing that you tired them, they are not a waste of time or effort if they had worked and progressing up that necessary route give equal chance of any procedure to be successful. Did the doctor say you would get 100% success?

For me eventually I could not stand up straight and that in itself determined the next process and although my fusion failed it is not reflective of the process itself and I do not use it to suggest that anyone should not grasp at any opportunity when nothing else is feasible.

As Dave said, this is a long journey.

John

Emj1988
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ok maybe I wrong about what I said?

Ok maybe the two procedures were not nerve blocks based on the replies? They injected anesthetic about 8 different times for the two separate procedures to try to determine where the pain was to see if I was a candidate for a facet Rhizotomy <-I guess that is considered a nerve block? So that is a no go I guess since that didn't work. The cortisone shots were worthless too ill never get them again. Basically after this my PM said to follow up with my ortho to discuss other options. That kind of made me wonder what crazy thing are they going to do next?

happyHBmom
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This is the standard

This is the standard process. If you look at the standards for chronic pain care management, conservative care includes these non-invasive measures- steroid injections, nerve blocks, medications.

I posted the practice guidelines here which shows you the procedures that work and those that don't, in terms of non-surgical interventions.

http://www.spine-health.com/forum/chronic-pain/new-practice-guidelines-chronic-pain-management

As you see you've mentioned quite a few of them as not working for you. You haven't mentioned physical therapy, which is the gold standard. There are a few other non-surgical procedures but they all depend on the cause of your pain (ruptured disk, etc).

Emj1988
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Yea im very confused with my

Yea im very confused with my docs (ortho&pain) doc. About 4 months ago the ortho said that physical therapy would not be beneficial which surprised me. I would switch docs but my case is a work comp so theres not much I can do without complicating things more than they already are.

L3-4: Mild bilateral facet arthroses.

L4-5: Mild desiccation and disc bulge. Mild bilateral facet arthroses.

L5-S1: Mild disc space narrowing and desiccation with a left central disc extrusion which extends dorsally up to 4mm. There is mild retrolisthesis of L5 on S1 of 2mm. There is mild ventral indentation on the dural sac and left S1 nerve root. There is no foraminal narrowing. Mild bilateral facet arthroses.

kathyy
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Check out my old post-see below

You might want to go back and look at the post I created called-
"Reporting in-just had my RF ablation and here is my experience" This post kind of chronicles my experience with radio frequency ablation over an extended period. I did have the testing and it appeared to be about 50% effective. I proceeded with the neurotomy (aka radio frequency ablation) and did ultimately get a good bit of relief. I didn't find the procedure particularly painful and had no prior sedation. I may not be talking about the same thing that you are going through but I thought it sounded similiar. Best of luck to you and feel free to pm me.