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. 

 

 

JOINT PAIN AND HOW TO OVERCOME IT…

As we get older we all suffer from joint pain. It can become quite a problem for many of us. For a number of years, herbalists have sworn by the effectiveness of rose hips for arthritic conditions. Eight out of ten osteoarthritis sufferers experienced less pain and stiffness after they took a wild rose hip preparation rich in compound called GOPO which is available from Superdrug, Amazon, Pharmacies and Health Food Stores.

Rose-hip is not only full of Vitamin C, but it’s also bursting with antioxidants, which are good for reducing inflammation in the body which is often the root cause of joint and arthritic pain. Studies have also shown that Vitamin C may be helpful in managing inflammation in the body.

Hot or cold therapy can help with joint pain as can acupuncture and regular massage. According to the Arthritis Foundation, regular massaging of arthritic joints can help reduce pain and stiffness and improve your range of motion.

Hydrotherapy is one of the oldest types of health treatments today and still occupies a major place in medicine throughout China, Japan and Europe. It is believed to have healing properties. It is particularly effective for reducing muscle pain, improving sleep disorders, increasing your mobility and reducing stiffness. Hydrotherapy UK says the only side effects are with any water-based activity, caution should be exercised to remain safe from drowning. Almost all hydrotherapy is carried out in pools more shallow than the height of the person using it. Hydrotherapy is a type of physical therapy which utilises water to create a therapeutic environment. It is used all around the world and is considered a valuable part of mainstream healthcare.

Another point is to become aware of your body positions. It’s good to avoid being in one position for a long time, or any posture that makes you feel stiff. It can help to avoid activities that need a tight grip or put too much pressure on your fingers. Try using equipment that helps to reduce stress on joints, such as easy-turn taps, a pick-up reacher and raised seats.

Try to maintain a healthy weight, as this helps to reduce stress on weight-bearing joints. It can lessen joint pain, and helps to avoid joint damage.

One activity which can cause significant arthritic pain, especially if the condition affects weight-bearing joints in your hips, knees or ankles, is going up and down the stairs in your home. So, take it easy if you are suffering from pain in your weight-bearing joints.

Turmeric is increasingly being used in formulas for back and arthritic problems. Many people report that turmeric can help, but it’s important to choose a high potency turmeric product. And recent studies have shown that turmeric may also help people with bloating and digestive discomfort.

Tumeric is safe to take long term and Nature’s Best have the High Potency capsules at 10,000 mg. We often see and read about different herbs that can help with pain and arthritis but not all of them come up to scratch. However my twin sister who suffers from severe inflammatory arthritis was in so much pain she felt it was worth a try.

After only 10 days of taking the Nature’s Best High Potency capsules she felt the benefits. Taking a sweater over her head was very painful and uncomfortable and yet she could easily take her sweater off after such a short period of being on Tumeric. She was so impressed that she rang me to tell me to try them.  Although some of my spinal problems are mechanical I do have arthritis in my facet joints.

SEPTEMBER – CHRONIC PAIN AWARENESS MONTH…

Pain Concern write that this month is dedicated to raising public awareness and understanding of pain. Many organisations around the world contribute, including the U.S. Pain Foundation, the International Pain Foundation and the American Massage Therapy Association (AMTA).

During September, the U.S. Pain Foundation will be sharing 30 stories of people living with pain over 30 days, while the AMTA has posted resources to inform people of the role of massage therapy in pain management strategies. Pain Concern, they will be posting regularly on social media.

Everyone can play a part during this month by using the hashtag #PainAwarenessMonth.

You can also get involved by ‘liking’/‘following’ Pain Concern on Facebook and Twitter to stay up to date and share the cause.

Links:

When people say what is chronic pain? You can only describe Chronic pain as different to acute pain. Your body keeps hurting weeks, months, or even years after the injury. Doctors often define chronic pain as any pain that lasts for 3 to 6 months or more. Chronic pain can have real effects on your day-to-day life and your mental health.

Curable Health explain that everyday stressors have more of an impact on the body than most of us realize. Once stressors are identified, the brain begins to put the body into a state of fight or flight, causing real, physical effects in the body.

Over time, the brain and central nervous system learn to continue to put the body into a painful state, which repeats the pain cycle. The Curable team pulled resources from modern neuroscience to visually depict the stress-related chronic pain cycle. While neuroscientists are still working to understand all the details of this cycle, this visual can help you grasp the concept on a deeper level.

A REIKI BATH FOR TOTAL RELAXATION…

Reiki (pronounced Ray-key) is a complementary therapy which was named after Dr. Mikao Usui, a Japanese theologist.

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Reiki is a Japanese word, meaning Universal Life Energy, an energy which is all around us. It is regarded as ‘life’s energy’ and creates a feeling of deep relaxation. Energy blockages are removed, allowing a free flow of life energy throughout the body. Toxins are removed from the body with other waste products leaving the system much more quickly. Then, with the toxins removed from your body, more energy can be received and your vital processors and functions become more highly tuned.

The hands are the main instrument used in the healing by Reiki and can be effective through clothing. It has also been useful for anyone taking drugs to help reduce some of the side effects. They say it is possible to heal acute injuries but chronic injuries can take longer to heal. Reiki is therapy available to anyone and can help the receiver of the therapy to achieve a more relaxed approach to life and greater harmony.

Natural Health Magazine talks about taking a Reiki Bath to help you relax and reduce feelings of anxiety. Jasmin Harsono, author of Self Reiki: Tune in to Your Life Force to Achieve Harmony and Balance believes that you can become your own healer. Jasmin says that a reiki bath is a wonderful way to relax and recharge your energy levels. It involves performing a full reiki self-treatment based on the seven main chakras: crown, third eye, throat, heart, solar plexus, sacral, and root.

With reiki, you normally find a quiet comfortable place to perform it but this way you like in a bath of warm water. This offers a simple way to remove toxic energies and encourages fresh energy to circulate clarity, balance and positivity. It can help you sleep better at night, reduce anxiety, and heighten a deeper sense of relaxation.

love romantic bath candlelight
Photo by Breakingpic on Pexels.com

Create the right atmosphere by filling your bathroom with candles, crystals, soothing music and pop a few of your favourite essential oils into your bath. Once you are settled into your bath simply close your eyes and place the palms of your hands together. As you allow your breath to flow naturally, you should feel your mind and body becoming calm and clear of distractions. Now starting at your crown follow the hand of positions of the full reiki self-treatment, spending about three minutes on each chakra. Then simply repeat the five principles which are, Just for today, do not anger. Just for today, be grateful. Just for today, work with diligence. Just for today, be kind to yourself and others. Just for today, do not worry. For the best effect repeat this every time you have a bath.

Before leaving your bath Jasmin suggests that you take three deep breaths into your abdomen, then exhale with an ‘ahhh’ sound. When your ready, let the water drain from the bath as you place your hands together and thank reiki.

 

THE BEST HAND REFLEXOLOGY POINTS FOR LOWER BACK PAIN…

Most people know ‘reflexology’ as something that is done to your feet but hand reflexology is definitely another technique that is becoming just as popular.

Hand reflexology certainly provides some benefits compared to foot reflexology. The obvious example is that our hands are far more easily accessible compared to our feet, which makes hand reflexology the most usable self-help tool for both adults and children.

Hand and foot reflexology has actually been used as part of medical care since as far back as the ancient Egyptian and classic Chinese times. The basic assumption used by the reflexologist is that each organ, gland, and part of the body is reflected in both the hands and the feet. Stimulation of the so-called ‘reflex points’ promotes relaxation, improves circulation, and encourages the body to heal itself. This explains why hand reflexologists sometimes use the axiom: “Health is at your fingertips!”

Hand reflexology is also brilliant as a relief from the new stresses technology has placed on our hands.

For lower back pain press the point where the centre of your hand joins your wrist and stimulate it. Always take medical advice if you don’t know what the problem is. This is a perfect antidote to a backache caused by sitting at a computer for too long.

A great site Reflexology Map that explains in detail how to start a hand massage.

YOU CAN FOLLOW THESE STEPS TO START YOUR HAND MASSAGE:

Step 1:  Sit in a comfortable chair in a quiet room.

Step 2:  Enter a state of relaxation using a few of your favorite oil hands. Oils and creams are normally not used in professional reflexology sessions, but will not hurt to use them in an informal session.

hand reflexology

Step  3: Rub the cream on your hands for several minutes until completely absorbed. This will relax your hands and increase flexibility in preparation for applying reflexology. Be sure not to use a cream or oil greasy your hands are not slippery.

Step 4: Close your eyes and focus on any area of your body where you feel an uncomfortable pain. Sometimes you just feel as if some part of your body feels misaligned.

Step 5: Consult a hand reflexology map to identify the points of reflection in your hands that correspond to the parts of your body you want to work. For example, if you have pain in your left shoulder, you have to query the map and see that the points of reflection for your shoulder are located on the little finger of the left hand.

Step 6: Firmly press the reflex point. You can gradually increase the pressure to make sure you’re “activating” the reflex, but loose a little if you feel some pain.

Step 7: Hold the pressure for 30 seconds and release.

Step 8: Wait a few seconds and repeat. You can press either 30 seconds or you can press and release the point of a pulsed for 30 seconds.

Step 9: Use your thumb to apply light pressure technique pressure if you are uncomfortable. To do this, use a circular motion over the same point of reflection for about 5 seconds, then rotates in a circular in the opposite direction for 5 seconds. Repeated several times for each point of reflection.

Step 10: Reflexology applies to all areas in both hands, but lend him more attention on problem areas.

Step 11: When you’ve finished your reflexology session sit quietly for at least 10 minutes. If possible, lie down and rest well for half an hour.

Step 12: Drink several glasses of water after applying reflexology. Water will help to drain the toxins released from your organs and muscles during the session.

 

Hand Chart

Shine Holistic says that “Reflexology is known to be of use for both chronic and acute back pain, but it is also good for reducing stress, which can sometimes exacerbate people’s perception of pain. Reflexology reduces stress and increases emotional well-being. This is related to back pain because it can cause stress which leads to an increase in the pain level experienced. By working on both fronts reflexology can greatly decrease the symptoms of chronic back ache.

Conditions such as sciatica and arthritis are optimally treated by having twice monthly sessions. Other treatment plans, such as for osteoporosis and herniated discs, will vary depending on the level of pain experienced and the severity of the condition.”