WHICH INJECTION IS IDEAL FOR BACK PAIN -EPIDURAL, STEROID, FACET JOINT OR TRIGGER POINTS?…

With so many different types of spinal injections available for back pain its difficult to decide which one to try. In a previous post I decided to do a bit of research on epidurals for back pain and other types of injections for back pain.

One I had (which was through the front of my neck ) was highly dangerous and not many pain consultants ( including mine) would perform this procedure. All the way through the procedure the consultant ( another one I had been referred to who specialised in this type of injection )kept saying I must not move one fraction of an inch but instead to shout stop whenever I started to feel it too uncomfortable.

I can honestly say it wasn’t the most pleasant or procedures but I’m always of the opinion of no pain no gain with these type as of procedures. Fortunately I had no after affects and after about three weeks ( I was told it could take that long) the pain relief kicked in and my neck and arm pain disappeared for the first time in years. Now 18 months later some of the pain and pins and needles are coming back but nothing like it was before. 

Spine Health wrote that while the effects of an epidural steroid injection tend to be temporary (lasting from a week to up to a year) an epidural steroid injection can deliver substantial benefits for many patients experiencing low back pain.

  • Recent research reports that lumbar epidural steroid injections are successful in patients with persistent sciatica from lumbar disc herniation, with more than 80% of the injected group with disc herniation experiencing relief (in contrast to 48% of the group that received a saline placebo injection).
  • Similarly, in a study focused on a group of patients with lumbar spinal stenosis and related sciatica symptoms, 75% of patients receiving injections had more than 50% of pain reduction one year following the injections. The majority also increased their walking duration and tolerance for standing.

So, I could see from this information that it seems to be ok for lumber pain but there is no mention of it for cervical pain.

An article in The Daily Mail said that tens of thousands of patients are being given a ‘useless’ back-pain injection, which costs the NHS nearly £40 million every year, an analysis suggests.

Patients that demand a ‘quick fix’ for their discomfort are being given the treatment, priced at £540 per procedure, despite doctors being told to recommend back-pain sufferers be more active or try psychological therapy.

According to an analysis of NHS data by The Times, 70,608 steroid injections into patients’ facet joints, which make spines flexible, occurred last year, compared to 62,570 five years ago.

Guidelines released in both 2009 and 2016 advise against the procedure. 

Figures also show 8,044 operations that fuse spinal bones together were carried out last year, up from 7,224 between 2012 and 2013. 

Spinal Healthcare point out that Epidural steroid injections are actually very safe, since they are simply an injection that contains both local anaesthetic and steroids. In effect these reduce the inflammation that is causing pain in the nerves and the disc in the spin and the local anaesthetic numbs the area, bringing short term numbness to the region. By the time the local anaesthetic wears off the steroid will be working to reduce inflammation.

However there are some risks with the procedure, but these need to be looked at in context. Almost every human activity carries some risk with it. For example, crossing the road, lifting heavy objects, even opening a tin of beans all carry risks. Yet we do them every day, simply because they are necessary to human function.

Reading through lots more posts on epidurals I have come to the conclusion that like anything in life one size does not fit all of us and for some this treatment gives great relief and for others none whatsoever. There is definitely a problem with the cost of this type of injection as you require x ray staff and others to proceed with it. My facet joint injections which were also done in X-ray were cut a couple of years ago due to funding.

After my move down south last June I managed to see a pain team in January of this year but they also said they do not cover facet joint injections which I have found to be the best for me. However, when I talked it through with my GP he said other hospitals offer it and if I got to the stage that I was desperate for them he could organise a referral.

I can quite understand the cuts as the NHS is under so much pressure but I think it would make sense to have a team of people who simply follow up your pain relief after the injection to monitor if it was worth doing or not. That way the ones who benefit could continue having them and and the ones that don’t could try something else.

As far as the safety of this type of injection, I guess any injection into your spine carries risks but that could apply to any type of procedure. However, having it for cervical pain is something I could not find so it makes me think that maybe the one I had was a one off that worked for a while but now it’s back to square one again.

The difference between the nerve block and the epidural is where they put the needle. The nerve block injection usually also contains a steroid to decrease inflammation and pain. The injection is similar to a transforaminal epidural steroid injection, but in a selective nerve root block, there is no attempt to have the medication enter the epidural space.

The differences between epidurals and the nerve blocks and facet joint injections is that facet joint injections are used for both diagnostic and therapeutic reasons in the treatment of degenerative or arthritic conditions. Along with the numbing medication, a facet joint injection also includes injecting time-release steroid (cortisone) into the facet joint to reduce inflammation, which can sometimes provide longer-term pain relief.

A trigger point injection which I have recently been offered is an anesthetic such as lidocaine (Xylocaine) or bupivacaine (Marcaine), a mixture of anesthetics, or a corticosteroid (cortisone medication) alone or mixed with lidocaine and are used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin.

But, all seem to include some kind of steroid medication for the pain, they are all put into different areas and some involve using x-ray guidance but to me, the actual drug they are using is the same, but of course this is just what I have read online and is not something have discussed with my pain consultant.

 
Another treatment at the Regenerative Clinic in Harley Street London is stem cell therapy and PRP can help patients avoid spinal surgery and the side effects of epidural steroid injections. These procedures utilise the patient’s own natural growth factors or stem cells to treat bulging or herniated discs, degenerative conditions in the spine, and other back and neck conditions that cause pain.

According to Back Pain Expert Researchers at Manchester University’s Division of Regenerative Medicine are still currently running clinical trials in people with back pain to test a revolutionary treatment that could repair damaged intervertebral discs. The revolutionary new treatment based on stem cells, pioneered by Dr Stephen Richardson at Manchester University, may turn out to offer a permanent cure for back pain related to damaged intervertebral discs. For over five years, and backed with funding from the Arthritis Research Campaign, he and his colleagues at the Division of Regenerative Medicine have been developing a way of using cells from the body to regenerate the nucleus polposus in the damaged intervertebral discs.

However, I’m not holding my breath that this treatment will be available on the NHS anytime soon. I do feel that if you have only tried one type of injection and it’s not working as well then it is definitely worth trying another as you can see from this article there are a number of different options available. 

 

 

IT’S SLEEP SUNDAY – LET’S TALK ABOUT 5 of THE BEST SLEEP SPRAYS…

It’s’ Sleep Sunday and this week I’m giving you my top 5 Sleep Sprays

1. Botanic Pillow Mist Lavender and Sweet Marjoram £6 available from Boots – This relaxing Pillow Mist helps to naturally calm the mind and prepare for a peaceful night’s sleep. Made with a soothing blend of Lavender and Sweet Marjoram oils, this Pillow Mist helps to relax body and mind to encourage inner peace before sleep.

This bottle is made from 100% recycled materials.
We’ve taken steps to reduce our impact on the planet at every stage in this product’s journey. People tested. Formulated without parabens.
No Parabens, Phthalates, Mineral Oils & SLS

2. Dr. Organic Lavender Sleep Therapy £7.99 available from Holland and Barratt.

  • Lavender Sleep Pillow Spray 
  • Relaxing Comforting Promoting deep sleep
  • Pillow Spray, Suitable for vegans

If you are searching for a perfect night time sleep, then look no further than the Dr Organic Lavender Pillow Spray. A truly unique night-time spray helping to diminish sleepless nights while promoting deep sleep and tranquillity. Complete with a proprietary blend of organic and natural ingredients, including bioactive essential oils such as Ylang-Ylang, Vetiver, Patchouli, Bergamot and Arabian Jasmine. Suitable for Vegan.

3. Bramble and Blossom Sleep Well Mist £15 available from Bramble and Blossom.

A calming blend of essential oils and flower water that helps promote a sense of calm and aids a restful nights sleep.

We have expertly blended essential oils renowned for their relaxing and calming properties. Lavender, marjoram and patchouli have been combined with chamomile flower water, so you can enjoy a tranquil sleep and awake refreshed and ready for the day ahead. Spritz around the bedroom and on pillow before bedtime. Relax breathing in the calming mist and enjoy a restful nights sleep.

4. Cowshed Sleepy Calming Pillow Mist £16 available from Cowshed. .

Slip into a restful night’s sleep with our Sleepy range. Our calming pillow mist calls upon a bespoke blend of Melissa and Lemon Myrtle essential oils, relaxing the body and mind with a citrusy fragrance. The layering of St John’s Wort and Lady’s Mantle with these oils creates an effective stress-reliever, which assists a good night’s sleep.Product quantity

5. Goodnight Pillow Mist £15 available from Neal’s Yard Remedies.

Wake up refreshed with our award-winning bedtime mist, proven to improve your sleep from the first night*. The tranquil blend of organic lavender, vetiver and mandarin essential oils promote a sense of calm for a peaceful night.

  • Restful and relaxing
  • Improve your sleep from the very first night*
  • 81% found Goodnight Pillow Mist helped calm and relax*
  • 74% found Goodnight Pillow Mist aids a peaceful night’s sleep*
  • 71% would recommend Goodnight Pillow Mist to someone with sleep issues*
  • 69% fell asleep quicker*

Medication For Sciatica and Natural Chiropractic Medicine — El Paso’s Injury Doctors® 915-850-0900

The use of prescription medication for sciatica is being discouraged while natural treatments/therapies are becoming the new standard. This is currently happening in the United Kingdom and its National Institute for Health and Care Excellence. The focus is to reduce the use of medication for sciatica and aim for natural treatments unless absolutely necessary. This…

Medication For Sciatica and Natural Chiropractic Medicine — El Paso’s Injury Doctors® 915-850-0900