Second time lucky - facet injections. - Pain Concern

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Second time lucky - facet injections.

AngieHazell profile image
21 Replies

I'm new to this but I thought I'd let you know about my experience with facet joint injections.

I had some in Feb 16 for the first time after years of back pain. Diagnosed as slipped disk but now only left with the disk membrane and facet degeneration L4/L5.

I run a lot despite the pain but when I stop I often seize up. There are so many simple tasks I can't do like ironing, mopping, bending forward without experiencing a huge amount of pain and the risk of spasming. Sneezing and coughing is unbearable; but I can run!!.

I received limited advice for post injection care, so I resumed to usual activity after 3/4 days as I was told I could. However a pile of ironing and a 6 mile run although it felt fine at the time left me crippled in agony for 3-4 weeks! Finally plucked up the courage to have them done again as the facets improved after cortisone shots , it was the ligaments around them that didn't cope. Had them done again in June 16 and touch wood they feel great. I'm not doing anything risky and not running for a fair few weeks; and refuse to iron ever again!!

Apparently I've learned since, the surrounding ligaments can be left vulnerable when the facets are freed up. I guess because they aren't used to being as mobile. So my advice is although you may feel great after the injections be very careful for a good few weeks and seek advice for strengthening exercises from a physio.

Now hoping for RFA as injections have been so successful.

Good luck everyone. Pain sucks, but there's usually something that can help; however I know not always xx

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AngieHazell
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21 Replies
Palioly profile image
Palioly

The effect of my injections lasted 3 months.

AngieHazell profile image
AngieHazell in reply to Palioly

I'm hoping for that too this time as they seem more successful this time. 👍

ScottishMisty profile image
ScottishMisty

I am getting these done in next couple of weeks! They didn't work when I had them done in my neck couple yrs ago but hopefully they will work this time around. L4/5/6 disc degeneration. Like you I can hardly do anything. Am so sick of the chronic pain! Hoping you have continued improvement.

in reply to ScottishMisty

Scottish, so looking back, did the pain finally go away on it's own?

ScottishMisty profile image
ScottishMisty in reply to

Didn't help me at all when it got them in my neck. Ended up having to get cage fusion done. Hoping they work this time. X

johnsmith profile image
johnsmith

Cortisone damages ligaments. You do not want strengthening exercises. You need exercises which improve the coordination of the body. You seem to indicate that the muscles in your back could be over contracted. Over contracted muscles are weaker than uncontracted muscle. Over contracted muscles apply pressure on body structures that should not receive pressure.

The injections you take attempt to reduce inflammation. They do not tackle the activity that causes the inflammation. It is worth seeing someone who can examine the muscle structure and stretch out any over contracted muscle you have.

Hope this helps

AngieHazell profile image
AngieHazell in reply to johnsmith

Hi there, thanks for your reply.

I've been doing coordination exercises and core strength exercise as per instruction from my physio. Apparently I'm hyper mobile so doing core will regain proper control of my movements?? The coordination stuff that I do is to fire up muscles that have stopped being used due to the locking up pre injections. It's so confusing, all I want is the RFA so ligaments don't get weaker and weaker .

johnsmith profile image
johnsmith in reply to AngieHazell

Thanks for the reply. It is difficult to comprehend what is needed to be done. I cannot tell you as this is a matter that needs careful investigation by yourself as to what works well, and what leaves aftereffects that are not good.

It is a problem and limitation with language. I can point to a carpet and we can agree to say it is green. When it comes to internal muscle movements we cannot share experience and as a result cannot share definitions. To this is added the very real problem that we can see the speck of dust in someone else's eye, but never the plank in our own. We need someone else to spot the posture and movement errors.

It is worth seeing an Alexander Teacher as they are experts in posture and muscle coordination. This is in comparison to a physio where one size fits all.

Hope this is helpful.

AngieHazell profile image
AngieHazell in reply to johnsmith

I will look into seeing an Alexander Technique specialist. Thanks for your help.

Barnclown profile image
Barnclown in reply to AngieHazell

So: I'm globally hypermobile...my spine probs started in childhood & became really bad in my 20s...I was fit & working in horticulture, mountain walking etc. I started Alexander technique before I turned 30...and am certain AT & bilateral spinal facet joint denervations made it possible for me to continue my career well into my 40s....although I did have to stop working in the manual side of things by the time I was in my early 30s

Unfortunately, the NHS & I were unaware I had been diagnosed with infant onset systemic lupus...which was causing inflammatory process denaturing of my soft tissues, especially globally tightening muscles & tendons. But I was always conscientious about lifestyle management + core stability work (yoga, pilates, tai chi) so, although immune dysfunction-related multisystem degeneration progressed, I managed to avoid daily lupus meds until 5 years ago in my late 50s when the early diagnosis was recovered & we realised SLE had been underlying my lifetime of increasingly dodgy health. Now, on daily combined therapy prescrip meds, i'm feeling better than I have since my teens...and much more pain free

In my late 30s NHS neurosurgery booked me for a double cervical discectomy, but at the last minute I forced them to refer me to pain clinic. Over the course of 20 years, I had a series of bilateral facet joint denervations to all my cervical, lumbar & sacral spine. Like you, I learned the hard way to go vvv gingerly for at least 3 months after each set of denervations. My pain consultant had warned me that in chronic cases like mine, a second set of denervations is often needed. He was right. My denervations helped enormously to numb the worst of my spine pain, but I continue to practice AT.

And, to my utter delight, I've found that my daily lupus meds have put a stop to any lingering spine-related pain....so now we know that both my version of immune dysfunction (early onset vascular type SLE + PID) & connective tissue disorder (specifically vascular type ehlers danlos hypermobility) play a part in my version of chronic spine pain.

Apologies for going on at such length, but your post & this discussion strike a big chord with me. I have posted on here about this quite a lot over the past 4-5 years, so apologies if you're already aware of my take on all this

Thanks for this great thread

Good luck

Coco

PS before performing any denervations, my pain consultant did diagnostic blocks to establish that denervations were spot optiates in my case. These nerve blocks numbed my facet joint pain temporarily, ie for only a few weeks. This was enough evidence for denervations to proceed

AngieHazell profile image
AngieHazell in reply to Barnclown

Wow!! You've been through it. I have no idea why I have arthritic facets, I believe it's down to a slipped disk which has now been absorbed.?? I glad to hear that you're doing well and hope to be pain free ish myself on an ongoing basis.

I run a lot and my fear is that the running doesn't help long term, although it's the only thing that doesn't hurt when I'm partaking in it.

Fingers crossed x

johnsmith profile image
johnsmith in reply to Barnclown

How was the Alexander Technique when you made use of it? Was it helpful in managing your condition with the other things you did?

For me I found I had to do a multitude of things to manage my condition.

Barnclown profile image
Barnclown in reply to johnsmith

Without Alexander I doubt I'd have had much of a life at all. I've been living Alexander for nearly 40 years. Yes, I have to do a multitude of things to manage my collection of immune dysfunction & connective tissue disorder related multisystem illnesses...+ my spine injury/spondylosis etc, but Alexander training has been key to coping with all that too. And almost all my establishment medics + my complimentary therapists are aware of Alexander & rate it highly. Of course, you need a good Alexander teacher you can click with...I've been very lucky to have 4 over the years....are you practicing Alexander Now?

johnsmith profile image
johnsmith in reply to Barnclown

Yes I still am receiving lessons.

I am also being taught how to practise it on others as part of those lessons. That is worth doing as it takes the lessons to the next level.

I had one teacher for 25 years, another for two years and my present teacher for about ten years.

I find it fascinating how my view on what the Alexander Technique is keeps changing.

Barnclown profile image
Barnclown in reply to johnsmith

Yes: I agree! Each of my teachers expressed a slightly different version & used slightly different approaches...and each teacher was perfect for me at that point in my life (emotionally, physically, intellectually, every way). As I understand it, Alexander, like most therapies, has gone through a lot of evolution over the decades...with various schools of thought developing under the umbrella AT.

I had my first once off Alexander session with an amazing teacher in Philadelphia in 1970 when I was 17...she had studied directly under Alexander himself. I moved to the uk in '78 & started Alexander in earnest around 1985 in my late 20s - desperate because my spine pain was interfering with my profession (I was in horticulture).

By the 1990s I was looking into how I might actually study to become an Alexander teacher by attending the official teaching Center...I think it was in London then?. But by that time my unrecognised infant onset lupus had become so debilitating that I was unable to take up the opportunity. So it's extra interesting to meet you. You're having a fascinating time, I'm sure! Many thanks for letting me know your involvement. I hope you'll feel free to private message me here...i'd be so vvv glad to know how you get on etc

Wishing you all the very best

🍀🍀🍀🍀 coco

in reply to johnsmith

Sorry Jaon, if you are not a professional there is no way for you to make such a statement... the injections indeed do reduce inflammation 'swelling' which is what causes the pain.

johnsmith profile image
johnsmith in reply to

Thanks for the reply. What are you referring to in the issue: "there is no way for you to make such a statement."

It is said that you can do 80% of the work with 20% of the effort. This is what professionals learn to do. However, the record keeping and the 80/20 approach can leave a not insignificant percentage receiving the wrong treatment and the side effects from the treatment not propably looked at.

The issue of cortisone damaging ligaments is well documented in the scientific literature. As a layman with interests in citizen science and a background in science I think it is worthwhile to let people know about the problems of cortisone so that they can investigate this issue for themselves.

You say: "the injections indeed do reduce inflammation 'swelling' which is what causes the pain." This is a half truth. There is something that is present which is causing the inflammation which needs to dealt with and often is not. The injection works to remove the pain then the professional is happy. But why does the pain come back in many people?

Thanks so much for this Angie, they are talking surgery but I'm wanting to try the injections and will remember what you said ;-)

AngieHazell profile image
AngieHazell in reply to

Surely injections should be offered before surgery? Depends what the issue is maybe. Is avoid surgery u til it stopped me living life properly. I can get by even during a normal flare, it's agony and stops me doing things but I've kinda got used to that now. Still enjoying the effects of the injections from 2 weeks ago. I've had sore days but I'm doing my exercises which I think may aggravate things a little. I refuse to not keep myself strong though so I'm continuing with walking (not running again yet) and doing some core stability and a few light weights in a laying down position.

Small steps xx

in reply to AngieHazell

Angie, I do believe we irritate that main nerve root, like me trying to do Dance Aerobics with the 40 year old and I'm right at 70 I swear I think it was the twisting but those nerves got inflamed so I figure I need to concentrate on 'Anti-inflammatory food, supplement and prescriptions and once the swelling is down all I need to do is be careful... about 2 years ago I inflamed the nerve root in my cervical spine and had terrible neck pain, numbness down the left hand etc. went to the ER having an asthma attack, doc gave me IV steroids and the neck pain went completely away with the wheezing ;-) I figure because the steroid took the swelling down, pain gone... Was the epidural injection, was it very painful?

AngieHazell profile image
AngieHazell in reply to

My cortisone injections were more painful the first time but the second time wasn't as bad. Still painful but worth is as I've been pain free now for just over 3 weeks!! My next port of call is to asks for ablation so that I can pursue my running again and have up to a year without pain returning. I'll try and run gently after my holiday but am enjoying the pain free existence and I would like that to continue into my holiday in 2 weeks time... So running can wait 😀

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