THE DIFFERENCE BETWEEN NERVE BLOCK AND FACET JOINT INJECTIONS…

As my readers will have read before I had great success with lumber facet joint injections for low back pain. I have never had facet joints injections in my cervical spine but nor have I had a nerve block in my lumber spine so it’s interesting to find out the difference between them both.

The cost is definitely different for these two injections with the facet joint ones coming out a lot more expensive.

To explain the difference with these two types of injections I will start with a facet joint injection which is a type of steroid injection that is administered to a very specific set of joints. Steroid injections directly into these joints of concern can help relieve both inflammation and pain in the neck or back. Several injections to different facet joints may be needed depending on the site of pain.

As explained by the Spine Institute of North America a nerve block injection can be done anywhere along the spine. This particular injection targets the sympathetic nervous system and helps to reduce inflammation in nerves that branch from the spinal cord and the ganglia that is present at a particular location. Nerve blocks are a form of pain management as the substance that is injected numbs the nerves and helps to block pain signals. This one can consist of a local anesthetics, steroid and lidocaine (a numbing agent).

In a facet injection procedure, a physician uses fluoroscopy (live X-ray) to guide the needle into the facet joint capsule to inject lidocaine (a numbing agent) and/or a steroid (an anti-inflammatory medication). If the patient’s pain goes away after the injection, it can be inferred that the pain generator is the specific facet joint capsule that has just been injected.

A nerve block injection is also done using Fluoroscopy (live X-ray) to ensure the medication is delivered to the correct location. If the patient’s pain goes away after the injection, it can be inferred that the back pain generator is the specific nerve root that has just been injected.

So, basically both injections administer similar drugs and both are done using live X-ray but they are put into different parts of the spine. Why they vary so much in price is something I cannot seem to find out about except that you seem to need more than one facet joint injection at each session. Let’s hope that nerve block injections funding doesn’t change to a postcode lottery like the facet joint ones have done.

MY INTERVIEW ON UK HEALTH RADIO ON FUNDING FOR FACET JOINT INJECTIONS…

I have written in the past about facet joint injections for back pain. A cervical, thoracic or lumbar facet joint injection involves injecting a small amount of local anaesthetic (numbing agent) and/or steroid medication which can anaesthetize the facet joints and block pain. They are usually done under x-ray to guide the injections to the facet joints.

Recently funding for facet joint injections has been stopped in some post-codes but not in others. Unfortunately, mine has been stopped so my pain consultant has given me steroid injections into  my gluteal muscles in the hope this will give me some pain relief.

I can have them every four months just like I did with the facet joint injections and I am hoping they will last as well. I only had them done in December so it’s early days yet.

Mike Dilke from Relax back has a program on UK Health Radio and asked if we could have a chat about the funding problem and we also chatted about the two latest health apps, DRUGSTARS ‘ Giving by Taking and Talking MedicinesMedsmart app. 

A POSTCODE LOTTERY FOR FACET JOINT INJECTIONS IN THE UK…

 

As some of my readers will know I have regular facet joint injections for my low back pain which I find really beneficial. I have them every four months and it has been an important part of my pain management program for some time so I was really disappointed when I found out that due to the postcode I live it I could no longer have these injections.

My pain consultant was as frustrated as me but very sympathetic and encouraging that we would find something else that would help with the pain. He is also introducing me to another painkiller rather than Tramadol which will start in a small dose and then increase over a period of time until I feel the most benefit of it and also another injection with a steroid.

The differences in quality of a number of treatments on the NHS seems to be quite common now, but you tend to just read about it and hope it never happens to you.

My local area is basically saying that they will not fund chronic pain as facet joint injections are used mainly for this reason. Other postcodes in my County have said they will not fund facet joint injections but they are willing to look at specific cases if the consultant in charge feels you really need them. My pain consultant was hoping this would be the case for me but unfortunately, my County is not even willing to look at a specific case.

To say I am gutted is, to put it mildly, but I trust my consultant so much that I am not giving up hope that he will find some form of injection that will help with some of my chronic pain.

 

 

WHAT IS THE TRUE COST OF FACET JOINT INJECTIONS?…

Today I had my third lot of facet joint injections on the NHS at the Circle Nottingham Hospital. For me personally these injections (I have one in both sides of my spine) have been the most effective pain relief I have ever had.

For the first time in many years I have been back in control of my pain and I had reduced my Tramadol right down to taking it ‘only‘ on my bad days instead of taking it on slow release. While slowly cutting down on my Tramadol I started to feel quite different in myself without the awful side effects of the opioids.

Painkiller addiction is an increasing problem in our society, and it’s certainly receiving more media attention than ever before. There’s a lack of understanding about the dangers of prescription painkillers—opioid drugs that are both extremely powerful and addictive. Long-term addiction is usually preceded by tolerance to the drug, which means you feel as though you need a regular supply of them.

The reason I wanted to cut down on my Tramadol was to prepare myself for my Cubital Tunnel Operation. A few years ago I was unexpectedly faced with awful pain after foot surgery and was told I could not have any more pain relief due to what I was already taking. Tramadol is routinely prescribed after major surgeries so I told myself if I ever needed surgery again I would make sure I had cut down on my medication prior to the surgery.

I have struggled over the last few weeks as my facet joint injections were due but they were put on hold for six weeks due to my elbow surgery so today could not have come soon enough. I’ve had the same compassionate pain consultant who has looked after me for a number of years and who has tried everything available to help me with my chronic pain.

Before I signed the consent form he informed me that due to the cost of facet joint injections they were being cut right back and may not be available in the future.  He assured me I would still be having some today and that he would put me down for another set in four months but pointed out that he would have to put a case together in order to hopefully get the all clear to carry on giving me these injections.

I was bitterly disappointed that there was a possibility of these being stopped. When I told my husband about it on our way home he told me to try and find out how much these would cost if we went privately to have them done.

I was quite shocked at what I found out which in our area were roughly about £1,145 – £1,500 (each) and I have two of these. I then realised that it’s not just the injection that I would be paying for as I need the use of the Xray department for these and so a radiologist is required, plus two nurses and of course my consultant.

It’s not until you encounter something like this that you appreciate just how lucky we are to have the availability of the NHS in the UK. We just arrive, have the treatment and follow their advice and hopefully get the benefit but you can see why they are now having to question who should be the ones that can have this treatment and who are the ones that cannot. I guess I will just have to hope that my case is one they sympathize with and continue letting me have them otherwise I guess I will be back on the opioid route again.

HOW I SPENT 10 DAYS PAIN FREE TIME…

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As my followers will know I had some more facet joint injections 10 days ago into my lumber spine. I’ve tried numerous types of lumber injections from trigger points to epidurals but I’ve never had the reaction I got from the facet joint injections. They made me feel completely pain free.

This is only my second lot of facet joint injections but the last one lasted 3 weeks and this time I had two instead of one so I was hoping it would last longer. However the pain free time was broken after just 10 days when my back went back into spasm.

After the injections I rested up for 24 hours, which was what they advised. Just being able to get dressed in a morning without pain was a bonus. I decided I would take no pain medication whatsoever but continue taking my muscle relaxants.

For the next 48 hours I had the most awful shakes which I had been warned could happen when you come off Tramadol.  What I could not believe was how clear my head felt, how much more in control of I felt. The fuzzy head which you also get with Fibromyalgia is doubled when you are on a high dose of Tramadol.

Apart from writing, which is my first passion, I also love to make hand made cards. I sell a few through my local post office but otherwise I just make to send to friends and family. But my husband has always been an avid fan (obviously) and has said on numerous occasions that I should open an online shop.

The pain free time inspired me to have a go at setting up a shop. My local post office asked me for some Valentine cards so I thought this would be an ideal time to get the cards on the market. I happily sat without any pain making lots of new cards and designs and felt confident I could get this launched and off the ground.

I felt well enough to walk more and my sleep was better waking up with a clearer head which is something I always appreciate when I am off the medication. I was on a roll and soon decided I would set up a shop on Etsy. It looked easy enough but I took my time putting it together as I really wanted it to work.

By my 7th pain free day I had made a number of cards, taken great pictures of them and had started to build my online shop. I was in heaven. Life was just peachy and nature soon helps you to forget about the sort of pain you had been in before. I was starting to have a few twinges in my cervical spine but I put that down to all the card making and the fact that I had two disc’s fused in my neck does put a bit of pressure on the disc below it. However I could sit with a heat pad around my neck which soon soothed the pain away.

On day 8 I was starting to feel some pain in both my hips but I put that down to the fact that I had been sitting for a long time making the cards and just took a couple of paracetamol for it. By day 9 I was feeling a few more twinges and realised that my pain free time was limited but I felt elated about my online shop and what I had achieved in such a short space of time.

On day 10 I woke up without pain and had a few more cards to photograph. As I put the cards in a position to take the photos of them my back went. I completely froze as the pain when it goes into spasm is so bad that you are frightened of moving at all. I went straight for my heat pad and decided to lie on the settee to rest it and keep it warm as I have always found heat a great healer.

By the afternoon I knew it was well and truly in spasm and that I could not attempt to take any more photos or make any more cards, at lease for the time being. By the following morning I was in such pain I went back onto the Tramadol and struggled to even get dressed again. I spent most of yesterday just keeping it warm and resting in the hope the spasm would ease. I didn’t even look on my new site once as I felt so flat after being so high about it all.

Today is a new day and the pain is more under control but that is with the help of my pain medication.  I have decided I need to start looking at how to adjust certain areas in my house so that I can continue with my cards and my writing. My pain free time made me realise that this is how my life is going to be from now on as there is no more surgery they can do for my back.

Pain free time will always be something I will treasure, but trying to plan around it can be hard to say the least. Just keeping my eye on any new products/drugs to help ease pain will always be at the top of my list and writing is something I can manage without being in pain.

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