Yesterday I went in hospital for a C7 Corticosteroid Root Block Injection for pain relief and diagnostics.
I saw a neurosurgeon recently who after looking at my MRI could see disc osteophyte complex at C6/7 which he thought was probably causing all my pain but due to all my previous surgeries the images were not great so he suggested a root block and diagnostic injection.
My symptoms have been cervical radiculopathy on my right side (mainly) and pain, numbness, pins and needles and weakness from my shoulders down my arm and into my hand and into my middle finger which now feels completely numb.
Cervical radiculopathy most often arises from degenerative changes that occur in the spine as we age or from an injury that causes a herniated, or bulging, intervertebral disk. As the disks in the spine age, the lose height and begin to bulge. They also lose water content, begin to dry out, and become stiffer. The problems causes settling, or collapse, of the disk spaces and loss of disk space health.
On Thursday I went in hospital for my injection. When the consultant who was doing the injection arrived he sat with me and explained in detail what he was going to do and also a number of very important side effects that could happen from having this injection. This is the second time I have had this injection and both times the consultants have said it is a very tricky one to do. I was told the risks included bleeding, infection, making things worse, arm weakness and numbness, blood clots, very small risk of a severe stroke and potentially increased risk from Covid 19.
I have to say I was most definitely rather hesitant but then when you sit down and think of any injection or surgery in hospital most of them carry a number of risks as well as all the different types of medication we take. It is a bit of a balancing act for the patient in how much more she/he can cope with the pain and other problems they are suffering.
I decided to go ahead with the procedure which was done using the CT Scanner. First they take preliminary scans for the consultant to decide how he wants to proceed. The skin is marked and cleaned for the procedure and the consultant directs a local anesthetic to the spot where the nerve is and leaves it for a couple of minutes to react. He then directed a fine needle towards the specific nerve in several steps. Between each step the couch moved me into the scanner to check the position of the needle while continually asking me what I was feeling.
An injection of steroid was then done to the point where I could feel it right down to my finger. My neck was then cleaned and a small dressing was put over the puncture site. I was told that sometimes you may feel weakness or numbness in your arms or chest or vision problems and they asked me to wait for 10 minutes for them to check I was ok before they would allow me home.
He said the local anesthetic would probably ease after a couple of hours and so I may need pain killers as it could have stirred everything up. I felt fine to leave and felt confident I had made the right decision.
I had a rough night and probably did the wrong thing by reading a bit more about risks with this procedure which made me think I will definitely not have this injection again. The British Orthopedic Association Guidelines alone for just having steroid injections says that due to the injected steroid being taken up by your body into the bloodstream, your body’s immune system may be temporarily affected. You are advised to take extra precautions after the injection to avoid catching the virus. They wrote “In terms of your susceptibility (risk of catching Coronavirus or other viruses), a study looking at people who had steroids injected into joints showed a 0.1% higher risk of catching flu in the following seasonal winter flu virus period. We still do not know if there is any increased risk of catching Coronavirus after having a steroid injection“
This was then something I was really thinking hard about as I have already had two other steroid injections this year for my arthritis in my sacroiliac joints and on the Versus Arthritis website they say that “if you’ve had a steroid injection into a joint or muscle, your healthcare professional may give you a steroid card for you to carry around. This will have details of the treatment you’ve had.“
Steroid injections can stop the body producing natural hormones, which can be dangerous if you get ill, have an accident or need an operation. There is evidence that this can be a risk for up to one month after just one steroid injection. If you’ve had three steroid injections over the course of 12 months, this risk could last for a further 12 months. Keeping the card with you will help any other doctor who treats you to manage your care correctly. It’s definitely food for thought.
The second thing I read up about was some of the major complications that can happen with this type of injection which are what I mentioned above “bleeding, infection, making things worse, arm weakness and numbness, blood clots, very small risk of a severe stroke and potentially increased risk from Covid 19“, but it also mentioned on a number of other sites that you could also suffer from new neurological deficits, problems with swallowing or vertigo which would hopefully not be with you for long.
So, looking at all of the above problems that could arise from one single injection into the epidural space is really quite tricky. Having gone through one incident over 20 years ago when the injection did stop me breathing (for only a short time) it did resonate with me a bit.
The pain relief has been great, the motor sensory and pins and needles are slightly better but I am only on day two and it can take three days to kick in. If this helps with my persistent pins and needles and numbness then I will be delighted and if my consultant now has a better picture of what is going on in my cervical spine then it was worth going through with the procedure.
I realize that it is up to the individual to decide whether to go ahead with their procedure when presented with the possible side effects or problems that can arise from any type of treatment or operation. Maybe it is because I am getting older that I now find I am a bit more frightened and hesitant about going through with these types of treatments.