Severe Pain after Facet Joint Injection. - Pain Concern

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Severe Pain after Facet Joint Injection.

hezzamj profile image
13 Replies

Hi I'm Helen and I am new here.

I had a facet joint injection back in May last year and have not been the same since. Before the injection I had back pain and this was starting to affect my being able to walk far without pain. I only took co-codamol at night to ease the pain (and not every night at that). I was advised by phsyio that the facet joint injection would help me because it would mean they could do intense physio when it was done.

The day after the injection I felt dreadful and had a rash and a bit of a fever but was told these were all side effects. I also in so much pain with my back more than I had every experienced before. As the week went on I got worse. I was again told it was just side effects. The following week I could hardly walk and I couldn't sit down without severe pain, I also had chest pains and I really thought I was dying (the pain was just so bad). I got admitted to hospital as my blood pressure was 210/140. I was sent home late that night was antibiotics. I went back a few days later for a check up as I was still no better apart from the blood pressure had come down to 180/120. I was then admitted and stayed in hospital a week.

I had a further MRI scan in hospital that showed a disc bulge at L1 and L5 but nothing else. I have tried explaining that when I am lying down my pain eases a lot but when I stand or sit that is when I feel like my back is collapsing in on itself.

I am not on morphine slow release 60mg twice a day and gabapentin 600mg 3 times a day plus medication to bring my blood pressure under control - I didn't have high blood pressure before all of this.

All of my treatment was done by the pain clinic but since my injection I have seem them twice, once when they put me on morphine and the second time for them to tell me I shouldn't be on morphine as I will become addicted! Every time I try and get an answer as to what is wrong with me I just get told "oh these things happen" or "there is no clinical medical reason". This is 100% not in my head as even with the morphine I still have pain but the pain eases when I lie down. I get spasms in my back and in my legs, I have burning pain up my back and also in my legs, when I walk I feel as thought my lower back cannot handle my upper back and is collapsing.

The pain clinic have now decided that they want to transfer me to Walton Pain Clinic to undergo their pain management programme so I am now on a waiting list that will take me until at least May for an appointment - all I want to know is what is wrong with me and why am I like this but all I get is -"it wasn't the injection" - I don't care to be honest I just want to know whats wrong and how I can get better. This has destroyed my life, I cannot do anything, I have to now walk with walking sticks - I am trying to get back to work but I struggle to sit long enough and then am totally useless the day after I have been in.

Help - has anyone got any ideas as to how I can get some answers or do they know what happens at the Pain Management Programme at Walton Hospital.

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13 Replies
Suem1960 profile image
Suem1960

Contact the pals office of the hospital that treated you and ask for a full

Explanation of what they have done?

What their treatment plan is for you?

Assurance that you will not be left in limbo while your waiting for your referral.

Make sure they treat you as a person and not a diagnosis.

Regards

Sue

hezzamj profile image
hezzamj in reply to Suem1960

Hi Sue,

Thanks for that, I have tried to get copies of my records but I am currently being fobbed off and told that I am in a queue and they will get to my request as some point but they have lots in front of me.

I will contact PALS as I hadn't thought of that. I just feel like I am going round in circles and that the current pain clinic just want rid of me. As I say every time I ask the question of what is wrong they either ignore me and change the subject or they say things like I have put i.e. these things just happen. I then have issues whereby they say I have refused treatment (because they have written it in my notes) - when I haven't I will do absolutely anything to get back to where I was pre-injection - but I also write notes after all my appointments, to try and remember as the morphine is messing with my head!

At my last appointment I went at it a different way saying that I have a holiday booked for May this year and need travel insurance and also want assurance I will be able to go and my physio told me that the new pain clinic should be able to answer that - I asked why she couldn't and again she changed the subject.

Anyway so sorry for ranting on - I am in a very frustrated mood today after being told that its a 18-19 week wait to see someone - thanks for your advice :)

Suem1960 profile image
Suem1960 in reply to hezzamj

Hi Helen,

Take someone with you and write down the questions that you want them to answer.

Make sure that while your waiting for your pain clinic appt

You can still access the clinic that treats you so that your not left in limbo land.

Get a copy of the referral letter that they've sent and keep a diary of all apps and who you see.

If pain or meds are leaving you confused or feeling muddled

Tell them that you need to record your appt.

Good luck

Regards

Sue

adecyclist profile image
adecyclist

Hi Helen. First off; I'm sorry that you are having such a hard time. There are a lot of us on here that have had or still suffer from pain caused by bulging discs, myself included. I have to spend a lot of time lying down as, like you, it is one of the few things that eases the pain.

I agree with your doctors in that the facet joint injections are probably not what is causing the pain. When I had it done (twice) the first time it made the pain flare-up really badly, but that subsided after a week, the second time nothing happened at all. The injections are merely a steroid to reduce swelling and the liquid disperses after a few days, but if they work the pain reducing effects can last a few weeks. So it is highly unlikely that the injections are still causing your pain. Bulging discs, however can cause pain for years if they do not retract on their own or are surgically repaired.

However... I am not a doctor, nor have I ever met you. So I cannot offer any diagnosis or suggestions as to what is causing your pain. What I can say is this; sometimes the doctors can never totally identify what is causing your pain. I had to go through this a few years ago. I have constant, severe sciatic nerve pain and lower back pain. It's a long story, but after four operations on my spine the surgeons still don't know why I am still in pain. It could be one of many things. They just don't know which or how to fix it. It took a lot to deal with the fact that the doctors kept saying "I don't know what is causing it, sometimes this just happens". I just had to accept that I am in pain, but we don't know why. I kept saying, "but surely there is a doctor who can make this go away". In the end there wasn't.

Your pain management programme will help you find ways to accept where you are and how to find yourself again. Unfortunately, and I know you won't want to hear this, but sometimes we just have to pick ourselves up, accept what shit we have been given and get on with our lives. Otherwise we end up being miserable forever trying to find answers that aren't there.

Like I said, I am not a doctor, but I am somebody who has been through it. So although I may be wrong and you might find a treatment to take the pain away (I really hope you do), but if that doesn't happen I do know that you can still be happy and have a great life. Even though it may be a bit different. I and many others are proof that living with pain is hard, but we can still have a great time :D

I hope this is of some help.

hezzamj profile image
hezzamj in reply to adecyclist

Hi

Thanks for the reply and I appreciate what you say. I do get that "shit happens" and sometimes you just gotta get on with things and I am trying to do this by getting an access to work grant so I can get back to work.

My issue however is that I had at least one of the bulging discs prior to the injection and whereas I had pain I could function and get by on over the counter meds or co-codamol at night.

What I don't understand and this is what I have a problem with is how it can go from that one day to the next me being unable to do anything. I also don't understand why I also now have high blood pressure when I didn't before.

One thing I forgot to mention was that I was sedated for the injection as i had an injection put in the back of my hand and don't remember anything till I woke up. I didn't want sedation but was told it was mild and that's how they did things. When I woke up I was on oxygen however no one else was - I'm 42 and the ladies who were in their 60's and 70's were fine. Again no one would tell me why.

At no point during any of this have I seen a back consultant only the pain clinic. When I was discharged from A&E they recommended I see either a back surgeon or a neurologist - my dr referred me but they refused to see me unless the pain clinic referred as I was currently under them. When I asked the dr in the pain clinic he said A&E didn't know what they were taking about and no he wouldn't refer me.

The pain clinic dr when he tried to tell me it was all in my head said that sometimes when people believe something will work and it doesn't get worse! The thing is that I never even got the chance to think this as I was in pain from the day after. It is now 9 months since the injection and the morphine has only taken the edge off my pain.

A background a bit to the sort of person I am is that at the age of 3 I was diagnosed with a condition that causes extra bones throughout my body, most people who have this maybe have 1 or 2 extra bones but I have around 20 throughout. Some are really small but others such as one on my arm meant I had to wear boys shirts all through school just to get it to go over my arm. I have had many operations, my worst being a leg one where at the age of 10 I was in the operating theatre for 6 hours and have a 5 inch scar to show. So I do know what it's like to have pain my problem is this pain is like nothing I have ever experienced before.

I am sorry if this sounds aggressive (I think it might) I don't mean to be with you as I really do appreciate you taking the time to respond to me but I am just very frustrated.

noemi74 profile image
noemi74 in reply to hezzamj

Hi, wow, you went through as I see more than me. I have as well lots of pain due to my scoliosis in my thoracic back and since 2017 I have constant pain in my lower back due to a bulged disk and got worse to the extent that very difficult to walk, loose balance and having nerve pain so I take 300 mg Gabapentin and diazepam for muscle spasm plus I have multilevel degenerate changes in my cervical spine and mid back and sacral area and cervical spinal stenosis and affecting my arm and hands, I have just got a steroid injection yesterday first on my right side of neck and still need on my left side and my pain management doc will look at my lumbar spine problem what can do as having pain in my buttock when I walk. And I also having at several area of my spine bulged it slipped disk. Plus recently discovered am having an extra cervical rib as well which is very rare. Despite all these pain and discomfort just have to carry on with our lives and do what we can and be positive.

Take care,

Heather-Bee3 profile image
Heather-Bee3 in reply to adecyclist

Well said I learnt a lot from my pain management advisor. And it was to deal with my life as it is now an too stop looking back at what I could do but to pace myself rest and go at a completely different pace now it's hard i won't lie I want to do what I did but if I push myself my pain is so bad and I end up in bed for days . A great thing to learn about having pain on a daily basis is to except it and don't try to exceed your limits do as much as yr body let's you on your good days no more and learn to enjoy and live your new life as best you can and make those around you understand your ways an needs in this new life good luck to you all out there living in pain x

Splittt profile image
Splittt in reply to adecyclist

The exact same thing happened to me. It sounds just like my story down to the pain clinic not wanting to give me any straight answers. I know it was the injection because I didn’t have any low back pain before and it started immediately after the numbing wore off.

adecyclist profile image
adecyclist

I understand that you are frustrated and you don't need to justify yourself. Nor do you need to quantify your resilience.

There are many things which cause high blood pressure. Pain being one of them. Anxiety being another. It sounds like you are struggling from a bit of both. That said, none of us are your doctors so we can't say for sure. Trusting that doctors know what they are doing and are not making you feel miserable on purpose is more important, but also quite hard. Why they do what they do will probably always be a mystery to most of us and getting a straight answer out of most doctors is even harder to get your head around ;) Usually the most highly regarded doctors (by their peers at least) are the hardest to communicate with. Maybe medical brilliance goes hand-in-hand with lack of personal skills, who knows?? :D Try not to get too hung up on every detail of what they are doing and try to establish what exactly you want to know and, as someone else has suggested, write down some key questions. Such as why they have not referred you to a neurosurgeon. The sedation thing is common for facet block injections because they are seriously painful. Just because you didn't see the old ladies get given oxygen dosen't mean they weren't. Also they may not have had exactly the same thing as you so comparing yourself to others will get you nowhere.

I would have thought that seeing a neurosurgeon would have been the sensible thing too if you have two bulging discs, but I'm not an expert. Maybe the bulges weren't severe enough to merit operating. They usually only do this as a last resort. However a pain specialist surely ought to refer to a neurosurgeon to make that opinion. Asking your pain doc why is the only way to know why he won't refer you.

I know it's hard when you're desperate for answers. Many of us have been there or still are. The thing to remember is that pain is literally in your head. It's your brain telling you something in your body is not quite right. However, how severe it is depends on many factors. How mentally strong you feel at any given time, how anxious you feel, how tired you are, if there is something elsewhere in the body that is causing pain... there are hundreds of reasons. So when your doctor says it is the same, but feels worse he is right in some respects, but is not giving you the full picture (no surprises there), but it takes more than their allotted ten minute appointment to explain it properly. Your pain management course will explain it properly.

The mechanics of pain is a complicated subject, but the bottom line is you are going through a hard time and the more anxious you get the worse your pain will feel. I'm not saying your pain isn't real, it's just that worrying about it makes it all feel worse. When you feel yourself getting anxious about it try doing something that normally makes you feel good about yourself. It's hard, but it really does help.

hezzamj profile image
hezzamj in reply to adecyclist

Thanks for replying again.

I am at this stage because I have done everything I can think of. I have been to every appointment with a list of questions and everytime no one will answer those questions. As I said about the neurosurgeon when I asked he said he wouldn't refer when I asked why he said because it wasn't necessary when I said but A&E said it was he said they didn't know what they were talking about. When I ask my physio she changes the subject.

So you see my frustration.

I would love to go and do things that make me happy but walking my dogs I can't do because of th pain when I try. I had to cancel my holiday because I can't sit for more than 5 mins without back spasams and pain. I can't drive again because of the back spasms, leg spasams, the pain and the medication. I try and go swimming but even that I can't do because I can't lift my arms high enough to swim so I just float around but by the time I get out I can't walk and have to be helped.

I believe I am mentally strong as i have done everything in my power to get back to work. I have got back for 2 days a week so far.

Jenles profile image
Jenles

I would ask for a second opinion earlier than the existing referral. If you can afford it you might even consider paying for it.

Although I have no personal experience of the Walton Pain Management programme I have read reports that suggest it is among the best in the country.

I hope you get some answers soon.

(I have had facet joint injections in the past and have never experienced the subsequent symptoms/problems that you described. Nor have I heard anyone else complain of such a result. It does sound connected to me, though. I had a really serious reaction when I stopped Gabapentin abruptly prior to surgery and spent 5 days in ICU as a result. Manufacturers were disinclined to believe it but at least 1 other person apparently reacted in a similar way - so even if you are, or appear to be, the only person in this position it doesn't prove that there is no connection).

hezzamj profile image
hezzamj in reply to Jenles

Thanks for your reply. I'm hoping that Walton will be my second opinion I'm just annoyed that I've gone to the back of the queue again and won't be seen until at least May. I have a holiday booked for the end of May which was booked a year ago and I have no idea if I will be able to go!

As I said I'm just frustrated as I do not understand how I can be in mild pain one day and the next be unable to sit or stand without medication and even then only for a few minutes at a time.

Anyway thanks for your support

Splittt profile image
Splittt

I don’t have answers but my story is like yours! I’m in the hospital now trying to figure it out but the MRIs don’t show anything and they are acting like it wasn’t the shot but I didn’t have any of this before it and it started as soon as the numbing wore off. I already feel like my life is over and it’s only been a month. I just want an answer. I feel for you

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