As I am sure my readers know I have had several different types of spinal injections from epidurals to facet joint injections and even a life-threatening episode with one particular injection. But what are the pros and the cons of these types of injections which have given you time-limited pain relief?
The facet joint injection provides important information for your doctor and can also give you pain relief. Why do I have to have an injection in the facet joint? The procedure is designed to prove if the facet joint is causing your pain by placing a temporary medication to reduce discomfort in the joint.
The pros are that it provides a direct management for joint pain and inflammation. It provides faster pain relief and relieves moderate to severe pain. Steroid injections also provide faster pain relief than oral forms of anti-inflammatory drugs. Joint injections allow the drug to be absorbed in the blood stream faster than oral medications. Making pain receptors less sensitive, in turn sending fewer pain signals through the nerves
There are no stitches or open wounds to deal with, and because of this, you have an extremely small risk of infection. Overall, facet joint injections are considered a very safe treatment.
You may get between three weeks and three months’ pain relief from a steroid joint injection, though this varies. You can have the injections every three months if you need them. Generally, it’s best not to have more than four steroid joint injections in a year into any one joint. This is because there’s a chance any more could damage your joint.
The waiting list on the NHS for any spinal injections is long but having them done privately is not cheap. It varies across the UK from £1,200 in the far north to £2,043 in the south.
The cons are that steroids have various side-effects. Age can also become a factor with facet joint injections. As you age, your facet joint becomes more damaged. This makes the injection more technically difficult because the joint is too small and maybe tighter. You may also grow small bones called osteophytes, which you do not normally see on an X-ray.
You could have an allergic reaction or cause bleeding although this is usually only a risk with patients who are on blood thinners.
Minor infections occur in less than 1% to 2% of all injections. Severe infections are rare, occurring in 0.1% to 0.01% of injections.
You could get discomfort at the point of the injection or worsening of pain symptoms. And while very rare, damage to the spinal cord or spinal nerves can occur from direct trauma from the needle, or secondarily from infection, bleeding resulting in compression, or injection into an artery causing blockage.
Have you had any spinal injections and if so how long did the pain relief last? I would love to hear from anyone who has had this treatment either on the NHS or privately as I am trying to get as much information as possible to write a much bigger article on it.
For me personally I enjoy every second of my pain free time after my injections and would not hesitate accepting any being offered to me.
Here are fourteen ways to naturally boost your immune system to help keep yourself healthy.
Mix up your shower temperature. Changing it to either hot or cold every 2 minutes will boost your immunity by increasing two types of white blood cells.
Drink, drink, and drink. Your immune system relies on the water so drink lots.
Sleep – poor sleep can affect the immune system so the more sleep you get the better you will feel.
Laugh – we all need it nowadays but studies have shown it boosts energy, decreases stress hormones, improves immunity, and diminishes pain. I have a few videos of my granddaughter I watch if I feel like a giggle but there are plenty on YouTube.
Ditch the dairy – try to avoid dairy as it is mucus-forming and an inflammatory product.
Eat to Beat – include pumpkin and sunflower seeds, fish, and leafy green vegetables into your diet. Also garlic, red meats, lentils and berry fruits, papaya, kiwi, peppers, broccoli, and brussels sprouts. All types of leafy greens are great for the immune system.
Leave the sweet stuff alone as sugar can have an inflammatory effect and feeds yeasts and bacteria in our body which can prolong a condition or illness.
Get out in the fresh air – those who exercise moderately are 25% less likely to develop a cold compared to those who recently go out regularly.
Hug a tree as with Covid-19 most of us cannot hug our family and friends. Physical touch has been something we have missed greatly. It can help to decrease the level of the stress hormone cortisol in your body which decreases your immune system. If it is just the two of you living together at the moment then make sure you hug each other regularly.
Pump up your Vitamin D – according to the NHSThe Daily Telegraph has reported that “vitamin D ‘triggers and arms’ the immune system”. It said that researchers believe that vitamin D plays a key role in boosting the immune system. It is important to have enough vitamin D to maintain a healthy body. Vitamin D forms in our skin in response to sunlight. However, care should be taken to avoid burning or over-exposure. Vitamin D is also found in foods such as oily fish, eggs, fortified margarine, some breakfast cereals, and vitamin supplements.
Start a new hobby – Woman & Home wrote “Getting into physical hobbies promotes good health,” Dr. Partha Nandi, a medical doctor and leading patient advocate, agrees. “These hobbies not only benefit the body but also help in making your mind more alert and sharp.” But you don’t have to get physical to reap the benefits. “Science is finding that the hobby diverts the focus of attention away from the problem causing the stress and places it on the hobby. People who engaged in leisure activities were 34 percent less stressed and 18 percent less sad during the activities.” Plus, “hobbies are a great way of meeting new people, and interaction is great for the spirit and body”. Also, check my post yesterday on how to find a new hobby here.
Don’t smoke – I’m sure I don’t really need to write why you should not smoke but just as a reminder – the NHS says – People breathe more easily and cough less when they give up smoking because their lung capacity improves by up to 10% within 9 months. Within 2 to 12 weeks of stopping smoking, your blood circulation improves. This makes all physical activity, including walking and running, much easier. When you stop smoking, your senses of smell and taste get a boost. Half of all long-term smokers die early from smoking-related diseases, including heart disease, lung cancer, and chronic bronchitis. This list is a small number of reasons to stop smoking but is very important with how the Covid-19 virus affects your health.
Maintain a healthy weight – start your new year with a determination and mission to lose some weight. You can only feel better. Why not raise some funds in the process and sign up for a charity.
Avoid alcohol. Take advantage of dry January and carry on avoiding alcohol for the time being.
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 fromlumbar 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 withlumbar spinal stenosisand relatedsciatica 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 NHSnearly £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 byThe 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 ExpertResearchers 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.